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Learning and Teaching Strategies for Medication Administration for StudentsMedication Administration Learning StrategiesKnowledge: Nurses are geared to administer medications via the 8 rights for medication administration but to also fill the gap of pharmacy knowledge and patient assessment. With that in mind, here is the research and explanation for how student nurses should think of medications and the level it is to be practiced before they are licensed and independent in practice (QSEN Institute, 2014).Attitude: "The proposed strategy, based?in part on the work of Wissman and Wilmoth (1996), may help decrease the delay between?acquisition and application of pharmacology knowledge.?This strategy can also be used to emphasize the importance of client education for medication?regimen safety and compliance. It also encourages nursing students to begin seeing the "whole?picture" of their clients, beyond a name and diagnosis" (QSEN Institute, 2016). This method is called the SBAR method for medication administration.?Skill:The student states the med Lasix is a?"diuretic."Your professor states,?"You are only defining the meds, not telling me?why this patient?is needing the medication."?Use the SBAR method for understanding medication administration for that patient below.(Situation): pt is admitted with chest pain(Background): edema and CHF(Assessment): the patient's current input is greater than output & weight has decreased by only 0.5kg since admission, CXR is reported to have infiltrates, patient has a congestive cough and is short of breath on exertion. He has crackles bilaterally and sat maintained at 92%. 122/86, HR 84, RR 20, T=98.8, and negative orthostatic blood pressure readings.(Recommendation): Student writes: “I would give the Lasix.” (If you do not want to give the Lasix, you must support that decision with clinical reasoning: Here is an example of why a nurse would hold a diuretic: “I would not give Lasix due to Na+= 154, BP=84/42, HR=110, mucous membranes are dry, skin is tenting.)These are critical thinking skills you are to practice. It is ok if you disagree with a med to be given; give the reason using evidence - a lab or assessment finding. I will see how you are thinking and you will become a safe clinician. *Remember, if you withhold a med, a phone call to the MD is the next action (tell your instructor this as a way for s/he to validate you understand the communication standard of holding a med.) You must always provide clinical evidence for reasons holding a medicine; always document your reasoning and conversations with the advanced clinician you spoke with. Never call an MD on your own in the clinical setting, ask your RN or instructor for assistance; do not take verbal orders from any clinician at any time while you are a student (unlicensed.) Medication Interpretation Example:S: Patient is a 21 y/o male. Patient is here for blunt head trauma and pulmonary aspiration with subsequent malignant intracranial hypertension. He is full code with NKDA and NKFA. B: Patient has no past medical and pertinent surgical history. He is in the army and was found on the floor of a parking lot. A: (for assessment) – define what the med does, state why the patient needs the med. R: (for recommendation)- state if you would give or hold med. If you choose to hold the med, state why and that you would alert the patient care provider.Ampicillin/ SulbactamUnasyn This antibiotic is active against streptococci, pneumococci, and enterococci (Nursing Central, 2014.) FYI: Make sure you state what pathogens this antibiotic is effective against; always check your culture report before administration. 3 gm q 6 hoursA: This medication binds to bacterial cell wall, resulting in cell death; spectrum is broader than that of penicillin (Nursing Central, 2014). The patient’s cultures revealed gram-positive cocci clusters resembling staph, and moderate gram-negative rods in his sputum. In his bronchial, he tested positive for a few gram-positive cocci and many staph aureus. The patient is trying to fight off infection in his body, and particularly his lungs. This antibiotic is active against streptococci, pneumococci, and enterococci (Nursing Central, 2014). R: I would recommend giving this medication. The patient is positive for cocci and the med acts against streptococci, pneumococci, and enterococci. I would check the temp at least q 1 hour and if temp is >101 - I would consider holding the med and ask provider if cultures should be redrawn because the patient may have resistant organisms to the drug. If the patient experiences diarrhea, I would ask the provider if stool culture is needed to determine if c. diff is positive. Continue with your next med, no need to retype Situation and Background.It is ok if you disagree with a med to be given. Give the reason you wish to hold a med or change frequency of a lab draw, using evidence such as an assessment finding, your lecture notes, Nursing Central, or your text. Remember, if you withhold a med, a phone call to the MD is the next action when you become a licensed nurse (state this in your recommendation.) Also, you must provide clinical evidence for reasons holding a medicine; always document your reasoning and conversations with the advanced clinician you spoke with; finish the loop of communication and document.Medications (add Additional Pages as needed)S: Patient is a 21 y/o male. Patient is here for blunt head trauma and pulmonary aspiration with subsequent malignant intracranial hypertension. He is full code with NKDA and NKFA. B: Patient has no past medical and pertinent surgical history. He is in the army and was found on the floor of a parking lot. A: (for assessment) – define what the med does, state why the patient needs the med. R: (for recommendation)- state if you would give or hold med. If you choose to hold the med, state why and that you would alert the patient care provider.Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: Generic Name: Trade Name: Therapeutic Class: Pharmacologic Class: Rationale for use: Expected therapeutic effect: Action: Dosage:Safe dose:Frequency:Route:Time:A: R: ................
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