Curriculum to Accompany



Curriculum to Accompany

Medical Assisting:

Administrative and Clinical Competencies,

6th Edition

Course:

Assisting with Medications

Curriculum to Accompany Medical Assisting: Administrative and Clinical Competencies, 6th Edition

Course: Assisting with Medications

Contents

Part A: Prescription and Nonprescription Medications

Part B: Methods of Administering Medications

Part C: Injections and Immunizations

Curriculum to Accompany Medical Assisting: Administrative and Clinical Competencies, 6th Edition

Course: Assisting with Medications

Course Overview

This module discusses various prescription and on-prescription medications with which the medical assistant should familiarize themselves. Prescription medications are constantly coming out on the market and keeping current can be quite challenging. You will find that various providers have a tendency to prescribe certain medications more regularly, and you must learn their indications and adverse effects. In many states, medical assistants are delegated the responsibility of administering medications orally, transdermally, rectally, or via inhalation, plus giving injections and immunizations. Whenever administering any medications, it is vitally important that you document correctly. Another aspect of injections that you need to learn is the principles of intravenous (IV) therapy, although it is not within your scope of practice to “hang” IV fluids for administration.

Resource List

Textbook: Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar Cengage Learning, ISBN 1-4180-3266-2. Chapter 18.

Student CD-ROM: CD-ROM that accompanies Medical Assisting: Administrative and Clinical Competencies, Sixth Edition. This CD-ROM contains StudyWARE, The Critical Thinking Challenge, and an Audio Library.

Workbook: Workbook to accompany Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar Cengage Learning, ISBN 1-4180-3267-0. Chapter 18.

Instructor’s Materials: Instructor’s Resource Manual to accompany Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar Cengage Learning, ISBN 1-4180-3268-9.

Instructor’s CD-ROM: Electronic Classroom Manager to accompany Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar Cengage Learning, ISBN 1-4180-3269-2.

The Internet: It is strongly recommended that faculty and learners alike have a working knowledge of the Internet.

Equipment List

1. Multimedia projector

2. Computer with Internet access

3. Multimedia equipment

4. AAMA credentialing information

5. AMT credentialing information

6. DVD player

CAAHEP content

III.C.1.g.(5) Pharmacology

III.C.1.g.(7) Principles of IV therapy

ABHES content

VI.B.1.b.9.h. Injections

CAAHEP competencies

III.C.3.b.(4)(g) Apply pharmacology principles to prepare and administer oral and parenteral (excluding IV) medications

III.C.3.c.(2)(f) Demonstrate knowledge of federal and state health care legislation and regulations

III.C.3.b.(4)(h) Maintain medication and immunization records

III.C.3.c.(2)(b) Perform within legal and ethical boundaries

III.C.3.c.(2)(e) Document appropriately

ABHES competencies

VI.B.1.a.4.(m) Prepare and administer oral and parenteral medications as directed by physician

VI.B.1.a.5.(e) Dispose of controlled substances in compliance with government regulations

IV.B.1.a.5.(g) Monitor legislation related to current healthcare issues and practices

VI.B.1.a.4.(n) Maintain medication and immunization records

VI.B.1.a.5.(b) Document accurately

Learning Activities

(HW) Terminology Notebook. Assign chapter for reading and have students define key terms and retain in a key term notebook for future reference.

(ICA) PDR Activity. Bring several PDR’s to the classroom. Give students a list of several medications, both brand name and generic, to reference in the PDR. Have them record indications, contraindications, adverse effects, and usual dosages for adults.

(HW) Pharmacy Research Project. Make an assignment for the students to visit their local pharmacies to obtain an insert form from a recently released medication. Ask the students to provide a summary of the medication based on what they were told and provided.

(ICA) Drug Form Review. Bring in various drug forms for student examination.

(ICA) Prescription Practice. Provide blank prescription forms to have the student practice in completing them properly.

(HW) Competency Assignment. Have students research your state laws governing controlled substances. Retain each student’s completed, graded, and dated work as documentation for the CAAHEP and ABHES competencies.

(ICA) Documentation Activity. Provide several scenarios of medication administration to have the students to practice proper and appropriate documentation of such administration. Critique their documentation and provide guidance until properly completed as would be found in a medical record.

(ICA) Dosage Calculations Exercises. Compose multiple math problems to have students practice calculations.

(HW) Chapter 18, Unit 1 Workbook Assignment Sheet

(ICA) Competency Evaluation, Procedure 18-1. Prepare medication orders for students to prepare and administer orals medication; evaluate the students on their competency of Procedure 18-1.

(ICA) Show and Tell. Collect various oral dosing devices for students to examine.

(HW) Chapter 18, Unit 2 Workbook Assignment Sheet

(ICA) Syringe Display. Bring in various size and types of syringes for students to examine. Point out parts of the needle and the syringe.

(ICA) Competency Evaluation, Procedure 18-2. Demonstrate the proper technique for withdrawing medication from an ampule; have the students to return the demonstration and evaluate them for competency of Procedure 18-2.

(ICA) Competency Evaluation, Procedure 18-3. Demonstrate the proper technique for withdrawing medication from a vial; have the students to return the demonstration and evaluate them for competency of Procedure 18-3.

(ICA) Competency Evaluation, Procedure 18-4. Provide the students with the necessary supplies to reconstitute the powdered medication; evaluate the students on their competency of Procedure 18-4.

(ICA) Competency Evaluation, Procedure 18-5. Demonstrate the technique for intradermal injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-5. Have the students to document in the chart the “medication” administered and retain as work product.

(ICA) Competency Evaluation, Procedure 18-6. Demonstrate the technique for subcutaneous injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-6. Have the students to document in the chart the “medication” administered and retain as work product.

(ICA) Competency Evaluation, Procedure 18-7. Demonstrate the technique for intramuscular injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-7. Have the students to document in the chart the “medication” administered and retain as work product.

(ICA) Competency Evaluation, Procedure 18-8. Demonstrate the technique for intramuscular Z-track injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-8. Have the students to document in the chart the “medication” administered and retain as work product.

(ICA) Principles of IV Therapy. Obtain basic IV administration sets for students to see to acquaint them with IV supplies for principles of IV therapy.

(ICA) Immunization Schedule Activity. Review the immunization schedules presented in Figure 18-32, or download the latest schedule from the CDC’s web site: .

(HW) Chapter 18, Unit 3 Workbook Assignment Sheet

(HW) The Critical Thinking Challenge, page 949.

(HW) The Critical Thinking Challenge, page 950.

(HW) The StudyWare Challenge, Chapter 18. Have students take the Quiz in “Quiz Mode” and either email their scores to the instructor, or print the scores to turn in.

(ICA) Following review of the chapter and homework assignments, give a quiz on this chapter that includes the content and competencies listed for CAAHEP and ABHES.

Part A: Prescription and Nonprescription Medications

Learning Objectives

Cognitive

1. Spell and define the Words to Know in the unit.

2. Explain how to use PDRs for both prescription and non-prescription medications.

3. Explain how to properly phone in prescriptions to a pharmacist.

4. Describe how to write a prescription as ordered by the physician.

5. Describe the drugs that are under federal regulation according to category, or Schedules I through V.

6. Define abbreviations commonly used in regard to medications.

7. Explain how to record medications properly on the patient’s chart.

8. Explain how to categorize medications used in the medical office.

9. Describe medical/legal/ethical concerns regarding medications.

10. List and discuss the necessary information required when recording medications.

|Key Concepts |References & Activities |Slides |

|Commonly prescribed medications |Page 901 | |

| |Table 18-1 | |

| |(HW) Terminology Notebook | |

|The PDR |Pages 901-904 |3-6 |

| |(ICA) PDR Activity | |

|Drug classifications and categories |Page 904 |7-8 |

| |(HW) Pharmacy Research Project | |

|Drug actions |Page 904 |9-11 |

|Drug forms |Pages 904-905 | |

| |(ICA) Drug Form Review | |

|The medication order |Page 905 | |

|Prescriptions |Pages 905-906 |12-13 |

| |Figure 18-4 | |

| |(ICA) Prescription Practice | |

|Controlled substances and schedules of drugs |Page 907 |14-16 |

| |Table 18-2 | |

| |(HW) Competency Assignment | |

|Documenting medications |Page 910 |18 |

| |(ICA) Documentation Activity | |

|Common abbreviations |Page 911 |17 |

| |Table 18-3 | |

|Calculations |Pages 912-913 | |

| |Table 18-5 | |

| |(ICA) Dosage Calculations Exercises | |

|Storing medications |Page 912 | |

| |(HW) Chapter 18, Unit 1 Workbook | |

| |Assignment Sheet | |

(ICA) In-Class Activities

1. PDR Activity. Bring several PDR’s to the classroom. Give students a list of several medications, both brand name and generic, to reference in the PDR. Have them record indications, contraindications, adverse effects, and usual dosages for adults.

2. Drug Form Review. Bring in various drug forms for student examination.

3. Prescription Practice. Provide blank prescription forms to have the student practice in completing them properly.

4. Documentation Activity. Provide several scenarios of medication administration to have the students to practice proper and appropriate documentation of such administration. Critique their documentation and provide guidance until properly completed as would be found in a medical record.

5. Dosage Calculations Exercises. Compose multiple math problems to have students practice calculations.

(ICD) In-Class Discussion

1. How often is the PDR published?

Annually

2. What are the various drug categories and classifications?

Vaccines and immunizations, particular action on the body, target effect, preparation

3. What is the inscription of a prescription?

The inscription is the part of the prescription that states the name and quantities of the ingredients in the prescribed medication.

4. What agency oversees controlled substances?

The agency that has this responsibility is a branch from the U. S. Department of Justice, the Drug Enforcement Agency (DEA).

5. What schedule of drugs cannot be prescribed (unless in a research facility)?

Schedule I drugs have no acceptable medical use and cannot be prescribed.

6. What medical assistant duties are relative to controlled substances?

(1) Knowledge of state and federal laws that manage the prescribing (2) maintaining thorough and accurate inventory and records for those offices that administer controlled substances (3) keeping controlled substances secure (4) maintenance of a current DEA physician license (5)keeping track of prescription pads (6) proper disposal of expired drugs with a record of the disposal

7. What information needs to be recorded when administering medications?

Who, what, when, where, and why

8. What is the most practical way to store medications?

There are two practical ways based on the provider’s preference – either by category or alphabetically.

(HW) Homework Assignments

1. Terminology Notebook. Assign unit for reading and have students define key terms and retain in a key term notebook for future reference.

2. Pharmacy Research Project. Make an assignment for the students to visit their local pharmacies to obtain an insert form from a recently released medication. Ask the students to provide a summary of the medication based on what they were told and provided.

3. Competency Assignment. Have students research your state laws governing controlled substances. Retain each student’s completed, graded, and dated work as documentation for the CAAHEP and ABHES competencies.

4. Chapter 18, Unit 1 Workbook Assignment Sheet

Presentation Tools

Note to Instructors: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Chapter 18, Slides|Introduce the course and unit. |

|1-2 | |

|Slides 3-6 |Using the PDR |

|Slides 7-8 |Drug classifications |

|Slide 9 |Drug actions |

|Slides 10-11 |Classifications of drug actions |

|Slide 12 |Parts of a prescription |

|Slide 13 |Phoning in prescriptions |

|Slides 14-15 |Federal regulations in registering with the DEA |

|Slide 16 |Drug schedules |

|Slide 17 |Common abbreviations |

|Slide 18 |Documenting medications |

|Slides 19-20 |Medical, legal and ethical concerns |

| |Include in the discussion that there is a controlled substances log that must be maintained when health |

| |care providers administer this type of medications. This log includes disposal of small amounts of |

| |controlled substances to verify that vials are being destroyed and not sold. |

|Slide 21 |Have students answer the checkpoint questions on the slide to review the content in the unit. |

Part B: Methods of Administering Medications

Learning Objectives

Cognitive

1. Spell and define the Words to Know in the unit.

2. List and describe the various methods of administering medications.

3. Explain how to apply a transdermal patch medication properly.

4. Describe precautions in applying a transdermal patch medication.

5. Explain the importance of checking medications prior to administration.

6. Explain patient education to females regarding vaginal medications.

7. List considerations regarding drug action in the body

Psychomotor

8. Obtain and administer oral medications.

|Key Concepts |References & Activities |Slides |

|Methods of administering medications |Page 914 |24 |

| |(HW) Terminology Notebook | |

|Six rights of medication administration |Page 914 |23 |

|Medication errors and accuracy in administering medications |Pages 915-916 | |

|Oral administration |Page 917 | |

| |(ICA) Show and Tell | |

| |(ICA) Competency Evaluation, Procedure | |

| |18-1 | |

|Sublingual and buccal administration |Page 918 | |

|Inhalation administration |Page 918 | |

|Topical administration |Page 919 | |

|Vaginal administration |Page 920 | |

|Patient education |Page 920 | |

|Considerations of drug actions |Page 921 |25 |

|Body surface area and nomograms |Page 921 | |

| |(HW) Chapter 18, Unit 2 Workbook | |

| |Assignment Sheet | |

(ICA) In-Class Activities

1. Competency Evaluation, Procedure 18-1. Prepare medication orders for students to prepare and administer orals medication; evaluate the students on their competency of Procedure 18-1.

2. Show and Tell. Collect various oral dosing devices for students to examine.

(ICD) In-Class Discussion

1. What are the six rights of administering medications?

The medical assistant needs to ascertain the right: patient, medication, dose/amount, route/method, technique, and time/schedule.

2. Identify the different routes of medication administration.

(1) Topical (applied to the skin) (2) inhalation (3) sublingual (4) rectal (5) vaginal

(HW) Homework Assignments

1. Terminology Notebook. Assign unit for reading and have students define key terms and retain in a key term notebook for future reference.

2. Chapter 18, Unit 2 Workbook Assignment Sheet

Presentation Tools

Note to Instructors: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Chapter 18, Slide |Introduce the unit. |

|22 | |

|Slide 23 |Six rights of medication administration |

| |Click on the icon to show a brief video clip |

|Slide 24 |Methods of administration |

|Slide 25 |Considerations regarding drug actions |

|Slide 26 |Transdermal patch application |

|Slide 27 |Have students answer the checkpoint questions on the slide to review the content in the unit. |

Part C: Injections and Immunizations

Learning Objectives

Cognitive

1. Spell and define the Words to Know in this unit.

2. Correctly identify the parts of a syringe and needle.

3. Name the tissue layers and sites of injection for intradermal, intramuscular, and subcutaneous injections.

4. List and explain the immunization schedule for normal infants, children, and adults.

5. Explain the importance of informing patients, or the responsible party for a minor, verbally and in writing, of both the benefits and the risks of immunizations before they are administered.

6. Discuss the importance of patient education regarding medications.

7. Identify the various sites for administering insulin injections.

8. Explain the theory of IV therapy.

Psychomotor

9. Withdraw medication from an ampule and a vial.

10. Demonstrate how to administer intradermal, intramuscular, and subcutaneous injections properly.

11. Demonstrate how to prepare and administer an insulin injection.

12. Demonstrate an intramuscular injection by the Z-track method.

13. Reconstitute a power medication for injection.

|Key Concepts |References & Activities |Slides |

|Injections |Page 922 | |

| |(HW) Terminology Notebook | |

|Syringes |Page 923 |29 |

| |(ICA) Syringe Display | |

|Withdrawing medication from vials and ampules |Page 923 | |

| |(ICA) Competency Evaluation, Procedure | |

| |18-2 | |

| |(ICA) Competency Evaluation, Procedure | |

| |18-3 | |

|Preparing to administer injections |Page 928 | |

| |(ICA) Competency Evaluation, Procedure | |

| |18-4 | |

|Patient education for teaching patients about medications |Page 929 | |

|Intradermal injections |Pages 929-931 |30 |

| |(ICA) Competency Evaluation, Procedure | |

| |18-5 | |

|Subcutaneous injections |Page 932 |30 |

| |(ICA) Competency Evaluation, Procedure | |

| |18-6 | |

|Intramuscular injections |Page 932 |30 |

| |(ICA) Competency Evaluation, Procedure | |

| |18-7 | |

|Z-track IM injections |Page 935 |30 |

| |(ICA) Competency Evaluation, Procedure | |

| |18-8 | |

|Administering injections to small children |Page 936 | |

|IV injections |Page 936 |30 |

|Principles of IV therapy |Pages 937-940 |33 |

| |(ICA) Principles of IV Therapy | |

|Insulin injections |Page 940 |31 |

|Vaccines and immunizations |Pages 940-949 |32 |

| |(ICA) Immunization Schedule Activity | |

| |(HW) Chapter 18, Unit 3 Workbook | |

| |Assignment Sheet | |

| |(HW) The Critical Thinking Challenge, | |

| |page 949 | |

| |(HW) The Critical Thinking Challenge, | |

| |page 950 | |

| |(HW) The StudyWare Challenge, Chapter | |

| |18 | |

| |(ICA) Quiz on chapter material | |

(ICA) In-Class Activities

1. Syringe Display. Bring in various size and types of syringes for students to examine. Point out parts of the needle and the syringe.

2. Competency Evaluation, Procedure 18-2. Demonstrate the proper technique for withdrawing medication from an ampule; have the students return the demonstration and evaluate them for competency of Procedure 18-2.

3. Competency Evaluation, Procedure 18-3. Demonstrate the proper technique for withdrawing medication from a vial; have the students return the demonstration and evaluate them for competency of Procedure 18-3.

4. Competency Evaluation, Procedure 18-4. Provide the students with the necessary supplies to reconstitute the powdered medication; evaluate the students on their competency of Procedure 18-4.

5. Competency Evaluation, Procedure 18-5. Demonstrate the technique for intradermal injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-5. Have students document in the chart the “medication” administered and retain as work product.

6. Competency Evaluation, Procedure 18-6. Demonstrate the technique for subcutaneous injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-6. Have students document in the chart the “medication” administered and retain as work product.

7. Competency Evaluation, Procedure 18-7. Demonstrate the technique for intramuscular injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-7. Have students document in the chart the “medication” administered and retain as work product.

8. Competency Evaluation, Procedure 18-8. Demonstrate the technique for intramuscular Z-track injections; allow the students practice time to perfect their technique followed by evaluation of their competence of Procedure 18-8. Have students document in the chart the “medication” administered and retain as work product.

9. Principles of IV Therapy. Obtain basic IV administration sets for students to see to acquaint them with IV supplies for principles of IV therapy.

10. Immunization Schedule Activity. Review the immunization schedules presented in Figure 18-32, or download the latest schedule from the CDC’s web site: .

11. Following review of the chapter and homework assignments, give a quiz on this chapter that includes the content and competencies listed for CAAHEP and ABHES.

(ICD) In-Class Discussion

1. What are the angles for the four types of injections?

Intramuscular – 90 degrees; subcutaneous – 45-90 degrees; intravenous – 25 degrees; intradermal – 10 to 15 degrees

2. Why are intradermal injections given?

Intradermal injections are given to solicit responses to allergy and tuberculin testing.

3. Name the most common administration sites for subcutaneous injections.

The most common sites are the upper outer part of the arm, abdominal areas, and the upper thigh.

4. When are intramuscular medications indicated?

When large doses or medication are ordered, medications that are oil-based (non-water based) or thicker medications, the IM route is indicated.

5. Where is the preferred IM site for infants and young children?

The vastus lateralis is the preferred site for this population of patients.

6. When are intravenous medication indicated?

IV medications are used when patient need long term access for a prolong infusion of various medications and products.

7. Name some advantages of IV therapy.

Advantages include: immediate absorption; maximum bioavailability; fluid administration to increase blood pressure; hydration and/or electrolyte replacement; quick administration; time saving; and, more comfortable than administering individual injections.

8. What are some guidelines for inserting the intravenous cannula?

Find the best possible site for the patient; use a larger vein for administration of irritating and/or hypertonic solutions. Locate a site that will remain viable for at least 48-72 hours; use the smallest cannula possible. Don’t use irritate or sclerosed veins and avoid sites when the patient is status post mastectomy, status post CVA, partial amputation, and/or when 3rd degree burns are present. Also avoid shunts places for hemodialysis.

9. What are three categories of vaccines?

The three types are live attenuated, pathogenic toxins, and killed pathogens.

10. Name several vaccines that protect us from diseases.

Influenza, pneumonia, haemophilus influenza B, MMR, diphtheria, pertussis, rabies, tetanus, rotavirus, varicella zoster, hepatitis A, hepatitis B, meningitis, polio

(HW) Homework Assignments

1. Terminology Notebook. Assign unit for reading and have students define key terms and retain in a key term notebook for future reference.

2. Chapter 18, Unit 3 Workbook Assignment Sheet

3. The Critical Thinking Challenge, page 949.

4. The Critical Thinking Challenge, page 950.

5. The StudyWare Challenge, Chapter 18. Have students take the Quiz in “Quiz Mode” and either email their scores to the instructor, or print the scores to turn in.

Presentation Tools

Note to Instructors: If you change Objectives or Assignments, don’t forget to change the slides accordingly.

|Chapter 18, Slide |Introduce the unit. |

|28 | |

|Slide 29 |Parts of a needle and syringe |

| |Click on the icons to show brief video clips |

|Slide 30 |ID, SubQ, IM, and IV injections |

| |Click on the icons to show brief video clips |

|Slide 31 |Insulin injections |

|Slide 32 |Benefits and risks of immunizations |

|Slide 33 |Principles of IV therapy |

|Slide 34 |Have students answer the checkpoint questions on the slide to review the content in the unit. |

|Slides 35-36 |The Keys to Career Success slides emphasize the relationship of the material learned in the classroom to |

| |on-the-job success. |

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