Medication Workbook Questions

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Question 1

The nursing practitioner is a primary care giver. When it comes to the issue of medication, the nursing practitioners are tasked with preparing the patient for the medication, administering it and then observing the patient. They need to ensure that the medication is taking effect or that there are not any unexpected reactions to the medications (Bullock & Manias, 2010). All these are carried out under observation and then reported to the medical officer in charge of the case. The nurse is also responsible for recording any ordered changes to the medication and also reporting them to the head nurse so that there are not any errors in the event of changing work shifts.

The Medical Officer is, on the other hand, the one responsible for writing the prescription. Medical officers are thus responsible for deciding on the kind of medication the patient is given as well as how much they need based on their specific needs and conditions (Bullock & Manias, 2010). They are also responsible for any changes to the medication once they get a report that it is either not working as expected or that the side effects are too severe. The Pharmacist is responsible for filling out the prescriptions as ordered by the physician in the case.

Question 2

Once a pharmaceutical company has conducted a research and development for a new type of medication, it presents it to the TGA for assessment and approval. This often implies looking into the research of the pharmaceutical company and, in some cases, conducting another independent study on the medicine where necessary. TGA also monitors the drug after approval to ensure that its quality, safety as well as effectiveness are up to the expected standards internationally (Duguid, 2009). The PBAC then comes in once the TGA has approved the drug, and lists it on the PBS after the price has been set and the drug approved by the Minister. Once all this has been accomplished, the drug can be safely prescribed by the medical practitioners.

Question 3

Environment

i. Bad lighting may affect the ability of the practitioner to read properly, thus making it hard for them to fully access the information left for them by the physician or the primary nurse (Duguid, 2009). The nurse in charge may also be distracted by noise or heat among other things that could affect their concentration while administering the medication. The environment is a very important factor in ensuring that the practitioner is able to concentrate and thus give the right medication.

ii. The two possible solutions for the lighting problem would be to adjust the lights within the health facility to ensure that the practitioners can see accurately. Alternatively, the solution is to have a nurse’s office where all the reading and preparation for the medication can take place. As for the noise and heat, the nursing practitioner should be able to rise above such challenges and remain focused on their work. This may take a lot of effort and training but it is possible, seeing as they often do not have a choice.

Individual

i. Sleep deprivation is an individual causative factor which renders the medical practitioner fatigued and rather slow as well as unable to concentrate. Under these circumstances, it is very easy for them to commit an oversight when administering medication. Medical practitioner may forget to administer the medication, administer the wrong medication or follow the wrong frequency for the medication among other things. Incompetence is also another individual factor in that the practitioner may not be well qualified to handle the condition, thus leading to mistakes in the administration of medication (Duguid, 2009).

ii. Medical practitioners need to get adequate rest so that they can be fully alert during their shifts and in cases where there is a lot of work, expanding the work force to include medical interns is actually a viable solution. As with competence, nursing education should be considered as a mandatory factor not only during the basic education period, but also as a continuous factor given the dynamic nature of health care practice.

Team

i. Miscommunication may occur, whereby the nurse may have forgotten to pass on changes prescribed by a doctor to the next nurse thus resulting in a medication error. Nurses are expected to communicate effectively with each other or at least with their team leaders to ensure that the message is passed on to the relevant people. Poor handwriting is also a major issue where one nurse may be unable to understand the recordings of the doctor, the team leader of the other nurse thus getting misled.

ii. Nurses have to report to their team leader in order to ensure that in the event that they do not communicate effectively when changing shifts the team leader can brief the new nurse on the needs of the patient in question with regards to the medication (Lisby et el., 2010). In addition, regarding the handwriting issue, the practitioners could resort to printing the instructions in bold letters or having them typed out to avoid misunderstandings brought about by poor handwriting.

Task

i. Lack of appropriate labeling mechanisms especially owing to the fact that preparing medication often entails repackaging them into small units to be administered within a short time frame (Lisby et el., 2010). When these units are labeled wrongly, they are likely to end up being given to the wrong patient or at the wrong time or even in the wrong way. In addition, sometimes the information on the medication is not readily available thus the nurse administering the medication cannot confirm in case they are not sure about the timing or composition of the medication.

ii. The solution for the labeling challenge is to ensure that the medication is prepared as close to the time of administering as possible so that the memory is not over indulged with remembering what has been packaged. Preparing the medicine right before administering it will ensure that the patients get exactly what they need rather than second guessing. As for the issue of information, the nurses should be able to consult freely within the health care facility or in the hospital’s databases rather than taking a leap of faith where lives could be endangered.

System

i. Poor communication within the health care system impeded the accuracy of medication by limiting the interaction between the nurses and the doctors as well as the pharmacists (Lisby et el., 2010). In this way, the changes in medication may not be accurately communicated, leading to errors. In addition, there might be an issue of poor leadership in the health care sector. This is especially influenced by the fact that a majority of the nursing practitioners are considered as interns or subordinates and thus not given the required respect and consideration within their professional circles.

ii. Effective communication systems must be designed and implemented if the patients are to be assured of accurate medication processes. These could include frequent meetings to discuss the patients and their medications. In addition, health care practitioners should start looking at each other as colleagues with equal importance to the well being of the patient. This will enable their cooperation thus eliminating the risk of medication errors.

Question 4

The available brands of Warfarin are Marevan and Coumadin. The drug is used for the prevention and treatment of venous thrombosis, thromboembolic complications and recurrent myocardial infarction. The drug, however, does not reverse the effects of any of these conditions and can rather only be used to prevent extension of the clot (Ghaleb et al., 2006). The dosage is always dependent upon the individual patient and it can be administered as a tablet or as an injection. Warfarin attains peak concentration four hours after oral ingestion and is distributed slowly for up to 12 hours (Ghaleb et al., 2006). It is then eliminated by metabolism before excretion in the form of metabolites through the urine. The drug, however, often takes action within 24 hours of administering (Ghaleb et al., 2006). The adverse effects in this situation include respiratory, immune system and skin disorders as well as chills and gastrointestinal problems. The interactions include synergism among other things. A relevant consideration here would be on the drug’s effects on geriatrics and patients in need of surgery seeing the possibility of fatal bleeding.

Question 5

This patient is a relatively old woman from a foreign culture implying that she needs cultural competent care that is specially tailored to her needs. She will need a different and considerate mode of communication that may require a lot of explanations seeing as English is the second language for her. The main goal here would be to teach her about diabetes and give her all the necessary information on how to manage it, especially as far as her diet and medication is concerned (Walker, 2011). This will require not only availing the learning materials that include brochures and booklets but also involving her family in the process so that they can help her to understand her condition. The evaluation will be based on how much the patient learns about her condition, implying that it can be measured by the level of sustainable lifestyle changes she is able to voluntarily implement. Mrs. Ang is Vietnamese but she still is a regular patient whose wellbeing is just as important as that of any other patient and thus the criteria for evaluating her progress will be on the changes implemented since her diagnosis. Each change will qualify as a positive outcome for her learning process (Walker, 2011). The reinforcement used will mostly be dialogue with or without the involvement of family members especially seeing as she comes from a culture in which the family is considered as a support system.

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