THE MAR ( MEDICATION ADMINISTRATION RECORD}

 

What is the MAR?

The MAR is the medication administration record.
It is a complete record which is kept on every patient.

It includes the patient's name, age, diagnosis, height,
weight and allergies. All medications ordered by the
doctor and a place to sign when medications are given.

Five rights:

There are 5 basic rights for medication administration.
Over time, more rights have been recognized. This may 
vary from 7 or more. Always follow your Institution's
policies and procedures, in order to avoid error.

NEUMEICAL PAIN SCALE ASSESSMENT

 

Scenario: Paul had surgery on his back two days prior.
He is having pain and requests medication. The nurse
does an assessment.

Neumerical pain scale assessment

This a very useful tool when assessing pain. It is 
based on a scale of 0-10 ( 10 being the worst).
A ladder starts from the ground which is the
lowest point. It escalates to the highest point,
so does the pain. Pain scale:

0 = no pain
1-3 = mild pain
4-6 = pain is considered moderate
7-10 = pain is extreme or severe

Helpful hints:

Medication that is given by mouth, takes
longer to be absorbed than when it is given 
IM or IV.

It is important to do a pain assessment after
medication has been given. Documentation 
of the effect it has and any side effects, is 
also helpful. Learn more:
Safe medication administration

COMMON CAUSES OF MEDICATION ERRORS

• When a patient is admitted to a healthcare facility,
   information such as allergies, past medical history,
  height, weight and medications are taken and recorded.
  
  
  This will help  the doctor when prescribing medications.
   It will also be of use to the pharmacist with providing
  correct drug dosages.

  

MEDICATION ADMINISTRATION

 Regardless of where a nurse works, 
medication administration is done.
The nurse who gives drugs of any kind,
should take the time, to ensure
 that everything is done correctly.
Learn more: Nursing fundamentals 

Here are some of the ways in which errors may occur: 

 - Misreading MD orders. If the nurse is uncertain
  about an order , it is best to communicate with the
  doctor or pharmacist.                               
- Poor communication of information, for example,
  when a patient is  transferred from one unit to another.
- Improper dilution of medication ( always check
   manufacturer's instructions for proper dilution).           
- Drug incompatibility ; an example, is Dilantin is
 mixed with Normal Saline.                         
- Confusing one drug with another, as some drugs
   have similar names.                         
- Distraction, like having a conversation while
 administrating medications .       
- Forgetting to document medications when given.                                              

 

WAS AN ASSESSMENT DONE?

Scenario 1: Lynn is a new RN. Her preceptor did not

do a good job explaining the correct way to do an 
assessment. Lynn is not aware of the mistake she
is about to make.

She goes to the bedside of a patient who does not respond. 
Her mistake is obvious, no assessment was done.To compound
the problem, Lynn leaves the pills at the patient's bedside. She 
then advises the patient , to take the medication when awake.

Scenario 2 : Lynn returns twenty minutes later. The 
medication she left at the bedside, has been removed. 
She has no idea who took it . She has still not taken
steps to do an assessment or document findings and
notify MD. This is by no means good clinical judgement.

 

HORMONES AND THE ENDOCRINE SYSTEM

                           The Endocrine System is made up of glands that secrete hormones.

   Hormones are necessary for regulating normal body functions.      

   

    The information provided on hormones and the endocrine system
is intended to help the nurse understand this complex system.

           There are Parts 1, 2, 3 and 4 , including quiz questions in each part. 

To learn more, please click on the link below: 

       Hormones and the Endocrine System                      

                                                  

NURSING ADVANCEMENTS

 

Dear nurses,

There is no denying that the Nursing profession has come 
a long way. We need only look back at the Florence
Nightingale era and can clearly see the advancements.

These specialties, were once  non-existent, but have
 become commonplace. Dearnurses.com is no longer
available, but has been replaced by the links below.
Learn more, by clicking on the links:

-  ICP Monitoring
- Hemodynamic Monitoring
- Hemodialysis
- Clinical judgement   

DEFINING DERMATOMES

 

SPINAL COLUMN

The spinal column is made up of a collection of bones that
protect the spinal cord. There are disks between the bones.
There are nerves in the spinal cord that originate from the 
brain.

SPINAL INJURIES 
Injury to the spinal cord, may result in decreased sensation
to the extremities and torso.

CHECKING DERMATOMES

Checking dermatomes, is usually done by using a pin

and cautiously pricking the skin of the arms, fingers, 

legs and feet. In addition, asking the patient if the 
sensation is dull, sharp or absent.

It is important to document findings.

Enjoy watching the video:

Spinal trauma

What does SCI mean?
SCI means Spinal cord Injury.

What impact might this have on the spinal column?
It is important for the nurse to document her findings, when 
an assessment is done. 

Here are some of the problems that may result from SCI:
- injuries above C3 may affect breathing
Mechanical ventilation may be necessary
- C3 - C7 will involve some degree of weakness involving
shoulders, arms, hands and fingers
- T 1-T12 injuries may paraplegia
- L1- L5 injuries may affect the thighs, knees, feet and toes
See above for more info.

AN OVERVIEW OF HOW TO PREVENT THE SPREAD OF INFECTION

Dear nurses,

Hope you had a good holiday.

Let us take a look at what happens in the preoperative
and operative areas, in order to prevent the spread of infection.

The immune system is compromised by illness. Preventing the 
spread of infection in a Healthcare facility is a major concern,
as healing may be delayed. Every precaution is taken to keep
the Healthcare facility clean and germ free.

For example, prior to surgery, the nurses, doctors, technicians 
and more, spend extra time scrubbing up and changing into 
sterile gowns. They don masks and gloves as well.

It is important to remember that a part of the patient's body
will be cut open and healing following surgery, must not be
delayed due to infection.

Learn more by clicking on the link below:
Immune System