Course Syllabus VNSG 1227-Essentials of Medication Administration -Spring 2012- Re: 12/17/2011 QR 1
HOUSTON COMMUNITY COLLEGE SYSTEM HEALTH CAREERS EDUCATION DIVISION VOCATIONAL NURSING COURSE SYLLABUS Course Number and Title VNSG 1227, Essentials of Medication Administration Credit Hours Two (2) Class Hours Two (2) Clinical Hours None (0) Lab Hours One (1) Placement of Course Level I Pre-requisite/s Admission to the Program Co-requisite/s: VNSG 1400, 1122, 1423, 1161 Faculty: Qiana Ross, MSN, RN, CVRN Course Description: This is a beginning course that introduces the student to medication administration and drug calculation in children and adults. Emphasis will be placed on the pharmacological aspect of drug classifications including the uses, actions, pharmacodynamics, indications, pharmacokinetics, contraindications, adverse effects, and nursing implications. Oral, sublingual, intramuscular, intradermal and subcutaneous administration methods are covered. Additionally, the student is taught how to calculate drug dosage for patients when medications are delivered in amounts and formats that are not equivalent to what has been prescribed. Student practice involves reading drug orders, calculating the dosage, diluting and drawing up injectable medications, delivering the medication, and documenting the medication administration. The legal, ethical, and safety principles of drug administration are included as well as the role/s and competencies of the professional vocational nurse as they relate to drug administration. Course Objectives Following completion of this course the student will be able to: 1. Identify the rights of patients in regards to medication administration. 2. Discuss drug classifications including the uses, actions, pharmacodynamics, indications, pharmacokinetics, contraindications, adverse effects, and nursing implications. 3. Identify the classifications of drugs used for various system disorders. 4. Calculate, accurately, drug dosages using provided methods and/or formulas. 5. Administer medications using provided procedures. 6. Provide patient with education regarding a newly prescribed medication. 7. Identify special precautions in drug administration to children and the elderly. 8. Describe the DEC Competencies (2010) as they relate to drug administration in the practice of the licensed vocational nurse. (see attached list) Re: 12/17/2011 QR 2
9. Discuss professional nurse role behaviors, to include caring, safety, and advocacy, as they relate to medication administration within the context of the health-care team. Catalog Learning Outcomes: The student will demonstrate accurate dosage calculation; discuss the principles of medication administration safety; identify the elements of accurate documentation of medication administration; and identify the classification of drugs used for various disorders of the systems. Scan Competencies: Two SCANS workplace competencies are included in this course. Use Information Skills Enhance Basic Skills #7 Organize Information #32 Demonstrate Mathematics Skill Attendance: Attendance will be taken each class day. Students are required to sign the class roster daily to verify attendance. Each student is allowed two (2) absences. Absences in excess of two (2) days will result in expulsion from the course. Students will be responsible for material covered on days that they missed. Students will also be responsible for monitoring their number of latenesses and absences. Also, the instructor will not reiterate content covered in class sessions that a student missed. Absence is defined as any time not in class at the scheduled time. Three (3) tardies will be equivalent to one absence. Three (3) times leaving early will be equivalent to one absence. The student will be responsible for obtaining all materials, notes, handouts and making up assignments missed during any absences. The instructor will not be responsible for any materials not obtained during a student s absence. Methods of Accomplishing Classroom lecture & Online discussion (A computer with Internet access is REQUIRED for this class). Computer access is available at any HCCS campus for your convenience. Learning Outcomes: Handouts / Practice Problems / Multimedia Computer Assisted Instruction / Videos / PowerPoint Skills Labs Methods Of Evaluation: There are Five (5) unit examinations multiple-choice 50 questions One (1) hour will be provided for each exam A comprehensive final examination multiple choice 100 questions. Two hours will be provided for this exam. Re: 12/17/2011 QR 3
There will be Five (5) medication math quiz delivered online. An average of the quizzes will determine the overall quiz grade. You will have two chances to take each medication math quiz. The highest grade will be used. Refusal to take a quiz will result in a grade of a zero (0). See the Course schedule for the dates and times of availability. There will be five (5) online forums. Students will be required to respond to all five questions. The instructor will present a discussion topic each week that a lecture will be taught. They will open Monday morning (12:01 am) and be due the following Sunday evening (11:59 pm). Each student will be required to respond to the posted question in only ONE well-structured paragraph answering all components of the question. Failure to complete the online discussions will result in a zero. Please see the course schedule for the dates and times of availability. An online examination will be administered. The exam will be administered midterm and include all information presented from that point forward. Any regular scheduled or unscheduled course exam will not be made up. If the student must be absent on the day an exam is given then a grade of 50% will be given. On the day of a scheduled examination, leave all books, backpack, and roller carts in a locker or vehicle. Do not bring items to the computer lab. Audible devices are not allowed in the testing room. If you are late to any exam (scheduled or unscheduled), the following applies: a. You must complete the exam within the class time allocated for the exam. You will not have additional time in which to complete the exam. For example, if the exam is scheduled from 0800 to 0900, you must complete the exam by 0900 hour. b. If you arrive after any student has completed the exam and left the room you will not be allowed to take the exam. c. Exams will be administered on-line and will be reviewed on the scheduled date and time. Students not attending scheduled review will not be able to review the exam after the scheduled date and time. Any student that has a concern Re: 12/17/2011 QR 4
regarding an exam will need to make an appointment with the instructor before the Friday after the exam. Any questions after that time will not be entertained. d. Disruptions from cell phones, pagers, ect. (Students will be asked to leave the class or computer for the remainder of the class session and absent time will be cumulative. If dismissed from the computer lab during testing a grade of 0 will be given. Grade Computation The grade for this course is comprised of several components: Theory, examinations, and mathematic quizzes. Grading System The course grade will be derived as follows: Unit Examinations (5 @ 12%) 60 % Online Midterm Exam 10% Final Examination 20% Forum Questions 5% Average of Five Calc. Quizzes 5 % 100 % Required Text Books: Roach s Introductory Clinical Pharmacology. (9 th ed). By Susan Ford and Sally Roach Course Objectives for Mathematical /Pharmacological Concepts: Upon completion of this content, the student will have been provided with the learning activities to: 1. Define pharmacology and list the four sources of drugs as referenced to Member of the Health Care Team #1 and SCANS 7. 2. Calculate the rate of IV infusions and evaluate the medication effects as referenced to Provider of Care #5A and SCANS 7, 32. Re: 12/17/2011 QR 5
3. Prepare at least six points of teaching to facilitate patient education regarding the medication regimen as referenced to Provider of Patient-Centered Care #4B and SCANS 7, 32. 4. Identify the four processes by which drugs are used by the body as referenced to Member of the Health Care Team #1 and SCANS 7. 5. State the legal issues -----of concerns that have standards regulated by legislation as referenced to Provider of Patient-Centered Care #3F and SCANS 7. 6. Identify and describe the difference between chemical, generic, official, and trade names as referenced to Member of the Health Care Team #1A and SCANS 7. 7. List and discuss at least three functions of the Food, Drug, & Cosmetic Act and the Controlled Substance Act as referenced to Member of the Profession #1C and SCANS 7. 8. Recognize and apply common safety measures of medication calculation and administration to multiple clients as referenced to Provider of Patient-Centered Care #6A and SCANS 7. 9. State and illustrate the abbreviations of the various systems of measurements as referenced to Provider of Patient-Centered Care #2 and SCANS 7. 10. List and show the procedures of administration for various forms of medications as referenced to Member of the Profession #3E and SCANS 7. 11. State and apply the nursing process in relation to pharmacology as referenced to Provider of Patient-Centered Care # 2 and SCANS 7. 12. List the six rights of medication administration needed to prevent a medication error as referenced to Member of the Profession #1G and SCANS 7. 13. Identify and discuss the components of a medication order as referenced to Provider of Patient-Centered Care #3 and SCANS 7. 14. Define and apply terms used in metric, apothecary and household measures as referenced to Coordinator of Care #4C and SCANS 7. 15. Identify Roman numeral and implement nursing care using the conversion table when performing dosage calculations as referenced to Provider of Patient-Centered Care #3F and SCANS 7, 32. 16. Cite and use literature resources for researching medication information as referenced to Member of the Profession #2 and SCANS 7. 17. Use critical thinking to analyze procedures to perform when: a medication error occurs; a patient refuses a medication; a medication is to be wasted as referenced to Provider of Patient-Centered Care #7A and SCANS 7. Re: 12/17/2011 QR 6
18. List nursing diagnoses related to medication administration and documentation as referenced to Provider of Patient-Centered Care #1F and SCANS 7. 19. Identify the five FDA pregnancy categories as referenced to Provider of Patient-Centered Care #1F and SCANS 7. 20. Define and list pharmacologic drug classifications as referenced to Provider of Patient- Centered Care # 1F and SCANS 7. 21. List major drugs in each class according to the body system they affect as referenced to Provider of Patient-Centered Care # 2 and SCANS 7. 22. Identify the classification of medications used for cardiovascular disorders; endocrine & metabolic disorders; eye, ear, nose, sinus, & throat disorders; gastrointestinal disorders; hematologic disorders; immunologic disorders; integumentary disorders; liver, biliary, & pancreatic disorders; musculoskeletal disorders; neurologic disorders; peripheral vascular disorders; renal & urinary disorders; respiratory disorders; autonomic & central nervous disorders; infections; and various cancer pharmacotherapy management as referenced to Member of the Profession # 1F and SCANS Any student with a documented disability (e.g. physical, learning, psychiatric, vision, hearing, etc.) who needs to arrange reasonable accommodations must contact the Disability Services Office at the respective college at the beginning of each semester. Faculty is authorized to provide only the accommodations requested by the Disability Support Services Office. If you have any questions, please contact Donna Price at 713-718-5165 or the Disability Counselor at each college. EGLS 3 -- Evaluation for Greater Learning Student Survey System At Houston Community College, professors believe that thoughtful student feedback is necessary to improve teaching and learning. During a designated time, you will be asked to answer a short online survey of research-based questions related to instruction. The anonymous results of the survey will be made available to your professors and division chairs for continual improvement of instruction. Look for the survey as part of the Houston Community College Student System online near the end of the term. Re: 12/17/2011 QR 7
Course Outlline OBJECTIVES CONTENT CRITICAL #1-Demonstrate math skills by taking a pretest to determine strengths and weaknesses in solving arithmetic problems. #2-Write and apply abbreviations of the various systems of measurement. Arithmetic Review fraction decimal percents ratios & proportions Convert across the three systems of measurements, metric, apothecary and household. If a patient receives 1/3 of the usual dose and another patient receives 1/6 of the usual dose of the same medicine which patient receives the larger dose? How many cc s would you record if the patient drank (six) eight ounce glasses of water? Math pre-test. Chapter 1 Lecture Pharmacology calculation handouts. Quizzes #3-Demonstrate accurate medication dosage calculation #4-Draw a line through an illustration of an insulin syringe to indicate the dosage of units desired. #5-Select a solution and reconstitute a powdered drug. Calculation 1. Ratio- Proportion Formula Units and Milliequivalent (meq) Reconstitution. Dr. ordered 60 mg/tab. Pharmacy sent one grain. Chapters 2& 3 How many tablets do you give? What unit and system is mg in? Lab What syringe would you use if the doctor s order were for 15 units of insulin subcutaneous? What would happen to the injection site if a powdered drug were not reconstituted with the correct amount of diluent? Practice reconstitution of powdered drugs in lab with practice vials and solutions. 8 Re: 12/16/2011 QR
#6-Explain and apply nursing responsibilities when administering oral medication. Routes of Administration: Oral A patient is supine, states I don t want to move, how will you give the oral medicine? In Lab: Prepare accurate oral dosages, position mannequin correctly. #7-Name any four of the various forms of topical applications. #8-Name three routes for parenteral administration of medication. #9-Identify the tissue layer where the subcutaneous injection should be placed. Topical Parenteral Routes Subcutaneous Z-Track How will you apply calamine lotion to your client? A patient requests the two injections to be put in his arms, you have 600,000 units of Penicillin G in each what will you do? 300 lb patient needs her insulin shot how will the nurse deposit the medicine in the correct tissue layer? Chapters 5 & 13 Identify the correct landmarks for selected intramuscular injections on practice mannequin. Identify the correct landmarks for selected subcutaneous injections on practice mannequins. #10-Identify and show the correct movement of tissue prior to Z-tract injection. #11-Convert between units within the metric system. #12-Assemble equipment and calculate IV flow rate. Conversions Intravenous Lab A client states, I take iron injections but my skin is black and blue and there is a sore developing, what will you say and do before you Pharmacology calculation administer the next Fe practice handouts. injection? Dr. K orders 50 mg. and the pharmacist sends you 1 grain/tab. How many tablets will you give? Intravenous, the order is for ml/hr Do you need the drop factor? Chapters 3 & 8 In Lab: Pull correct IV Solution and assemble IV Tubing, calculate cc/hr; gtts/min. 9
#13-State the origin and definition of pharmacology. History Basic Pharmacology for What science deals with the Nurses 14 th ed., Chapter 1 study of drugs and their Lecture actions on living organisms? PowerPoint Presentation #14-Explain the meaning of therapeutic methods. #15-Describe the process used to name drugs. Therapeutic Methods Naming of Drugs Is drug therapy considered a therapeutic method? How important is the chemical name? Chapter 12 #16-Differentiate among the chemical, generic, official, and brand names of medicines. Different Names of Medicines What is the difference between Achromyn and Panmycin? #17-List official sources of drug standards. Drug Standards What is USP? #18-List and describe Researching Medications literature resources for researching prescription and nonprescription medications. What options are available to research the medication Lanoxin? 10 Re: 12/16/2011 QR
#19-List and describe Researching Drug literature resources for Interactions researching drug interactions and drug compatibilities. Discuss information a client would need to know if they were prescribed a new medication? Basic Pharmacology for Nurses 14 th ed., Chapter 1 Lecture PowerPoint Presentation #20-Cite literature resources for reviewing information to be given to the patient concerning prescribed medications. #21-List legislative acts controlling drug use and abuse. #22-Differentiate among Schedule I, II, III, IV, and V medications, and describe nursing responsibilities associated with administration of each type. Patient Teaching Drug Legislation Scheduled Narcotics Development of New Rx Should all patient teaching be done with written handouts? What would you do if you saw a nurse taking client s medication? What schedule narcotic is cocaine? Chapter 12 #23-Describe the procedure outlined by the FDA to develop and market new medicines. If a new disease appears, and a drug with possible curative powers is being developed, what tests are performed prior to human administration? 11
#24-Identify five basic principles of drug actions. #25-Explain nursing assessments, necessary to evaluate potential problems associated with the absorption of medications. Principles of Drug Actions Nursing Assessments After medication administration, what four stages do drugs go through? What is the correlation of medication between absorption and route of administration? Basic Pharmacology for Nurses 14 th ed., Chapters 2-3 Lecture PowerPoint Presentation #26-Describe nursing interventions that can enhance drug absorption. #27-List three categories of drug administration, and state the routes of administration for each category. Drug Absorption Drug Administration Categories Drug Inactivation Will you massage a subcutaneous injection of Heparin? What routes of administration can nurse give insulin? Chapter 12 #28-Name the process that inactivates drugs. Half-Life What is biotransformation? #29-Identify the meaning and significance to the nurse of the term half-life when used in relation to drug therapy. What is the half-life of Lasix? 12 Re: 12/16/2011 QR
#30-Compare and contrast the following terms used in relationship to medications: desired action, side effects, adverse effects, allergic reactions, and idiosyncratic reactions. #31-List factors that cause variations in absorption, metabolism, distribution, and excretion of drugs. #32-Differentiate among the following terms used in relationship to medications: additive effect, synergistic effect, antagonistic effect, displacement, interference, and incompatibility. #33-Discuss the effects of age on drug action. Desired action Side effects Adverse effects Allergic reactions Idiosyncratic reactions Absorption Metabolism Distribution Excretion of drugs. Effects of Medications Rx effects in Relation to Age Drug Action & Interaction What type of reaction can be life threatening? What relationship does age have on excretion of drugs? What happens when Warfarin and ASA are giving simultaneously? What age groups require special consideration for medication administration? Can medication be excreted in the saliva? #34-Cite major factors associated with drug absorption, distribution, metabolism, and excretion in the young and in older-aged populations. 13
#35-State the five steps in the nursing process. #36-State the information that should be obtained as a part of the medication history. Nursing Process Medication History Which step in the nursing process deals with collection of data? If a patient states he is allergic to PCN, is this subject or object data? Basic Pharmacology for Nurses 14 th ed., Chapters 4-5 PowerPoint Presentation Lecture #37-Define the term problem in relation to the nursing process and pharmacology. #38-Describe the process used to identify factors that could result in patient problems when medications are prescribed. #39-Apply the principles of learning to the content learned in pharmacology on patient teaching. Problem Process to Identify Potential Problems of Rx Principles of Learning / Pharmacology What is the Nursing Diagnosis? Dr. K orders an Rx, which costs $110.00, and the patient lives on a fixed income of $210.00; what can be done so the patient will be compliant in their Rx regimen? How can you teach a blind man to take his Lasix and Lanoxin? Chapter 12 14 Re: 12/16/2011 QR
#40-Describe essential elements of patient s education in relation to the prescribed medications. Patient Education Regarding Rx Ms. Kim is newly diagnosis with CA of the throat; when can a nurse begin patient teaching on the Rx regimen? Basic Pharmacology for Nurses 14 th ed., Chapters 4-5 PowerPoint Presentation Lecture #41-Research the Nurse Medication Administration Practice Act and identify the Limitations limitations relating to medication administration placed on LPN / LVN. #42-Cite the information contained in a Kardex and describe the purpose of this file. #43-Cite the advantages and disadvantages of the ward stock system, the individual prescription order system, and the unit dose system of drug distribution. #44-Identify & define the five FDA pregnancy categories. Kardex Different Systems of Rx Distribution Drug Pregnancy Categories Can a LPN/ LVN give medications IVP? Is the kadex a legal document? Which system is considered the most dangerous? What is the drug pregnancy categories of Lasix, Lanoxin, & Insulin? Chapter 13 15
#45-Identify the components of a medication order. The Components of a Rx order Dr. K writes Lanoxin 1.25 mg IM stat. Would you give this Rx? Basic Pharmacology for Nurses 14 th ed., Chapter 7 #46-Define each of the four categories of medication orders used. Types of Medication Orders Dr. K writes Dilantin 300 mg IVP stat. When will you give this medication? Chapter 13 #47-List the six rights of drug administration. #48-Describe specific safety precautions the nurse should Safety Precautions of Rx institute to ensure that Calculation correct medication calculations are performed. #49-Correctly define and identify oral dosage forms of Oral Dosages of Rx medications. #50-State the essential information that is included on either a physician order sheet or prescription. Six Rights of Drug Administration Prescription What is your nursing role, if a patient refuses to take a Rx? How can a nurse check the medication calculation using the ratio/proportion formula? PowerPoint Presentation Lecture Can a nurse give cough syrup to a patient in a soufflé cup? How does a standing order differ from a routine order? Video: Medication Errors Practice documentation on MAR 16 Re: 12/16/2011 QR
#51-Name the parts of a syringe. Syringe Parts What is the Luer-Lok tip? PowerPoint Presentation Lecture #52-Read the calibrations of the minim and cubic centimeter or milliliter scale on different types of syringes. Syringe Calibration Needle Parts What calibrations are labeled on most syringes? What is a bevel? Chapter 5 #53-Identify the parts of a needle. Needle Protector System How can the needle protector system prevent a needle stick? #54-Identify the meaning of needle protector systems. Administering Regular & NPH Insulin in One Injection #55-Describe, practice, and perfect the technique of preparing two different Universal Precautions drugs in one syringe, such as insulin. Which Insulin will you draw up first in the syringe? What is the purpose of gloves, in preventing transmission of HIV & Hepatitis B? Chapter 5 #56-Describe the precautions needed to prevent the transmission of HIV and Hepatitis B that should be implemented for all patients requiring venipuncture. #57-Describe the purpose of and procedure used for performing a patch testing. Patch Test Can Intradermal tests be used to determine allergenicity to specific antigens? PowerPoint Presentation Lecture 17
#58-Identify the Pharmacological aspect of classification of medications drug classifications used for cardiovascular including the uses, actions, disorders; endocrine & pharmacodynamics, metabolic disorders; eye, indications, ear, nose, sinus, & throat pharmackinetics, disorders; gastrointestinal contraindications, adverse disorders; hematologic effects, and nursing disorders; immunologic implications. disorders; integumentary disorders; liver, biliary, & pancreatic disorders; musculoskeletal disorders; neurologic disorders; peripheral vascular disorders; renal & urinary disorders; reproductive & respiratory disorders; autonomic & central nervous disorders; and various infections. What are the pharmacological aspects of Lanoxin including the classifications uses, actions, pharmacodynamics, indications, pharmackinetics, contraindications, adverse effects, and nursing implications? Basic Pharmacology for Nurses 14 th ed., PowerPoint Presentation / Lecture 18 Re: 12/16/2011 QR
Essentials of Medication Administration VNSG 1227 I have read the above syllabus for VNSG 1409 and understand all statutes presented within its constraints. I understand and agree to adhere to the above syllabus Student s Name: Signnature: Date: ]Re: 12/16/2011 QR