Help! I'm trying to understand this med test for employmentRegister Today!
- by tempestxoxo Jan 5, '11Okay so I have been offered a LPN job but I have to pass a medication test first and some of it isn't explained thoroughly so I need some help please!
General safe medication practice: Management of pain?
Medication and patient safety: Synthroid appropriate administration time (same time each day?)? and bronchodilaters: close oberservation and documentation of patient symptoms after dosing?
Thank you so much for the help!
- Jan 5, '11 by systolyWhat specifically is your question? Are you asking for instance, what to document after admin of bronchodilator and what to monitor for?
- Jan 5, '11 by tempestxoxoI'm not sure, that exactly how it says on the study guide and I don't understand what exactly it's asking??
- Jan 5, '11 by systolyI don't think it's that complicated. Take the bronchodilater for example: what is the desired effect? What would be an undesired, yet expected effect (Albuterol vs. Xopenex)?
- Jan 17, '11 by momwithlicenseSafe medication practices should be the 5 rights of medication administration you learned. Right patient, medication, dose, route and documentation.
Pain management requires assessment of pain before med, using pain scale and reassessment after med kicks in and to document the result. Synthroid is always given in the am before food. Bronchodilaters you will have to look up in your drug guide as there are short and long acting. Your drug guide is your best friend, it will give you the info you need regarding medication interactions, adverse effects and assessments. Good luck
- Nov 29, '12 by jagged777Thanks
- Nov 29, '12 by notmanydaysoffanother good question that may be asked, 'specially in a LTC setting, what pills can not be crushed?
- Synthroid is given on an empty stomach - typically 11-7 gives at 6 or 7 am - though my facility is experimenting with 4 pm for Residents that don't want to be woken early.
The guidelines for assessment of nebulizers are the ones Medicare expects documentation of - and also good practice. Medicare wants you to assess mental status before and after, heart rate before and after (important because albuterol can speed the heart rate and should not be given when it is greater than 140 - or per facility policy/MD) O2 Sat before and after, Lung sounds before and after (shows why you are giving and whether it is effective) cough before and after and length of time given - 10/15 minutes which relates to reimbursement of nursing time. All of this info needs to be charted.
Medicare regs are the most challenging part of working in LTC - but it's how your facility gets reimbursed.
- Also quality of cough and whether it's productive or non.
Pain management - you want to document if they have pain, where, how they describe it, rate it according to the scale your facility uses either 1-10 or 1-5 by what they say or by the facial scale - what you see - and always document whether pain is relieved or what number on the scale the pain would be about 30 to 60 minutes after. Also document what non medication measures you used, repositioning, ice (better be an order though) If it is not effective - make sure you document what you did.
If you are giving a narcotic always check respirations before or after as it can depress them.
Any psych med given such as Ativan (lorazepam) for any reason must have very good documentation before re behaviors and after for effect and must list what was done to try and calm resident without med.
Sleeping pills also require before and after notes.
I also recommend reviewing insulin onsets duration and administration.
- And general safe practice generally means wash your hands before and after patient care/ med administration and know the patient rights right time, right med, right person, right to refuse, etc. Check med three times, check expiration dates, bring a paper towel in room to put eye drops/ etc on for clean surface. Know when to wear gloves (anything invasive) patient privacy (anything invasive) time between eye drops, leave cart locked When you walk away, whew, all stuff you learned in school... Know what standard precautions, contact and isolation are...
You will do fine.