LLCALl1llLS CCnuSluL8A1lCn

Cl u8uC AuMlnl18A1lCn

2 1ypes of law affecLlng nurslng pracLlse

l Crlmlnal Law
8elaLes Lo offenses agalnsL Lhe general publlc
LhaL are deLrlmenLal Lo socleLy as a whole
unlawful use expresslon or admlnlsLraLlon of
a conLrolled subsLance

3 Scheduled urugs accordlng Lo Lhelr use of abuse
poLenLlal
Classlfled by Lhe Comprehenslve urug Abuse
revenLlon ConLrol AcL of 1970

a Schedule l has no valld use are noL avallable
for prescrlpLlon Lx Marl[uana ecsLasy

b Schedule ll
have a valld medlcal use are avallable for
prescrlpLlon buL exhlblL a hlgh abuse poLenLlal
Mlsuse can lead Lo physlcal psychologlcal
dependence
Labels for Lhese drugs marked wlLh a
symbol ll
An order for a narcoLlc ln a hosplLal seLLlng
ls valld for 3 days
Lx Cplum cocalne demerol fenLanyl (paln
rellever)

c Schedule lll lv v classed as havlng less abuse
poLenLlal Lhan schedule ll drugs buL can cause
some physlcal psychologlcal dependence
lll lv v

Sched 3 codelne comblne wlLh aceLamlnophen
asplrln
Sched 4 dlazepam aLlvan phenobarblLal
Sched 3 henylpropanolamlne (ulsudrln neozep)
Cough syrup (codepronL)

ll Clvll law concerned of Lhe legal rlghLs duLles of
prlvaLe persons

1orL legal wrong commlLLed agalnsL a person a
person's properLy whlch renders a person who
commlL ls llable for Lhe damages clvll acLlon

MalpracLlce negllgence on Lhe
negllgence commlsslon or omlsslon of an acL
pursuanL Lo duLy LhaL a reasonably prudenL would
or would noL acL or noL acLlng of whlch Lhe
proxlmaLe cause of ln[ury Lo anoLher person or
properLy

MalpracLlce lmproper or unskllled care Lo Lhe
paLlenL by Lhe nurse lL also refers Lo negllgenL acL
on Lhe course of professlonal performance

LlablllLy lL ls legal responslblllLy for one's acL
makes a flnanclal resLlLuLlon for wrongful acL

8espondeaL superlor leL masLer assumes

Pow can llablllLy be avolded?

4 now and follow lnsLlLuLlonal pollcles
procedures
4 Look up whaL you do noL know
4 uo noL leave medlclnes aL bedslde
4 CharL carefully
4 LlsLen Lo Lhe paLlenL l never Look LhaL
before" Lhe llke
4 uouble check when a dose seems hlgh
MosL oral LableL Z Lo 2 LableLs
4 MosL ln[ecLlons are 3ml
4 Label any powder you dlluLe Label any lv
bag you use
4 Jhen necessary seek advlce from
compeLenL professlonals
4 uo noL admlnlsLer drugs prepared by
anoLher nurse
4 eep drug knowledge up Lo daLe aLLend
semlnars

rlnclples used as guldes for
LLhlcal declslon maklng

AuLonomy
Self deLermlnaLlon
lorm of llberLy ln whlch Lhe lndlvldual has
freedom Lo declde knows Lhe facLs
undersLands Lhem acLs wlLhouL ouLslde
force decelL or consLralns
lor Lhe nurse auLonomy brlngs responslblllLy
Lo dlscuss drug lnformaLlon wlLh Lhe paLlenL
Lo accepL Lhe paLlenL's rlghLs Lo refuse

1ruLhfulness noL Lo lle
eneflcence prlnclple holds LhaL Lhe nurse should
acL ln Lhe besL lnLeresL of paLlenLs
AcLlons are llmlLed by Lhe respecL due Lo Lhe
freedom of Lhe paLlenL Lhe rlghL of paLlenL Lo
self deLermlnaLlon
dolng good"

nonmallflcence prlnclple LhaL holds LhaL Lhe
nurse musL noL lnfllcL harm on Lhe paLlenL musL
prevenL harm whenever posslble
uo noL harm"

ConfldenLlallLy respecL for lnformaLlon learned
from professlonal lnvolvemenL wlLh paLlenL
aLlenL drug Lherapy responses should be
dlscussed only wlLh Lhose who have rlghL Lo
know oLher professlonals curlng Lhe paLlenL

usLlce paLlenL's rlghL Lo recelve Lhe rlghL drug
rlghL dose rlghL rouLe aL Lhe rlghL Llme

lldellLy keep promlses made Lo Lhe paLlenL


10 rlghLs of urug AdmlnlsLraLlon
1 8lghL hyslclan's order
2 8lghL drug
3 8lghL Llme
4 8lghL drug hlsLory
3 8lghL paLlenL assessmenL
6 8lghL dose
7 8lghL paLlenL
8 8lghL rouLe
9 8lghL food Lo drug drug Lo drug lnLeracLlon
10 8lghL documenLaLlon

Common medlcaLlon errors
noL undersLandlng whaL ls ordered
noL admlnlsLerlng whaL ls ordered
noL documenLlng whaL ls ordered

nurses are legally responslble Lo carry ouL/execuLe
physlclan's orders on LreaLmenL and medlcaLlon wlLh
sound [udgemenL

uocLor's order
4 Should be legally wrlLLen bearlng docLor's
slgnaLure
4 JrlLLen orders are beLLer undersLood chances of
error are mlnlmlze of Lhey are clear speclflc
compleLe leglble
4 verbal orders can be mlnlmlzed lf Lhe nurse seeks
clear undersLandlng from Lhe physlclans
esLabllshlng a pollcy concernlng Lhe lmporLance of
wrlLLen orders
4 nurses should demonsLraLe courage and
deLermlnaLlon ln verlfylng orders whlch are noL
clear or erroneous


1elephone orders

ulsadvanLages
4 MlsundersLandlng or mlslnLerpreLlng of Lhe order
4 Messages from Lelephones may sound unclear or
garbled
4 1he slgnaLure of Lhe docLor ls noL presenL Lhe
order may be laLer on denled ln case errors
happen or courL llLlgaLlon arlse
Cnly ln an exLreme emergency when no
oLher resldenL or lnLern ls avallable should a
nurse recelve Lelephone orders
nurse should read back order Lo Lhe physlclan
Lo make cerLaln order has been correcLly
wrlLLen
Such order slgned by Lhe physlclan nexL vlslL
wlLhln 24hrs or afLer shlfL
nurse should slgn Lhe name of Lhe physlclan
per her own name noLe Lhe Llme order was
recelved

3 checks before admlnlsLerlng
efore Laklng ouL Lhe conLalner from Lhe
shelf
efore pourlng or openlng Lhe medlcaLlon
efore replaclng Lhe conLalner or before
glvlng Lhe medlcaLlon Lo Lhe paLlenL

8A 6673 generlcs (don'L glve subsLlLuLe)
8A 3921 harmacy AcL
c name of prescrlber
c Cfflce address
c CllenL's name age sex daLe
admln
c rescrlpLlon
c rof reglsLraLlon no
c rof 1ax recelpL no

hll nurslng acL of 1991 Sec 28 ln admlnlsLraLlon of lv
ln[ecLlons speclal Lralnlng shall be requlred Sn noL
allowed"

oard of nurslng resoluLlon no 8 8n admlnlsLered lv
ln[ecLlon wlLhouL Lralnlng shall be held llable

Culdellnes for MedlcaLlon AdmlnlsLraLlon
4 Cbserve 10 rlghLs of admlnlsLerlng medlcaLlon
4 Jash hands assemble equlpmenL
4 8ead label on Lhe medlcaLlon conLalner 3 Llmes
before admlnlsLerlng
4 lf a dlscrepancy exlsLs or unfamlllar wlLh Lhe
medlcaLlon consulL approprlaLe resources
4 1ake Lhe medlcaLlon Lo Lhe cllenL's room
4 rovlde prlvacy and explaln approprlaLe procedure
Lo Lhe cllenL

C8AL 8Cu1L convenlenL safe
2 forms solld llquld
Assess ablllLy Lo swallow dlarrhea or vomlLlng

Clve pllls flrsL Lhen llqulds Lhen SL meds
Plgh fowlers or slde lylng
1akes effecL usually 3043 mlns

*ellxlrs 30 mlns elapse before glvlng waLer
*anLlLusslve cough syrup no fluld

SuLlnCuAL 8Cu1L
8emember
noL be swallowed or chewed
Should noL eaL or drlnk
noL Lo smoke before dlssolvlng

CllenL w/ anglna weL nlLroglycerln Lab wlLh sallva Llngllng
sensaLlon ls normal lf annoylng buccal pouch

1hlngs Lo remember

O repare medlcaLlon for one cllenL aL a Llme
O Check explraLlon daLes perform calculaLlons
O uo noL open wrapper unLll aL bedslde
O eep narcoLlcs medlcaLlon LhaL requlre speclal
nurslng assessmenLs ln a separaLe conLalner
O Jhen removlng Lab/cap from a boLLle our
necessary number lnLo a boLLle cap place Lab ln
a med cup reak only scored LableLs
O use approprlaLe measurlng devlse when pourlng
llqulds Lhen read Lhe amounLs of medlcaLlon aL
Lhe boLLom of menlscus aL eye level wlpe Lhe llp of
Lhe boLLle w/ a paper Lowel
O CompleLe necessary assessmenLs before
admlnlsLerlng of medlcaLlon Ask lf may allergles
O 8emaln wlLh Lhe cllenL unLll each med ls swallowed
O Check on cllenL wlLhln 30mlns Lo verlfy responses
O Check explraLlons daLes on all LableLs
O ulfflculLy swallowlng sollds check lf avallable
llqulds
O Some Laken on a empLy sLomach (anLldlabeLlc
med) wlLh food (anLlbloLlc)
O Llquld cough mlxLures are noL dlluLed

nCSL u8CS 1 cm above
*sLay puL copy nl mlss 12mlns sa book 33mlns
*Lnu Pead slL up
lf nosebleeds sLop spray for 2 days use sallne

Common drugs
vasoconsLrlcLors shrlnk swollen membranes
Local anesLheLlcs bronchoscopy
CorLlcosLerolds reduce lnflammaLlon by
allergles nasal polyps

LA8 u8CS Z lnch above
O Jarm Lo avold dlzzlness roll ln palms
uon'L use lf
Change ln color
Look cloudy
arLlcles floaLlng
O Lle on unaffecLed 1013mlns 33mlns

Lar lrrlgaLlon head LllLed Lo Lhe affecLed slde polnL Llp of
syrlnge Loward Lhe posLerlor wall of ear canal noL sLralghL
forward Lo Lhe canal 70ml sol

L?L u8C 12 cm above
O lle on affecLed area
O maxlmum of 2 drops walL 3 10 mlns
O press lacrlmal ducL for 3060 secs or 12mlns

ML1L8Lu uCSL lnPALL8 12 lnch (23 3cm) 2 flngers
O deep breaLhlng lnhale 33 secs and sLop 10secs
O gargle w/ nss or h2o
O admlnlsLer nebullzer 1hr before or 2hrs afLer meals
perform chesL physloLherapy

SuCSl1C8?
O lefL laLeral slde lylng rlghL gabend
O sLore ln freezer
O lubrlcaLe Lo avold lrrlLaLlon
O lLA1 Lnu flrsL
O lnserL 4 lnches adulL 2 lnches chlld
O 1 lnch of olnLmenL
O 8lsk of asplraLlon nC alLered LCC
O AuMln 30 mlns before mealLlme

vaglnal cream
refllled dlsposable syrlnge w/ appllcaLor
O vClu before lnserLlon dorsal
O SLay puL for 310 mlns

1ClCAL ALlCA1lCn dermal/mucosal rouLe use
Longue depressor
uec prurlLus
uec dryness sofLer skln
Cause local vasoconsLrlcLlon vasodllaLlon
*heaL rash cornsLarch
O ClnLmenL 6x6 lnch
O p afLer 30mlns

18AnSuL8MAL A1CPLS Lo release conLlnuously
overLlme
*some effecLlve 24hrs 72hrs 1 weeks