Complementary and Alternative Medicine

T.LEWANAVANUA- FIJI SCHOOL OF NURSING2014

PRINCIPLES . 1. THE HEALING POWER OF

NATURE2. PATIENT CENTERED RATHER

THAN PHYSICIAN CENTERED:

3. RESULTS GENERALLY TAKE LONGER

4. IV.USE OF NATURAL AND WHOLE SUBSTANCES

5. HIGHER STANDARD OF HEALTH

Major Domains of CAM

1. DIET &HERBAL 2. Traditional alternative

medicine3. Body4. External energy5. Mind6. Senses.

Why do people use CAM?• Desire for health and wellness

(1)• Prevention• Pain• Very few individuals rely

exclusively upon alternative modalities .

• Most individuals who use CAM do so because of preference

Some common beliefs and values

• The body has self-healing potential.• Body mind and spirit are all important.• Therapy must be individualized.• People are responsible for their own healing.

NURSING IN EMERGENCY• DEFINITION: 1.Emergency Nursing is a nursing

specialty in which nurses care for patients in the emergency or critical phase of their illness or injury.

EMERGENCY MEDICINE1.MORHINE2.OXYGEN3.NITROGLYCERINE4.ASPRIN5.ATROPINE6.EPINEPHERINE7.DOPAMINE8.ADRENALINE

CARDIAC EMERGENCY DRUGS

DRUG CALCULATION PRESENTATIONConversions:

• 1 liter (L) = 1000 ml (milliters) • 1 gram (g) = 1000 mgs

(milligrams)• 1 mg (milligrams) = 1000

mcgs (micrograms)• 1 gram (g) = 15 grain (gr)• 1 grain (gr) = 60 mg

(milligrams)• 1 dram (dr) =4 ml (milliters)• 1 ounce (oz) = 30 ml

(milliters)• 1 drop (gtt) = 15 minims

• 1 tsp (teaspoon) = 5 ml (milliters)

• 1 tbs (tablespoon) = 15 ml (milliters)

• 1 kg (kilogram) = 2.2 lbs (pounds)

• 1 inch = 2.54 cm (centimeters)• 16 ounces (ozs) = 1 lb (pound)• 1 cup = 8 ounces (ozs)• 1 ml (milliter) = 15 minims• 1 tsp (teaspoon) = 5 ml

(milliters)• 1 tbs (tablespoon) = 15 ml

(milliters)

IV Drip Rate Calculation: drops per minute (dpm)• mls to infuse (X) drip factor ------------------- ----------- = gtts/min. minutes (min.) to infuse 1

Calculating IV rates: mls per hour:

Total volume to be given------------------------------------ = mls per hour.Time ( in hours)

Calculating mixtures & Solutions

Dose to be given stock volume--------------------- x --------------- = amt of solutions to be givenStock strength 1

Calculating Tablets• Dose to be Given• --------------------- = Number of Tablets• Stock Strength

Calculating IV Rates: Time RemainingVolume remaining ( in mls) drop factor----------------------------- x -------------- = minutes remainingDrops per minute 1

Drug Names:• Generic Names are official names used by the

drug companies (Acetaminophen).

• Trade or Brand Names are names assigned to a product by its manufacturer (Tylenol).

Recommended Volume for Administration Per Sites:Intramuscular injection = 3.0 ml per site

(1 ml in the deltoid)

Intradermal = 0.1 ml (example PPD, allergy testing)Subcutaneous injection = 0.5-1.0 ml per siteIV injection (IV push) = 1-60 ml

Practice Question:

Practice Question

Practice Question

Practice Question:

Practice Question

Practice Question

Client Rights of Medication Administration• Right Patient• Right medication• Right dose• Right Route• Right Time• Right documentation• Right Reason• Right Response

General Principles of accurate drug administration• Follow the ‘rights’ consistently• Learn essential information about each drug• Interpret prescriber’s orders correctly• Read labels for right medication and concentration• Minimize the use of abbreviations• Calculate dosages correctly• Measure doses accurately

General Principles of accurate drug administration ( Con’t)• Use appropriate anatomic landmarks to identify sites of IM injections-follow manufacturers recommendations• Verify client identity• *****Seek information about the client’s medical diagnoses and condition in relation to drug administration• Be especially vigilant with children to avoid errors

Legal Responsibilities• Nurse is legally responsible for safe

and accurate administration of medications

• Nurse is expected to have sufficient drug knowledge to recognize and question erroneous orders

• Unit dose wrappings of oral drugs should be left in place until the nurse is in the presence of the client and ready to administer the medication

Medication Orders• Include the full name of the patient• Generic or trade name of the drug• The dose, the route and frequency of

administration• Date, time and signature of the prescriber

Common abbreviations• PO• IM• IV• SL• Sub cut• Supp

Times of Drug Administration• ac• Ad lib• bid, tid, qid• PRN• Stat• pc

Drug Dosages• cc• g• Gr• gtt• mL• oz• Tsp• tbsp

Routes of Administration• Oral• Via GI tube• Parenteral-IM, IV and sub cut• Topical• Rectal, ophthalmic• Optic• Vaginal

Sites for injections• Sub q-abdomen, thighs, back and upper

arms• IM-deltoid, dorsogluteal, ventrogluteal and

vastus lateralis muscles• IV-antecubital, hands, arms, external jugular• Others: intradermal, intra-articular, intra-

arterial and intrathecal