Welcome, new nurses! We know transitioning from nursing school to working in a hospital can be challenging, but don’t worry! I’m here to help you every step of the way. Today, let’s dive into the world of common med-surg medications and some administration tips to help you get started on the right foot. Grab your pen and paper, and let’s get started! 💉
Common Med-Surg Medications You’ll Encounter
First, let’s explore the various types of common med-surg medications you’ll likely come across in your daily practice. These medications can be categorized into a few broad groups:
Pain-relief medications play a crucial role in managing patients’ pain and discomfort. There are several types of analgesics, including:
- Acetaminophen (e.g., Tylenol), a non-opioid analgesic that relieves mild to moderate pain and reduces fever.
- You may see it abbreviated as APAP
- BIG SAFETY ALERT: People can easily overdose on this medication, as it can be given in combination with many others. If your patient receives any acetaminophen-containing product that you are aware of how many milligrams they have ingested over a 24-hour period.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Advil) and naproxen (e.g., Aleve), which are used to alleviate pain, inflammation, and fever. These are most often oral tablets.
- Opioids, like morphine and oxycodone, which are powerful painkillers prescribed for moderate to severe pain. These are often given via IV.
Medications that prevent blood clot formation are essential for patients at risk of deep vein thrombosis, pulmonary embolism, or stroke. Some common anticoagulants include:
- Heparin, an injectable anticoagulant often used for rapid anticoagulation in acute situations. You may give this as an intermittent subcutaneous injection to prevent blood clots, or as a continuous drip for more serious situations.
- Warfarin (e.g., Coumadin), an oral anticoagulant typically prescribed for long-term therapy. This is given in pill form, often for patients at high risk for blood clots, and patients can go home on it.
There are many anticoagulants on the market, and more seem to keep coming out!
Medications that lower blood pressure help manage hypertension and prevent complications like heart attack and stroke. Key classes of antihypertensives include:
- ACE inhibitors, such as lisinopril (e.g., Prinivil) and enalapril (e.g., Vasotec), which relax blood vessels by inhibiting angiotensin-converting enzyme.
- Beta-blockers, like metoprolol (e.g., Lopressor) and atenolol (e.g., Tenormin), which reduce heart rate and blood pressure by blocking the effects of adrenaline on the heart.
As a med-surg nurse, you’ll give antihypertensives in both pill and IV form. The oral form is often given for normal blood pressure maintenance, while IV forms tend to be given to treat surges in blood pressure that need to be quickly controlled.
Drugs that treat bacterial infections are critical for managing various conditions, ranging from skin infections to pneumonia. Some common classes of antibiotics are:
- Penicillins, such as amoxicillin (e.g., Amoxil) and penicillin G, which are effective against a broad range of bacteria.
- Cephalosporins, like ceftriaxone (e.g., Rocephin) and cephalexin (e.g., Keflex), which are commonly used to treat respiratory, skin, and urinary tract infections.
You may give antibiotics in pill form or in IV form. Intravenous antibiotics are more potent. As a med-surg nurse, the key for these meds is to watch out for adverse reactions and ensuring the timing is right.
For a comprehensive list of med surg medication types, check out the American Nurses Association’s medication guide.
(Psst – we go through all of the common med-surg meds in my comprehensive med-surg review course here.)
Essential Tips for Med-Surg Medication Administration
Now that we’ve identified the common med-surg medications, it’s time to discuss best practices for administering them. I’m here to guide you, so let’s make sure you provide the safest and most effective care to your patients. Here are some tips to ensure top-notch med surg medication administration.
Double-Check the Five Rights 🖐️
Before administering any medication, always double-check the our five rights. They are:
- Right patient
- Right medication
- Right dose
- Right route
- Right time
This practice reduces the risk of medication errors and helps ensure patient safety. Remember, it’s always better to be safe than sorry, so don’t hesitate to double-check! 😊
Educate Your Patients 📚
As nurses, it’s our responsibility to educate patients about their medications. Take the time to explain the purpose, dosage, and potential side effects of each med surg medication. Encourage patients to ask questions and provide them with reliable resources, such as the U.S. National Library of Medicine’s MedlinePlus. Remember, an informed patient is an empowered patient! 💪
Your hospital may have a medication education database, where you can print off information for the patient/family to read more about it. You may also have other resources at your disposal – like a pharmacist! When patients are started on particularly serious or new medications that involve risk, pharmacists may come to the bedside to explain more about them.
Assess and Monitor
After administering a med surg medication, closely monitor the patient for any adverse reactions or side effects. Watch out for things like hives, itching, stomach upset, diarrhea, nausea, vital sign changes, telemetry changes, and more. Because these symptoms are so common and hospitalized patients are often on many medications, it can be challenging identifying if the patient does not tolerate the medication well. (So don’t be too hard on yourself if you miss something!)
It’s helpful to know which meds the patient already routinely takes (hint: look at their home medication list!) so you can know if there is a history of allergies or intolerances to similar meds. I also often got into the habit of asking patients a simple question whenever I was giving them a new med, “Have you ever taken this medication before?” You may be surprised with the answers you get!
Quick story: A front-line medication for treating hypertension is lisinopril. I had a patient who had new high blood pressure, so the physician ordered that medication. Before I gave it to him, I asked him that key question. His wife immediately spoke up, “Oh he’s VERY allergic to that! His tongue swells up and he almost died when they gave him that last time!” Apparently, it wasn’t listed as an allergy in the chart, which is why the doc was able to order it. The patient recently had a neurological injury, so he wasn’t able to recall that particular event, but his wife definitely did!
What to Do When You Make a Medication Error 😓
We all make mistakes, and it’s essential to know how to handle them. If you make a medication error, follow these steps:
- Assess the patient: Check for any adverse effects and provide necessary interventions.
- Report the error: Notify your charge nurse or supervisor immediately.
- Document the error: Record the details of the error and the actions taken in response.
- Reflect and learn: Analyze the error and identify ways to prevent it in the future.
Remember, it’s better to learn from our mistakes than to hide them. You’re a human, and humans make mistakes. Don’t beat yourself up; grow and move forward!💪
What to Do When Your Patient Refuses Their Meds 🙅
If a patient refuses their medication, follow these tips:
- Communicate: Validate the patient’s concerns and provide information about the medication’s importance.
- Involve the healthcare team: Consult with the prescriber, pharmacist, or other team members for alternative options.
- Document: Record the refusal, the reason, and any actions taken in the patient’s chart.
If a patient repeatedly refuses a medication, talk with the ordering provider. It might be worthwhile for him or her to have a direct conversation about it with the patient, and if the patient decides against taking it, then it needs to be removed from the medication list.
Even simple meds, like stool softeners, have a purpose. Physicians will need to know if there are meds that are routinely refused. The last thing you’d want is to just document “refused” on Colace and Senna for two weeks only for the patient to develop an ileus!
Remember: Patients have every right to refuse a medication. As long as you have educated them and ensure they understand the risk vs. benefit (this is informed consent!) then you have done your duty. You cannot force people to take medications they are unwilling to take.
Common Med-Surg Medications: Efficiency Tips ⏰
Administering medications safely and efficiently is key to providing top-notch care. Here are some tips to help you streamline the process:
- Double-check due medications before gathering supplies: Save time by confirming the medications, doses, and times in advance so that you’re not running back and forth.
- Plan for special requests and time-sensitive meds: At the beginning of the shift, note which medications will require you to give them during a strict time-frame, like insulin and Lovenox, and plan your other task around those (provided everyone else is stable).
- Cluster care: Minimize trips to the med and supply rooms by grouping tasks together whenever possible.
- For patients requiring routine pain medication: Before going to get their routine medications, stop in and ask them if they need any pain medication before you go to the med room. This will prevent them asking for pain meds after you’ve gathered all medications and administration supplies and cut down on time.
By following these tips, you’ll be able to provide care effectively and efficiently, without compromising safety.
More Resources for Med-Surg Nurses 📚
To further support your journey as a med-surg nurse, check out these helpful blog posts from FreshRN.com, specifically tailored for med-surg nurses like you.
- Med-Surg Nursing: Top Tips for New Nurses
- Responsibilities of Day Shift Med-Surg Nurses vs. Night Shift Med Surg Nurses
- Med-Surg Report Sheet: The Perfect Med Surg Brain Sheet
- Med-Surg Patients and Procedures: What to Expect and How to Prepare
Keep learning and growing, my dear nurses! 💖
In conclusion, understanding common med-surg medications and their administration is vital for new nurses transitioning to the hospital setting. By following the tips provided in this blog post and staying informed, you’ll be well on your way to a successful nursing career. I believe in you! Happy nursing! 🎉
Are you a new Med-Surg nurse?
Med-Surg Mindset from FreshRN is the ultimate resource for nurses new to this complex and dynamic acute care nursing specialty. Whether you are fresh out of nursing school or an experienced nurse starting out in med-surg for the first time, the learning curve is steep. With input from three experienced bedside nurses, this comprehensive course is all you need to learn all of the unspoken and must-know information to become a safe, confident, and successful medical-surgical nurse.