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    Medication Administration

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    Jemma Nocalan
    This document outlines the 6 rights of medication administration and provides guidance on proper procedures. The 6 rights are: right patient, right medication, right dose, right route, right time, and right documentation. Key steps include verifying the medication three times, having another nurse check doses, using two patient identifiers, consulting the healthcare provider on routes, and documenting administration accurately and immediately. Proper administration techniques are described for various medication forms and routes.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Medication Administration

    Uploaded by

    Jemma Nocalan
    26 views10 pages
    This document outlines the 6 rights of medication administration and provides guidance on proper procedures. The 6 rights are: right patient, right medication, right dose, right route, right time, and right documentation. Key steps include verifying the medication three times, having another nurse check doses, using two patient identifiers, consulting the healthcare provider on routes, and documenting administration accurately and immediately. Proper administration techniques are described for various medication forms and routes.

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    MEDICATION ADMINISTRATION

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    This document outlines the 6 rights of medication administration and provides guidance on proper procedures. The 6 rights are: right patient, right medication, right dose, right route, right time, and right documentation. Key steps include verifying the medication three times, having another nurse check doses, using two patient identifiers, consulting the healthcare provider on routes, and documenting administration accurately and immediately. Proper administration techniques are described for various medication forms and routes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views10 pages

    Medication Administration

    Uploaded by

    Jemma Nocalan
    This document outlines the 6 rights of medication administration and provides guidance on proper procedures. The 6 rights are: right patient, right medication, right dose, right route, right time, and right documentation. Key steps include verifying the medication three times, having another nurse check doses, using two patient identifiers, consulting the healthcare provider on routes, and documenting administration accurately and immediately. Proper administration techniques are described for various medication forms and routes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 10

    MEDICATION ADMINISTRATION

    - It is a dependent administration

    6 RIGHTS OF MEDICATION ADMINISTRATION

    1. RIGHT MEDICATION

    Check medication 3 times

    i. Before removing the container from the drawer or shelf


    ii. As the amount of medication ordered is removed from the container
    iii. At the pt's bedside before administering the medication to the patient

    2. RIGHT DOSE
    • Have another qualifies nurse check calculated doses when performing the
    medication to the patient
    • Use standard measurement devices (graduated cups, syringes, scaled droppers) to
    measure accurately
    • WHEN PILLS NEED TO SPLIT:
    ✓ Pharmacist split the meds
    ✓ Label and package them
    ✓ Send them to nurse for administration
    ✓ Use splitting device
    ✓ If possible, HCP need to avoid ordering medication that require splitting

    • WHEN MEDS NEEDS TO BE CRUSHED AND MIXED W/ FOOD


    ✓ Use crushing device
    ✓ Be sure to completely clean a crushing device before crushing the tablet.

    MEDICATION ADMINISTRATION Page 1


    ✓ Be sure to completely clean a crushing device before crushing the tablet.
    ✓ Mixed crushed meds w/ very small amount of food or liquid.
    ✓ X DO NOT USE a pt's fave food or liquids because meds alter their taste.
    ✓ Not all meds are suitable for crushing (e.g enteric-coated tablet)

    3. RIGHT PATIENT
    • Identify the pt with 2 identifiers
    ✓ Name
    ✓ Birthdate/medical record number
    ✓ If an identification bracelet becomes smudge or illegible or is missing, obtain a
    new one.

    4. RIGHT ROUTE

    ✓ Always consult the health care provider (HCP)


    ✓ Alert HCP immediately if the specific route is not the recommended route.

    5. RIGHT TIME
    ✓ Know why meds is ordered for a certain times of the day

    MEDICATION ADMINISTRATION Page 2


    6. RIGHT MEDICATIONS

    ✓ Document meds accurately at the time of administration


    ✓ ADMINISTRATION:
    ▪ BEFORE: ensure that the MAR reflects pt's full name of the ordered
    medication (no abbreviation)
    ▪ AFTER: immediately document which meds was given on a pt's MAR per
    agency policy to verify that it was given as ordered.
    ✓ Document the ff:
    □ Name of meds
    □ Dose
    □ Time of administration
    □ Route on the MAR
    □ Site of injection
    □ Pt's response to meds
    □ Name, time, date of HCP

    X NEVER document that you have given a meds until you have actually given it.

    PHARMACOLOGICAL CONCEPTS

    MEDICATIONS NAMES:

    ▪ Chemical name

    MEDICATION ADMINISTRATION Page 3


    MEDICATIONS NAMES:

    ▪ Chemical name
    - Exact description of meds composition
    ▪ Generic Name
    - Manufacturer who first develops the drugs assigns name
    - "Known name"
    - Example: Paracetamol
    ▪ Trade name
    - "Brand name" or "Proprietary name"
    - Name under which a manufacturer markets the meds.
    ▪

    CLASSIFICATION OF MEDICATIONS
    ✓ EFFECTS
    ✓ SYMPTOMS
    ✓ DESIRED EFFECTS

    MEDICATION FORMS

    ➢ SOLID FORMS
    - ORAL FORM
    ▪ Caplet
    ▪ Capsule
    ▪ Tablet
    ▪ Enteric-coated tablets
    □ Not crushed
    □ Not dissolve in stomach
    □ Dissolved in intestine where meds are absorbed

    MEDICATION ADMINISTRATION Page 4


    CAPLETS TABLET CAPSULE

    ➢ LIQUID FORMS
    ▪ ELIXIR- clear fluid (H2o or C2H6O); often sweetened
    ▪ EXTRACT- concentrated meds form made by removing the active part
    ▪ AQUEOUS SOLUTION- substance dissolve in water & syrups
    ▪ AQUEOUS SUSPENSION- finely dissolves; particles settle to bottom
    ▪ SYRUP- meds dissolved in a concentrated sugar solution

    ➢ TOPICAL ROUTES
    ▪ Ointment
    ▪ Liniment
    ▪ Lotion
    ▪ Paste
    ▪ Transdermal disk/patch

    ➢ INSTALLATION INTO BODY CAVITIES


    ▪ Intraocular disk
    ▪ Suppository (rectum or vagina)

    PHARMACOKINETICS
     (kinetics- movement)
    ➢ ADME
    Absorption Enters the body
    Distribution Movement of drugs between various compartments of the body
    -
    Metabolism Structurally altered into another chemical entity (Liver)
    Excretion Clearance of drug

    TYPES OF MEDICATION ACTION


    ▪ THERAPEUTIC EFFECT
    - Expected or predicted physiological response
    - "desired effect"

    ▪ ADVERSE EFFECT
    MEDICATION ADMINISTRATION Page 5
    ▪ ADVERSE EFFECT
    - Unintended, unexpected
    - Undesired effect

    ▪ TYPES
    □ Side effect- predictable, unavoidable secondary effect
    □ Toxic effect- accumulation of meds into the bloodstream
    □ Idiosyncratic reaction- over/underreaction or different reaction different
    from normal. Idio means unknown.

    ▪ ALLERGIC REACTIONS
    - Unpredictable response to a medication
    - E.g. Skin-test

    ▪ MEDICATION INTERACTION
    - When one meds modifies the action of another
    - (2 meds cannot be together)

    ROUTES OF ADMINISTRATION
    ORAL
    - Easiest and most desirable route for administering meds is by mouth.
    - Pt are able to self-minister oral medications
    ✓ Foods sometimes affects their absorption
    ◊ Give meds on an empty stomach if absorption is decreased
    ◊ Give meds w/ meals if absorption is enhanced by food
    ✓ Oral meds is contraindicated in some situation
    ✓ An important precaution: PROTECT PT FROM ASPIRATION
    ◊ Proper positioning is important; position in fowler's position in 90
    degrees
    ◊ Slightly flex head in a chin-down position if not contraindicated
    ◊ Use multidisciplinary approach

    ▪ PROTECTING PT FROM ASPITATION


    ✓ If possible, allow self-administer to pt
    ✓ Signs of dysphagia
    ✓ Assess pt ability to swallow and cough by checking the presence of GAG
    REFLEX
    ✓ Prepare oral meds that are easy to swallow
    ✓ Upright seated position w/ feet on the floor, hip & knees at 90 degrees,
    head midline and back erect if pos.
    ✓ If pt has unilateral weakness, place the meds on the stronger side of the
    mouth. Turn the head toward weaker side, meds move down the stronger
    side
    ✓ One pills at a time
    ✓ Refer to a meds reference to verify if meds are safe to crush
    ✓ Have pt hold and drink from a cup as poss.
    ✓ Avoid straws
    ✓ Time meds- coincide w/ meals or pt is well rested
    ✓ Use another route if aspiration is severe

    MEDICATION ADMINISTRATION Page 6


    PARENTERAL

    MEDICATION ADMINISTRATION Page 7


    TOPICAL
    ▪ Applied to skin

    INHALATION

    MEDICATION ADMINISTRATION Page 8


    EAR ROUTE

    MEDICATION CALCULATION

    TYPES OF ORDER
    PRN When needed
    STANDING Carried out until the health care provider cancels it by
    ORDER another order or prescribe number of days elapsed.
    E.g. Tetracycline 500 mg PO q6h, Decadron 10 mg daily x
    5 days
    SINGLE (ONE- Given once at a specified time
    TIME) ORDERS Common on preoperative meds
    ▪ E.g. Ativan 1mgIV on call to MRI
    STAT Single dose given immediately at once
    Often for emergencies when a pt's condition change
    suddenly
    NOW When pt needs medics quickly but not right away.
    Nurse has 90 min to administer the meds
    E.g. Vancomycin 1gIV piggyback now
    PRESCRIPTION Take meds outside of the hospital

    MEDICATION ADMINISTRATION Page 9


    MEDICATION ERROR
    ◊ Inaccurate prescribing
    ◊ Administering the wrong medication
    ◊ Giving the meds using the wrong route or time interval
    ◊ Administering extra doses
    ◊ Failing to administer a meds

    MUST DO IF MED ERROR OCCUR:


     Report! (do not ever hide)
     Patient safety is top priority
     Documentation
     Incident report (IR)
     Accurate
     Factual description

    MEDICATION ADMINISTRATION Page 10

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