Medication Administration
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Medication Administration

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A few things to remember BEFORE you give any medication to your patients.

A few things to remember BEFORE you give any medication to your patients.

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  • 1. Medication Administration We must get it right the first and every time!
  • 2. Five Rights of Administration
    • Right patient
    • Right medication
    • Right dosage
    • Right route
    • Right time
  • 3. Oral Medications
    • Most commonly used route. Absorption through stomach and small intestine.
    • Must first determine client’s ability to swallow medication, and aspiration risk.
    • Anxiety, knowledge deficits, and non-compliance in taking medications should all be assessed.
  • 4. A few tips when preparing oral medications:
    • Prepare medications for one patient at a time.
    • Do not open wrapper until at the bedside.
    • Recheck each medication package or preparation with the order as it is poured.
    • After medications are prepared, recheck them once again with order before taking to client.
  • 5. More tips for oral medications:
    • See that the client receives the medications at the correct time.
    • Identify the patient carefully—especially if they are verbally compromised!
    • Remain with the patient until each medication is swallowed. NEVER leave the medication at the patient’s bedside.
    • Check patient within 30 minutes to verify response to medication!
  • 6. Know your medications!
    • Before administering any unfamiliar medications, know the following:
    • Mode of action and purpose of medication
    • Side effects of and contraindications
    • Antagonist of medication
    • Safe dosage range for medication
    • Interactions with other medications
    • Precautions to take prior to administration
    • Proper administration technique
  • 7. Calculating Dosage:
    • You have a client who is to have 400mg of antibiotic, and you have 200mg tablets.
    • Formula is the following:
      • Dose on hand = Dose desired
      • Quantity on hand X
      • Cross you heart you will never forget!
      • 200 mg = 400mg 200X=400 X=2 tablets
      • 1 tablet X
  • 8. When using the needle/syringe technique:
    • Note the needle gauge (e.g. 18,20). The bigger the number, the SMALLER the bore size.
    • Note the need length (e.g. 1, 11/2). Determine length needed by what type of tissue you are trying to reach.
    • Size of syringe is determined by amount of medication.
  • 9. Angles of different types of injections
  • 10. Sites for subcutaneous injection
  • 11. Subcutaneous injections
    • Should contain no more than 1 ml of fluid
    • Give at 45-90 degree angle.
    • Sites are as follows:
      • Outer aspect of upper arm
      • Abdomen
      • Anterior aspects of thigh
      • Upper back
      • Upper ventral or dorsogluteal area.
    • Insertion site depends on patient’s preference, nurses preference, and type of medication.
  • 12. Intramuscular Injections
    • Should contain nor more than 3-5ml of fluid
    • Normal angle of insertion is 72-90 degrees.
    • Injections sites include:
      • Vastus lateralis
      • Ventrogluteal
      • Deltoid
      • Dorsogluteal
  • 13. Sites for intramuscular injections
  • 14. Insulin and working with vials:
    • A vial is a glass bottle, with a self-sealing stopper.
    • Swab top with antimicrobial swab before entering with a needle. Inject air.
    • Inject air into the vials to allow fluid to be pulled out.
  • 15. Insulins
    • If insulin is a suspension (NPH, Lente) roll and agitate the vial to mix it well.
    • Regular (Actrapid) insulin should never be contaminated with NPH or any insulin modified with added protein (medium and long-acting insulins).
    • Inject air into both vials when they are sitting flat, so that the insulin doesn’t touch the needle tip.
  • 16. Insulin preparation
    • Draw up the Regular (Actrapid) insulin first, and make sure it is not contaminated with the other types of insulin.
    • Roll the cloudy insulin between your hands to mix, and then draw up without over-drawing (have another R.N. observe you doing this).
  • 17. Tap while upside down to remove bubbles
  • 18. Clean area, and bunch up skin to inject
  • 19. Inject the insulin
  • 20. Massage site after subcutaneous—but not with clexane or heparins
  • 21. For lab this week:
    • You will need to work through worksheets on pages 23, 26, 27, 28, 30, 31, 32-33.
    • Have your lab partner/peer sign you off for each of the above sheets.
    • You may also be able to get some worksheets signed off when you are in clinical.