MEDICATIONMEDICATIONADMINISTRATIONADMINISTRATIONJay U. OcateBSN4
PRINCIPLES OF MEDICATIONPRINCIPLES OF MEDICATIONADMINISTRATIONADMINISTRATIONI. OBSERVE THE RIGHTS OF DRUGADMINISTRATION
1.The Right Medication – when administeringmedications, the nurse compares the label ofthe medication container with medicationform.The nurse does this 3 times:a. Before removing the container from thedrawer or shelfb. As the amount of medication ordered isremoved from the containerc. Before returning the container to the storage
2. Right Dose –when performing medicationcalculation or conversions, the nurse should haveanother3. Right Client – an important step inadministering medication safely is being sure themedication is given to the right client.To identify the client correctly: The nurse check themedication administration form against theclient’s identification bracelet and asks the clientto state his or her name to ensure the client’sidentification bracelet has the correct information.
4. RIGHT ROUTE – if a prescriber’s orderdoes nor designate a route ofadministration, the nurse consult theprescriber. Likewise, if the specified routeis not recommended, the nurse should alertthe prescriber immediately.
6. RIGHT DOCUMENTATIONDocumentation is an important part of safemedication administrationa. The documentation for the medicationshould clearly reflect the client’s name, thename of the ordered medication,the time, dose,route and frequencyb. Sign medication sheet immediately afteradministration of the drug
5. RIGHT TIMEa. the nurse must know why a medication isordered for certain times of the day andwhether thetime schedule can be alteredb. each institution has are commended timeschedule for medications ordered at frequentintervalc. Medication that must act at certain times aregiven priority (e.g insulin should be given at aprecise interval before a meal )
CLIENT’S RIGHT RELATED TOCLIENT’S RIGHT RELATED TOMEDICATION ADMINISTRATIONMEDICATION ADMINISTRATIONa. To be informed of the medication’s name,purpose, action, and potential undesiredeffects.b. To refuse a medication regardless of theconsequencesc. To have a qualified nurses or physiciansassess medication history, including allergies
d. To be properly advised of the experimentalnature of medication therapy and to givewritten consent for its usee. To received labeled medications safelywithout discomfort in accordance with the sixrights of medication administration.f. To receive appropriate supportive therapy inrelation to medication therapyg. To not receive unnecessary medications
II – Practice Asepsis – wash hand before andafter preparing the medication to reducetransfer of microorganisms.III – Nurse who administer the medications areresponsible for their own action. Question anyorder that you considered incorrect (may beunclear or appropriate)
IV – Be knowledgeable about the medicationthat you administer“A FUNDAMENTAL RULE OF SAFE DRUGADMINISTRATION IS: “NEVERADMINISTER AN UNFAMILIARMEDICATION”
V – Keep the Narcotics in locked place.VI– Use only medications that are in clearlylabeled containers. Relabeling of drugs are theresponsibility of the pharmacist.VII – Return liquid that are cloudy in color to thepharmacyVIII – Before administering medication, identifythe client correctly
X – Do not leave the medication at the bedside. Staywith the client until he actually takes themedications.X – The nurse who prepares the drug administers it..Only the nurse prepares the drug knows what thedrug is. Do not accept endorsement of medication.XI – If the client vomits after taking the medication,report this to the nurse in-charge or physician.
XII – Preoperative medications are usuallydiscontinued during the postoperative periodunless ordered to be continued.XIII- When a medication is omitted for any reason,record the fact together with the reason.XIV – When the medication error is made, report itimmediately to the nurse in-charge or physician.To implement necessary measures immediately.This may prevent any adverse effects of the drug.
Medication AdministrationMedication AdministrationORALa. The easiest and most desirable way toadminister medicationb. Most convenientc. Safe, does nor break skin barrierd. Usually less expensive
Disadvantagesa. Inappropriate if client cannot swallowand if GIT has reduced motilityb. Inappropriate for client with nausea andvomitingc. Drug may have unpleasant tasted. Drug may discolor the teethe. Drug may irritate the gastric mucosaf. Drug may be aspirated by seriously illpatient.
SUBLINGUALa. A drug that is placed under thetongue, where it dissolves.b. When the medication is in capsuleand ordered sublingually, the fluid mustbe aspirated from the capsule and placedunder the tongue.c. A medication given by the sublingualroute should not be swallowed, or desireeffects will not be achieved
Advantages:a. Same as oralb. Drug is rapidly absorbed in thebloodstreamDisadvantagesa. If swallowed, drug may be inactivated bygastric juices.b. Drug must remain under the tongue untildissolved and absorbed
3. BUCCALa. A medication is held in the mouth against themucous membranes of the cheek until the drugdissolves.b. The medication should not be chewed,swallowed, or placed under the tongue (e.gsustained release nitroglycerine, opiates,antiemetics, tranquilizer, sedatives)c. Client should be taught to alternate the cheekswith each subsequent dose to avoid mucosalirritation
Advantages:a. Same as oralb. Drug can be administered for local effectc. Ensures greater potency because drugdirectly enters the blood and bypass theliverDisadvantages: If swallowed, drug may be inactivated bygastric juice
4. TOPICAL – Application of medication to a4. TOPICAL – Application of medication to acircumscribed area of the body.circumscribed area of the body.DermatologicOphthalmicOticNasalInhalationVaginalRectalParenteral
Parenteral RouteParenteral Route--administration of medication by needle.--administration of medication by needle.Intradermalunder the epidermis.Indicated for allergy and tuberculin testingand for vaccinations.Site:Inner lower armUpper chest and backBeneath the scapula
c. Use the needle gauge 25, 26, 27: needlelength 3/8”, 5/8” or ½”d. Needle at 10–15 degree angle; bevel up.e. Inject a small amount of drug slowly over 3to 5 seconds to form a wheal or bleb.f. Do not massage the site of injection. Toprevent irritation of the site, and to preventabsorption of the drug into thesubcutaneous.
Subcutaneous – vaccines, heparin,preoperative medication, insulin, narcotics.Sites: outer aspect of the upper arms anterior aspect of the thighs Abdomen Scapular areas of the upper back Ventrogluteal Dorsogluteal
a. Only small doses of medication should beinjected via SC route.b. Rotate site of injection to minimize tissuedamage.c. Needle length and gauge are the same as for IDinjectionsd. Use 5/8 needle for adults when the injection is toadminister at 45 degree angle; ½ is use at a 90degree angle.e. For thin patients: 45 degree angle of needle.f. For obese patient: 90 degree angle of needle
For heparin injection:--do not aspirate.--Do not massage the injection site to preventhematoma formationFor insulin injection:--Do not massage to prevent rapid absorptionwhich may result to hypoglycemic reaction.--Always inject insulin at 90 degrees angle toadminister the medication in the pocket betweenthe subcutaneous and muscle layer. Adjust thelength of the needle depending on the size of theclient.
For other medications, aspirate beforeinjection of medication to check if the bloodvessel had been hit. If blood appears onpulling back of the plunger of the syringe,remove the needle and discard themedication and equipment.
IM injection --Z tract injectiona. Used for parenteral iron preparation. Toseal the drug deep into the muscles andprevent permanent staining of the skin.b. Retract the skin laterally, inject themedication slowly. Hold retraction of skinuntil the needle is withdrawnc. Do not massage the site of injection toprevent leakage into the subcutaneous.