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Medication Administration

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

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Medication Administration

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

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