Explain the two types of order and theresponsibilities in carrying out order List and elaborate the 6 right of administeringmedication Identify the do and don’t in administeringmedication Identify the common abbreviation whenadministering medication Discuss the important consideration ofmedication administration Practice the right technique in administeringmedication by following the 6 rights
Drug(pharmacological definition):A chemical substance administeredfor the diagnosis, cure, treatment,relief or prevention of disease. Usedto otherwise enhance physical ormental well-being
Drug administration is very important andcan be a dangerous duty› Given correctly – restore patient tohealth› Given incorrectly – patient’s conditioncan worsen
Nurses must:› Understand principles of pharmacology› Understand fundamentals of drugadministration Routes Dosage calculations Techniques for injection Six rights Patient education
Standing Order- it is carried out until thespecified period of time or until it isdiscontinued by another order. Single Order- it is carried out for one time only. Stat Order- it is carried out at once orimmediately. PRN Order- it is carried out as the patientrequires.
1. Observe the “6 Rights” of drugadministration.› 1. Right drug› 2. Right dose› 3. Right time› 4. Right route› 5. Right patient› 6. Right documentation
2. Practice asepsis 3. Nurses who administer medicationsare responsible for their own actions.Question any order that you considerincorrect. 4. Be knowledgeable about medicationsthat you administer. 5. keep narcotics and barbiturates inlocked place. 6. Use only medications that are clearlylabeled containers in.
7. Return liquid that are cloudy or havechanged in colour to the pharmacy 8. Before administering a medication,identify the client correctly. 9. Do not leave the medications at thebedside. 10. If the client vomits after taking oralmedication, report this to the nurse incharge and/or physician.
Identify the drug from the Dr.’s order. Clarifywith the Dr. if in doubt.Check the drug three times:- before removing it from the trolley or shelf- when the drug is removed from the container- before the container is returned to storage- check the expiry date of the drugCheck the drug with another RN for DDA &barbiturate.
The nurse should be familiar with thegeneric drug name as well as the tradename. The use of generic name in clinicalpractice is preferred to reduce the risk ofmedication errors.
- Check the dose, read the containerlabel, calculate the dose & checkwith a RN if necessary.- Use proper measuring devices forliquids, do not crush tablets or opencapsules unless directed to by thepharmacist. (do not crush entericcoated tablets).
If a drug is required in another form youmay get it from the pharmacy. Pediatric & elderly more sensitive tomedications – need extra caution withdrug dosage.
For routine medication orders, themedications must be given no more than30 min before or after the actual timespecified in the prescriber’s order. E.g.,9.00am med, may be given between8.30am-9.30am. The effect of changing in dosing or timingof medication should never beunderestimate because one missed dose ofcertain medication can be life threatening.
Other factors must be considered whendetermining the right time e.g., multipledrug therapy, drug-drug or drug-foodcompatibility, scheduling of diagnosticstudies, bioavailability of drug (e.g., theneed for consistence timing of dosesaround the clock to maintain bloodlevels), drug actions, and any biorhythmeffects such as occur with steroids.
Oral Route Forms: a) solid: tablet, capsule, pill,powder. b) liquid: syrup, suspension, emulsion. Enteric coated tablets should not be crushedbefore administration. Suspensions are neveradministered intravenously. If the patientvomits within 20 – 30mins of taking the drugs,notify the physician. Do not readminister thedrug without a physicians order.
2. Sublingual- drug placed under thetongue, where it dissolves. 3. Buccal- medication is held in the mouthagainst the mucous membranes. of thecheek until the drug dissolves. 4. Topical a) Dermatologic- lotions,liniments, ointment, pastes and powders. b)Ophthalmic- instillations and irrigations. c)Otic, d) Nasal, e) Inhalation, f) Vaginal-tablet, cream, jelly, foam, suppository 5. Rectal- (objectionable taste or odor)
6. Parenteral- administration of medications byneedle. a) Intradermal (ID)- under the epidermis (into thedermis). b) subcutaneous (SC)- in the subcutaneoustissue (also, hypodermic) c) intramuscular (IM)- into the muscle. d) intravenous (IV)- into a vein. e) intraarterial- into an artery. f) intraosseous- into the bone.
› Checking the pt’s identity before givingeach medication dose is critical to thept’s safety.› Ask the patient to state his/her name andcheck his ID band to confirm pt’s name,ID number, age, and allergies against themedication chart.
Documentation of information r/toadministrations is crucial to pt safety. The pt’s chart should always have thefollowing:› Date & time of the medication administered› Name of medication, dose, route & site ofadministration.› Drug action – to assess the changes ofsymptoms the pt experiencing, adverseeffects, toxicity & other drug-related physical& physiologic symptoms.
Improvement of the pt’s condition,symptom, disease process. No changes/lack of improvement. Patient’s teaching/degree of pt’sunderstanding.
Other info:› if a drug not administered & reason why?› Refusal of a medication & reason for refusal.› Actual time of drug administration› Data regarding clinical observations &treatment of the pt if a medication error hasoccurred.
Drugs can have three types of names:a. chemicalb. genericc. trade/brand/proprietary
a.Chemical name:- a very precise description of the drug’schemical composition, identifying thedrug’s atomic and molecular structure.- this name is of significance to thepharmacist.
b. Generic name:- The name assigned by themanufacturer who first develops thedrug. Often the generic name is derivedfrom the chemical name.- the official name is the name by whichthe drug is identified in the officialpublication.
c.Trade/ Brand/ Proprietary name:- Is selected by the drug companyselling the drug and is copyrighted- a drug can have several trade nameswhen produced by differentmanufacturers
e.g. Chemical name= Acetylsalicylic acidGeneric name = AspirinTrade names include Aspro, DisprinBe aware that in different countriesgeneric and trade names will also differ,e.g. in Australia & the United States onedrug has the generic names ofparacetamol & acetaminophen, i.e.Panadol/Tylenol.
Drugs can be classified from differentperspectivese.g. drugs may be classified by -(a) body systemsi.e. drugs affecting the respiratory systemdrugs affecting the cardiovascular systemOR(b) the symptom relieved by the drug, or theclinical indication for the drug i.e. analgesic,antibiotic
MANE MIDI NOCTE BD/BID TDS/TID QID STAT PRN morning midday Night twice a day three times a day four times a day give immediately when requiredwhen necessary
ac Pc q.h.or 1/24 q2h or 2/24 q4h or 4/24 qod before meals after meals every hour every two hours every four hours Every other day