1. .
Medication Aide Chapters 1-5

2. Things to know
 Class is from
 Breaks
 Restrooms
 Smoking
 Vending machines
 Parking lot
 Food and drink
 Cell phones
 Questions
 If you need to step out

3. Foreword
 January 13, 1975
 Non-parenteral medications by unlicensed personnel
 Approved by
 Iowa Board of Nursing
 Iowa Department of Health
 Iowa Board of Pharmacy Examiners

4. Cont.
 June, 1978
 Iowa Legislature gave the Iowa Board of Pharmacy
Examiners the right to determine who can
administer medications other than physicians,
podiatrists, and dentists
 Persons who have successfully completed a medication
administration course approved by the Iowa Department of
Health and the Iowa Board of Pharmacy Examiners
 Advanced emergency medical technicians and paramedics
 Registered physician assistants

5. Purpose of this course
 The purpose of the course is to prepare people to
safely administer nonparenteral medications in
nursing facilities and related areas
 You need to pay attention, take notes, and study to
successful reach competencies in all skills and
knowledge required

6. Quote to remember
 In the administration of medications there is no
place for luck. Therefore, we wish each of you success
in achieving your goals.
• UNIVERSITY OF IOWA CERTIFICATION CENTER, 2011

7. Introduction
 Wellness is a predominate factor in health care.
 Medications influence consumer at all ages in
different ways.
 Safety in drug preparation, administration,
documentation and follow-up is essential.
 As a medication aide, learning the principles and procedure of
safe medication administration will help you to do your part to
ensure resident safety in the area of medications.

8. Course overview
 This is a 50-60 hour course which consists of 40-42
classroom hours and 10-20 clinical hours
 A minimum of 10 hours clinical.
 This will be in your individual facilities under the supervision
of a RN Both you & the RN will need to sign off on the
individual skill sheets in your workbook starting on p 109.
 The emphasis is on the safe administration and
students are provided theory and practice to achieve
course competencies.

9. Course pre-requisites
 Substance free and currently working in a facility
 If employed in a certified nursing facility
 All applicants must be employed for at least six months by the facility
sponsor
 Must be on the nurse aide registry
 Provide recommendation from the administrator in the facility in
which they are employed
 If employed in a residential or related type of licensed
facility
 All applicants must be employed for at least six months by facility
sponsor
 Must provide evidence of successful completion of residential
attendant course
 Provide recommendation from the administrator in the facility in
which they are employed

10. Cont….
 .
 If applicants are working in more than one type of
facility, it is recommended that the higher
requirements be met to allow applicant to legally
work in multiple assignment areas.

11. continue
 Medication aide from other states
 Written documentation of current certification of medication
aide in other state
 Successfully complete nurse aide written and skills
competency test prior to challenging written exam
 Successfully complete medication aide challenge exam (both
written and skill competency exams)

12. Why take the course?
• These courses provide background information that will assist
the applicant in successfully completing the Medication Aide
course.

13. Requirements for class
 Course Instructor:
 The course instructor must be an RN for both didactic and clinical
 Course methodology:
 Classroom, laboratory, and clinical activities
 Required textbook Mosby’s Textbook for Medication Assistants
 Course evaluation:
 You must pass the course with 80%. Successful completion of clinical
hours with written documentation from the RN supervising you
 Successful completion:
 Both portions of the course; classroom and clinical, must be
completed with 6 months of the beginning of the course. Upon
successfully completing course a certificate will be mailed to you
from the college.

14. Medication Aide Competencies
 Describe the role and responsibilities of the
medication aide
 Discuss general information related to the
administration of nonparenteral medications and
explain how this information assists the medication
aide in safely administrating nonparenteral
medications
 Administer nonparenteral medications
 Utilize information regarding medication
classifications when administrating medications

15. Requirements for Class
 2 vocabulary tests (20 pts each)
 3 tests (100 pts. each) There is an optional 4th test
that can be completed if necessary
 Final state exam this will be completed after
completing your 10 hrs. of clinical
 Clinical hours (at your facility)
 Can be started after the 3rd day if you have passed your 1st tests
 Completion of 20 med cards

16. Medication Cards (20 on 4x6 note cards)
 Name: Brand & Generic
 Dose
 Side effects
 Nsg. Precautions
 Classification as to family
 What is to do?
 Anything unusual about the medication
 Place to find information:
 Discovery.com
 Health.msm.com
 Drugs.com
 Drug hand books
 These can be started on day 4 based on meds from your facility 4-5
from each chapter beginning with chapter 10

17. Unit I
This unit will examine the role of the medication
aide, what the medication aide will be prepared to
do, and what the medication aide is not prepared to
do. The legislation regarding administration of
medications will be discussed. Safety in
administering medication is also included.

18. Introduction
 The guidelines to ensure the safety of consumers
who receive medications are shared by both the
federal and state governments. Federal and state
laws identify safe practices for the preparation,
issuance, and administration of drugs. Federal and
state agencies are required to see that these laws are
enforced. The purpose of the legislation and the
agency enforcement is to protect the consumer as
well as the health care worker who assists in the
preparation, dispensing, and administration of
drugs.

19. Cont….
 The laws and rules for implementing the laws provide for
safe standards of care. This requires that credentialing of
the various levels of health workers who order, dispense,
and administer medications. The credentialing assures
that each health worker has been educationally prepared
to assume responsibility within the assigned role. Each
person who orders, dispenses, or administers medication
IS RESPONSIBLE for his/her own actions. This
responsibility requires the health care worker to be aware
of the medical-legal problems that could arise when
medications are administered to consumers.
 The nurse you work under is responsible and so are you
personally

20. Where do medication aides work?
 Nursing facilities
 Residential care facilities
 Residential facilities for mentally retarded
 Residential facilities for the mentally ill
 Intermediate facilities for MR and mentally ill
 Assisted living
 NOT hospitals!

21. Role of the medication aide
 Very important role in health care!
 Always use sound judgment, be honest, have moral
integrity, use common sense, be accurate, and
develop good observational skills.
 Should be able to determine when to refer to the
licensed professional.

22. Terms
 Nursing assistant personnel
 CNA
 CMA
 Nurse practice act
 Regulates the nursing practice in each state
 Allows denying, revoking, and suspending licenses and
certifications
 Main purpose is to protect the puplic’s safety &
welfare

23. Terms
 Patient
 Client
 Resident
 Consumer
 All of these people are seeking a service that we as health care
providers, provide.

24. Regulatory Agencies
 State Board of Nursing
 Department of Inspections and Appeals
 Department of Human Services
 Make sure standards of care are met
 Refers to the skills, care, and judgment required by nursing
assistive personnel under similar conditions.

25. Professional Boundaries
 Separates helpful behaviors from behaviors that are not helpful
 Boundary crossing
 Brief act or behavior outside the helpful zone (something thoughtless
you didn’t mean to do)
 Boundary Violation
 Acts or behaviors that meet your own needs (abuse, too much self-
disclosure)
 Professional sexual misconduct
 Act, behavior, or comment sexual in nature
 Boundary signs
 Acts, behaviors, or thoughts that warm boundary crossing (accepting
gifts from residents)

26. Responsibilities
 To yourself
 To legally and ethically protect themselves the aide must have
knowledge which includes basic preparation through class and
continued study of new methods for the administration of
medications. Don’t stop learning!
 Must know your limits. What you can and can’t do
 Knowledge of resident’s rights
 Right to know
 Right to refuse
 Dignity and privacy
 Right to self administration
 A right to a competent, caring medication aide

27. The organization
 You owe loyalty to the organization for which you
work.
 You are responsible for knowing and following your
facility policies.
 Know and respect the roles of others
 Work as a team
 I teach you the basic, but you need to learn your
facility policy and protocols.
 This does take time

28. Job description
 Give only medicines from written orders of the
prescriber. You need an order for everything- even
chap stick!
 Work within your scope of practice

29. Know or look up
 Intended use/why is this consumer receiving this
medication
 When is this medication expected to work
 Side effects which might occur
 Interactions with other medications, food, alcohol,
herbals
 Special administration and storage considerations
 Is this a controlled substance: if so, which schedule is
it in?

30. 6 rights
 Right person
 Right drug
 Right time
 Right route
 Right dose
 Right documentation

31. special physical conditions
 Know if consumer is allergic to certain medications,
ability to swallow and how this might affect how
medication is administrated
 “As needed drugs” determined by nurse
 Safe medication to prevent complications- prevent
errors
 Report signs and symptoms, side effects, and adverse
reactions to the nurse
 Give as needed drugs as specified by nurse
 Prevent drug errors

32. What to report to the nurse
Life threatening signs/symptoms
Life threatening events
Drugs that have no results as observed or reported to
you
Drugs that have undesirable effects as observed or
reported to you

33. Measure, report, record measurements as related
to ordered drugs
 Vital signs
 Weight/height
 Intake/output
 Blood glucose

34. Cont.
 Record drugs given following agency procedure and
policy
 Follow agency policy/procedure for reporting and
recording drug errors or suspected drug errors

35. Follow administration rules
 Right dose
 Right medication
 Right consumer
 Right time
 Right method
 Record
 Know the 6 rights!!!!!

36. limitations
 Do not give drugs, unless allowed by state law, if:
 Person’s need for drug must be assessed by licensed nurse
 Drug requires dosage calculation
 Dosage of drug must be converted from one measurement
system to another
 Nurse not available to monitor person’s progress
 Nurse not available to monitor how drug affects person
 Person is not stable
 Person’s nursing needs are changing

37. Medication Aides CANNOT do
 Parenteral medications
 Take medication order
 Transcribe order
 Calculate dosage
 Return medication to container or dispose of
medications
 PRN medications
 Enteral medications
 Wound care
 Oxygen, nebulizers
 Enemas

38. Cont.
 Glucose monitoring(unless trained by a RN,
according to the manufacture’s instructions-
completes a return demo-must be repeated every 6
mo, keep a copy for you & in your personnel file)
 Preparations of meds for outings
 Re-label medication containers or transfer
medication from one container to another
 Distribute medication someone else has set up or
take medications from an unmarked or soiled
container

39. Delegation
 Nurse legally accountable for nursing task; delegates
administration of medications to medication aide
 Nurse provides clear/complete directions
 Must be within the scope of practice and training of a
medication aide
 Assesses person’s need for drug
 Determines need for PRN drugs
 Assesses and evaluates side effects
 Recognizes allergic reactions
 Assesses/evaluates immediate desired effects
 Assesses/evaluates unusual effects

40. Cont.
 Recognizes when drug use is harmful
 Recognizes when drug is no longer needed
 Anticipates effects which affects the person’s life or
well-being
 Make judgment/decision of action to take if person’s
life/wellbeing is threatened

41. Four steps to delegation
 Assess and plan
 Communication- clear, complete direction
 Surveillance and Supervision
 Evaluation and Feedback

42. Five Rights of Delegation
 The right task
 The right circumstance
 The right person
 The right directions and communication
 The right supervision

43. Your choice
 Accepting the task
 When you agree to perform a task, you are responsible for your
own actions.
 Refusing the task
 you have the right to say “no”
 Tell the nurse about your concerns

44. Ethical conduct
 Knowledge of right and wrong
 Be nonjudgmental and nonbiased
 Do not cause person harm
 Based on person’s values/standards
 Code of conduct
 Residents rights

45. Duty to facility/organization
 Facility policies
 Administrator
 Supervising nurse
 Physician
 Pharmacist

46. Duty to self
 Knowledgeable
 Medication information
 Medication preparation
 Medication administration
 Recording/reporting
 Facility policies
 Legal responsibilities
 Know limitations
 Drug free

47. Advance directives
 Living will
 Document about measures that support or maintain life when
death is likely (tube feedings, CPR)
 Durable power of attorney for health care
 Gives power to another person to make health care decisions
in the even you can no longer do this.
 Do not resuscitate (no code)

48. Federal legislation related to medication
use/administration
 Drug legislation
 Pure Food, Drug and Cosmetic Act of 1938
 Determine safety/effectiveness of drugs
 Ensure manufactures meet labeling requirements
 Ensure advertising standards met
 Legal classifications of drugs
 Over the counter drugs
 Prescription drugs
 Controlled substances

49. Comprehensive Drug Abuse Preventions and
Control Act of 1970
 Drug classification
 Schedule 1 drugs (Experimental, high potential for abuse)
 Schedule 2 (accepted medical use, still high potential for
abuse)
 Schedule 3 (high potential for abuse, moderate to low physical
dependence, high psychological dependence)
 Schedule 4 (low potential for abuse)
 Schedule 5 (prescription not needed)

50. Torts and Crimes
 Civil laws
 Concerned with relationships between people.
 Criminal laws
 Concerned with offenses against the public and society in
general
 Torts
 A wrong committed against a person or the person’s property
 Negligence
 Unintended wrong
 Malpractice
 Negligence by a professional person

51. Intentional Torts
 Defamation
 Injuring a person’s name and reputation by making false statements to a third
person.
 Libel
 Making false statements in print, writing, or through pictures or drawings
 Slander
 Making a false statement orally
 False imprisonment
 Unlawful restraint or restriction of a person’s freedom of movement
 Invasion of privacy
 Violating a person’s right not to have his or her name, photo, or private affairs
exposed or made public without giving consent
 Protected health information
 HIPAA (Health Insurance Portability and Accountability Act 1996)
 Fraud
 Saying of doing something to trick, fool, or deceive a person

52. Assault & Battery
 Assault
 Intentionally attempting or threatening to touch a person’s
body without the person’s consent
 Battery
 Touching a person’s body without his or her consent.

53. Possession of a controlled substance
 Federal and state laws make the possession of
controlled substances a crime.
 Can have a controlled substance in your possession
if:
 Administering the medication to a person while on a outing
 The person is receiving the medication themselves
 The official custodian of a limited supply of a controlled
substance

54. Abuse
 Is the intentional mistreatment or harm of another
person
 Abuse has one or more of these elements
 Willful causing of injury
 Unreasonable confinement
 Intimidation (to make afraid with threats, force, or violence)
 Punishment
 Depriving the person of the goods or services needed for
physical, mental, or psychological well-being

55. Vulnerable adults
 Are persons 18 years or older who have disabilities or
conditions that make them at risk to be wounded,
attacked, or damaged.
 Mental, emotional, physical, or developmental disability
 Brain damage
 Changes from aging

56. Elder abuse
 Physical abuse
 Neglect
 Verbal abuse
 Involuntary seclusion
 Financial exploitation
 Emotional abuse
 Sexual abuse
 Abandonment

57. Child Abuse and Neglect
 Involve the following
 Child 18 years or younger
 Recent act or failure to act on the part of a parent or caregiver
 The act or failure to act results in death, serious physical or
emotional harm, sexual abuse, or exploitation
 The act or failure to act presents a likely or immediate risk for
harm

58. Types of child abuse
 Physical abuse
 Neglect
 Sexual abuse
 Molestation
 Rape or sexual assault
 Child pornography
 Incest
 Child prostitution
 Emotional abuse
 Substance abuse
 Abandonment

59. Domestic abuse
 Domestic violence, partner abuse
 Physical abuse
 Sexual abuse
 Verbal abuse
 Economic abuse
 Social abuse

60. Nursing process
 Assessment
 Observation (see, listen, touch, smell)
 Objective data (signs seen, heard, smelled)
 Subjective data (symptoms resident tells you)
 Nursing diagnosis
 P. 31 box 4-3
 Planning
 Nursing interventions
 Nursing care plan
 Implementation
 Evaluation

61. Observations to report immediately
 Change in the ability to respond
 Change in mobility
 Complaints of sudden, severe pain
 Sore or reddened area on skin
 Complaint of sudden vision change
 Complaint of pain/difficulty breathing
 Abnormal respirations
 Complaint of signs of difficulty swallowing
 Vomiting
 Bleeding
 Vital signs outside normal ranges

62. Processing of measuring vital signs & etc..
 Accurate measurements
 Temperature
 Pulse
 Respirations
 Blood pressure
 Pain
 Height & Weight
 Blood glucose testing

63. How to accurately report
 Report care and observations
 Resident’s name, room #
 Time observation made, care given
 Report as resident’s condition changes
 Report changes from normal at once
 Record
 What you observed
 What you did
 The resident’s response
 Complete medication record (drugs given, time)

64. Rules for recording
 Write in ink and writing readable, neat
 Include date, time of each entry
 Use only approved abbreviations
 Use correct spelling, grammar, punctuation
 Don’t use ditto marks
 Never erase or use correction fluid (white out)
 Sign all entries with name, title
 Do not skip lines
 Make sure form has resident’s name and identification
 Record only what observe and did

65. Cont…
 Do not record for someone else
 Don’t chart until procedure, treatment, or care is
complete
 Be accurate, concise, factual
 Be descriptive
 Use person’s exact words
 Chart changes from normal
 Do not omit information
 Record safety measure used

66. Cont….
 The person in control of the key to medication
cabinet is determined by each facility. The key is to
be carried by the person directly responsible for the
administration of drugs. If you are the responsible
person, KEEP IT WITH YOU AT ALL TIMES!!!!
 Medication storage and handling:
 Iowa Department of Inspections and Appeals developed the
Rules and Regulations regarding drugs, storage and handling
in nursing facilities.

67. Basic structure of the cell
 Cell
 Cell membrane (covering)
 Nucleus (control center)
 Cytoplasm (surrounds the nucleus)
 Protoplasm (living substance within the cell)
 Chromosomes (carries genes, each cell has 46)
• Mitosis
 Tissue growth and repair (cell division)
 Tissue (groups of cells) role
 Epithelial (covers internal and external body surfaces)
 Connective (anchors, connects, and supports other tissues)
 Muscle (stretches and contracts to let body move)
 Nerve tissue (receives and carries impulses to the brain and back to
body parts)

68.  Organs
 A group of tissue with the same function form. Has one or
more functions
 Systems
 Formed by organs that work together to perform special
functions.

69. Systems
 Integumentary (skin)
 Layers
 Epidermis
 Dermis
 Subcutaneous tissue
 Appendages
 Hair
 Nails
 Sweat glands
 Oil glands
 Functions
 Protective covering
 Prevents microorganisms, other from enter body
 Prevents loss of excess fluids from body
 Helps regulate body temperature
 Nerve endings sense pleasant, unpleasant stimulations

70. Systems cont.
 Musculoskeletal
 Bones
 Long bones (bear body weight)
 Short bones (allow skill and easy movement)
 Flat bones (protect organs)
 Irregular bones (vertebrae and spinal column)
 Joints
 Cartilage
 Synovial fluid
 Synovial membrane
 Ligaments
 Ball and socket joint
 Hinge joint
 Pivot joint

71. Cont.
 Muscles
 Voluntary muscles
 Involuntary muscles
 Cardiac muscle
 Move body parts, maintain posture, produce heat
 Tendons connect muscle to bone
 Function
 Provide framework for body
 Lets body move
 Protects body
 Gives body shape

72. Nervous system
 Central nervous system
 Brain
 Spinal cord
 meninges
 Peripheral nervous system
 Cranial nerves
 Spinal nerves
 Sympathetic nervous system
 Parasympathetic nervous system
 Function
 Nerves carry messages to and from brain
 Brain controls reasoning, speech, memory, consciousness, voluntary
muscles movement, vision, sensation, balance, vital functions,
involuntary processes

73. Sensory Organs
 Eye
 Sclera (white part)
 Choroid (blood vessels)
 Pupil (middle of the iris)
 Retina (inner layer- receptor)
 Aqueous chamber (separates cornea from lens)
 Aqueous & Vitreous humor (maintains eye shape)
 Optic nerve (carries messages)
 Cornea (light enters)
 Ear
 External ear (pinna)
 Middle ear (malleus, incus, stapes)
 Inner ear (semicircular canals, cochlea)
 Auditory nerve

74. Circulatory System
 Blood
 Red blood cells (hemoglobin- picks up oxygen)
 White blood cells (leukocytes- fights infection)
 Platelets (thrombocytes- for blood clotting)
 Plasma (carries substances the body needs)
 Function
 Carriers food, oxygen, etc… to cell
 Remove waste products from cells
 Helps regulate body temperature
 Assists in preventing & fighting infection

75. Cont…
 Heart
 Layers (pericardium, myocardium, endocardium)
 Chambers (right & left atrium, right & left ventricles)
 Valves (tricuspid & mitral)
 Phases (diastole & systole)
 Function- pump blood to body

76. Cont…
 Blood vessels
 Arteries (carry blood away from the heart)
 Veins (return blood to the heart)
 Capillaries (tiny vessels where food oxygen exchanged for
waste products)
 Function- system to move blood throughout body

77. Respiratory system
 Respiration
 Inhalation
 exhalation
 Upper airway
 Nose
 Pharynx
 Larynx
 epiglottis
 Lower airway
 Trachea
 Lungs
 Right & left bronchus
 Bronchioles
 alveoli

78. Cont…
 Diaphragm
 Ribs, sternum, vertebrae
 function:- provide oxygen to body, remove carbon
dioxide

79. Digestive System
 Gastro-intestinal or GI system or Alimentary Canal
 Digestion- breakdown of food for use by cells
 Mouth
 Pharynx
 Esophagus
 Stomach
 Small intestines (duodenum, jejunum, ileum)
 Large intestine (colon)
 rectum

80. Cont…
 Accessary organs
 Teeth, tongue
 Salivary glands
 Liver
 Gallbladder
 pancreas
 Peristalsis
 Involuntary muscle contraction

81. Urinary system
 Kidneys
 Nephrons
 Convoluted tubules
 Bowman’s capsule
 Glomerulus
 Collecting tubule
 Renal pelvis
 Ureter
 Bladder
 Urethra
 Meatus
 Function
 Remove waste products from body
 Maintain water balance in body

82. Reproductive system
 Male
 Testes
 Epididymis
 Vas deferens
 Seminal vesicle
 Sperm
 Ejaculatory duct
 Prostate gland
 Scrotum
 Hormone- testosterone

83. Cont…
 Female
 Ovaries
 Eggs
 Fallopian tubes
 Uterus
 Vagina
 Hormones – estrogen, progesterone
 Mammary glands

84. Endocrine system
 Endocrine glands
 Pituitary (master gland)
 GH, TSH, ACTH
 ADH, and oxytocin
 Thyroid gland (regulates metabolism)
 Parathyroid glands (regulates calcium use)
 Adrenal gland (produce energy quickly in emergency)
 Pancreas (regulates amount of sugar in blood, produces
insulin)
 Gonads (glands for reproduction)

85. Immune system
 Protects body from disease & infection
 Antibodies
 Antigens
 Phagocytes
 Lymphocytes
 B lymphocytes
 T lymphocytes