Medication Administration

• 7 Rights
• Physician’s Orders
• Essential Information
• Computation
• Client Teaching
• Documentation

7 Rights
--Right Patient
–Right Drug
–Right Reason
–Right Dose
–Right Route
–Right Time
–Right Documentation
Also check for drug allergies and expiry date of medication

3 Checks Note changes

• When are these completed?
• 3 Checks
–Removing medication bubble pack, envelope or bottle from
drawer
–Pouring medication
–Returning medication to drawer

Physician orders---check the order first --- does it contain the following?

Client’s Name & Identification

–Medication Name
–Amount & Frequency of Dose
–Route of Administration
–Date & Time the prescription was ordered
–Signature of the prescriber

Essential information to know before Administering

• Classification
• Subclasses
• Action/Indication of Use
• Nursing Process
• Principles of therapy
• Nursing Actions – administer accurately,
 • assess therapeutic effects and adverse effects
Medication History
Assess for Allergies.
–Obtain Medication history (including OTC, supplements and herbs)
–Obtain a Medical history (renal, hepatic, respiratory, cardiac, endocrine, neurological-
related health
challenges, substance abuse).
–Assess Pregnancy or Lactation Status

Medication Assessment before medication administered

Assess Diet & Fluid Status.

–Aware of Lab Values
–Ability to Swallow
–Gastrointestinal motility
–Adequate Muscle Mass & Venous
Access
–Vital Signs
–Understanding/Client Rights

Principles
–Accurately interpret physician orders
–Position client in appropriate position when administering medication (oral,
eye/ear/nose, enteral feeding tube, rectal, vaginal, inhalation)
–Have Client drink enough fluid to avoid lodging in esophagus
–Avoid touching medications (tablets, lotions, creams, ointments)
–Follow standards care according to route:
–Liquid
• Keep cap of bottle inverted when placing on counter
• Ensure label of bottle is in the palm of your hand
• Hold liquid medication at eye level
–Transdermal
Ensure previous transdermal patch has been removed
• Rotate sites of administration (s.c., transdermal patches)
• Ensure skin surface is clean/dry/intact, free of hair/bone
• Date/time & initial patch
–Eye
• O.D. (right eye); O.S (left eye); O.U.(both eyes)
• Retract conjunctival sac
• Avoid touching eye/lashes/lid with tip of bottle
• Place pressure on inner canthus to avoid systemic absorption
- Ear
• A.D (right ear); A.S. (left ear); A.U. (both ears)
• Straighten canal up/back (older children/adults) & down/back (infants & children
<3 years)
 • Remain side lying for 5 – 10 mins
• Massage tragus of ear
–Rectal
• Position on left side lying Sims with upper leg flexed upward
• Have client take deep breaths, lubricate supp
• Retract buttocks with nondominant hand
• Insert with dominant index finger, gently past internal sphincter and against rectal
wall
• Avoid inserting suppository in stool
Inhaled
• Use a spacer with children/older adults
• Ensure the canister has been shaken if MDI
• Position mouth piece (without spacer) 2.5 to 5cm away from mouth
• Start inhaling slowly, press on the canister, hold breath for 10-15 seconds
• Wait 1-3 minutes before administering a second puff