Basics of med.

administration
ADM. OF ORAL, TUBE, EYE, EAR, AND TOPICAL
MED. FOR CPNE
3 CHECKS The 6 RIGHTS:
Check The Medication Label Against The MAR;
1) when removing med. from drawer
2) before opening to dispense
3) when returning med to cart or as adm. To pt.
6 rights
1) right pt. ID pt. X 2 name, birth date or pt. #
2) right med. check against MAR X3 (check expiration date)
3) right dose
4) right route
5) right time within 30 minutes of ordered time
6) right documentation (within 30 minutes of giving)
ASSESSMENTS MAY BE NEEDED.
PRIOR to adm.
1) assess related labs prior to administration
2) assess vitals signs if needed
3) assess pt for signs or symptoms that would contradict giving
AFTER administration
1) assess for therapeutic effects
2) assess for side effects
a) PO med. 30 min.
b) Subcutaneous or IM 20-30 min.
c) IV 5-20 min.
THIS IS AN AVERAGE CHECK MED. REFERENCE FOR ONSET/PEAK
KNOWING THE MED. YOUR GIVING.
Therapeutic effect
Normal dose range
Special NSG considerations

Complete needed ASSESSMENTS PRIOR TO ADMINISTERING

Check for allergies AP< 60, BP parameters, PT or PTT times, sx of
bleeding, blood glucose, signs sx hypo/hyperglycemia hospital policy
on double checking certain meds. (Heparin, coumadin, insulin)
adverse effects
ex. Administer NSAIDS with food, iron suspension through
a straw
contraindications
incompatibilities
onset/peak so you can assess the effect (ie; pain med.
insulin)
MED. ADMINISTRATION
PO by mouth
1) swallowed may be liquid, tablet, capsule
BUCCAL
1) between gums and cheek absorbed completely
2) tell pt. not to drink until a few minutes after med.
absorbed
sublingual
1) under tongue until absorbed completely
2) tell pt not to drink until a few min. after med. absorbed.
trouche
1) sucked (ex; cough drop)
ORAL MED. (tid bits)
hold liquid med. bottles with label against palm when
pouring
read measurement from bottom of meniscus
open unit dose packages at bedside
explain to pt what med. is and its purpose
assist pt to upright position to take med.
pt. preference one at a time or all @ once from souffl cup
or in hand.
Offer water or allowed fluid (add to I and O if its monitored
Watch pt take med.
Doc. Administration, refusals, or held med. MAR
Report held or refused med. to primary

PEDIATRIC TIPS PO med.

use syringe or dropper to adm. Liquids to infants place it
between gum and cheek adm (slowly) to prevent aspiration
crush uncoated tabs or empty soft capsules in to food
dont mix meds with a childs favorite food (youll wreck it
for them)
popsicle before giving numbs tongue- if flavor is
objectionable to older peds pt.
Praise the child for a job well done after they take the med.
Teach the parent how to measure and give.
MEDS VIA FEEDING TUBE
follow 3 checks & 6 rights
know your medication
adm. Liquids at room temp
HOB elevated
Suction and feeding off
CHECK PLACEMENT
Flush 15-30 ml adults 5-10 ml children
Give meds
1) separately with 30 cc warm water
2) flush between each drug & after the last
NG suction
1) clamp tube suction disconnected X 30
gastric feeding
1) do NOT turn off cont. feeding without MD order
(source EXCELSIORS skills online)
2) turn feeding off source CPNE chat
document on MAR and add fluids to intake record if
assigned
CHECKING PLACEMENT PH
Check color and pH of aspirate
color

1) GASTRIC FLUID GREEN, OFF-WHITE OR TAN,

BROWN
2) Intestinal fluid yellow or bile colored pH gastric 2-4
respiratory >6
pH
1) GASTRIC FLUID 1.0-4.0 (ACIDIC)
2) Respiratory fluid > 6
MIXING PARENTERAL MED.
know the meds
Check compatibility of meds (valium) & limited compatibility
(must be adm. Within certain time of being drawn up
Check expiration date & date/time opened on vial ampule or
syringe
Check med. for precipitate cloudiness (disguard in
syringe this is a sign of incompatibility)
PROPER ORDER TO WITHDRAW
Multiuse vial to single use vial
Vial to ampule
Insulin clear to cloudy
Dont mix more than 2 meds in 1 syringe
ADMINISTERING EYE DROPS
glove
have tissue handy
pull down the cheek, stabilize hand with dropper on pts
forehead, have pt look up, and place the drop in the
conjunctival sac.
Apply gentle pressure with tissue to inner canthus to
prevent systemic effect.
NOTE; resting the hand with the dropper on the pts face
prevents accidentally contaminating the dropper and/or
injuring eye.
ADMINISTERING EYE OINTMENT.
glove
have pt look up, pull lower lid down
place a ribbon of med. in the conjunctival sac

 apply from INNER canthus to OUTER

stabilize the hand with the med tube on the pts forehead
prevents contamination
twist the tube to break off the ribbon of med. when med.
reaches outer canthus
have pt keep eye closed briefly to aid in dispersing med.
ADMINISTERING EAR DROPS
position pt. to promote drainage of med into ear canal
pull the pinna up and back to straighten the ear canal in an
adult
CHILD LESS THAN 3 YEARS OLD == pull the pinna down
and back to straighten the ear canal in
Do NOT contaminate the dropper by touching the pt.
TOPICAL MEDICATIONS
cleanse skin before applying a topical
do NOT apply a transdermal patch to excoriated tissue,
scars, or hairy area
glove for topical applications
avoid touching the med. area of patches could absorb med.
LABEL patches initial and date/time
FYI ESTROGEN PATCH should NEVER be applied to the breast area