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,

Medication History
Assess for Allergies. –Obtain Medication history (including OTC, supplements and herbs) –Obtain a Medical history (renal, hepatic, respiratory, cardiac, endocrine, neurologicalrelated health challenges, substance abuse). –Assess Pregnancy or Lactation Status

assess therapeutic effects and adverse effects

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