ADMINISTERING ORAL MEDICATION

1. Perform hand hygiene.

2. Prepare medication, adhering to five rights of drug
administration.
3. Identify client by reading identification bracelet and
by addressing client by name.
4. explain procedure and purpose of drug.
5. prepare equipment needed.
6. Verify any allergies listed on medication record or
electronic medication record.
7. obtain preassessment data.
8. Separate drugs that might be withheld on
preassessment data.
9. Assist client in semi-Fowler’s or sitting position.
10. Don gloves if there is possibility of exposure to
oral secretions.
11. Open unit-dose packages and place one drug in
client’s hand or pour in medication cup and give to
client; provide assistance if needed.
12. Instruct client to place tablets or capsules into
mouth and to follow with enough liquid to ensure.
13. Administer liquid medications after pills,
instructing client to drink all of the solution; provide
assistance if needed.
14. Remain with client until all medications are taken;
check mouth if there is any question of whether drug
has been swallowed.
15. Reposition client and place call light within reach.
16. Lift side rails.
17. Discard or restore equipment properly
 If client refuses drug or drug has not been given for
any reason, DO NOT leave drug at the bedside.
 Remove drug from the room and restore in
medication drawer or cabinet only if unopened
unit-dose package
 If unit-dose package has been opened, discard in
sink, or flush down toilet, with witness present, if
necessary.
18. Remove gloves and perform hand hygiene
19. Document administration in medication
administration record
20. Assess client 30-60 mins after administration and
document client’s response to medication.
ATTITUDE
1. Accepts constructive suggestions and criticisms
2. Assume responsibility of his or her actions.

PREPARING MEDICATION FROM A

VIAL
PROCEDURE
1. Perform hand hygiene.
2. Organize equipment
3. Check label of medication vial with medication
record or electronic medication record using five
rights of drug administration.
4. Perform dosage calculations if vial contains more
medication than client requires.
5. Remove thin seal cap from top of vial without
touching rubber stopper.
6. Firmly wipe rubber stopper on top of vial with
alcohol swab.
6.1 Read the instruction at vial label as to the
amount of diluent you are going to use.
6.2 Dilute/reconstitute the powder drug in the vial.
7. Pull end of plunger back to fill syringe with a
volume of air equal to the amount of solution to be
drawn up, do not touch inside of plunger.
8. Remove needle cap and needle if necessary.
9.Using a slightly slanted angle, firmly insert needle
into center of rubber top of vial, with the sharpest
point of the needle (tip of bevel) entering first.
10. Continue insertion until needle is securely in vial
yet above the level of fluid.
11. Press end of plunger of down to instill air to vial.
12. Hold vial with non-dominant hand and turn it up,
keeping needle/spike inserted; control syringe with
dominant hand and keep plunger down with thumb.
13.Pull needle/spike back to point at which bevel is
beneath fluid level.; keep needle/spike beneath fluid
as long as fluid is being withdrawn.
14. Slowly pull end of plunger back until appropriate
amount of solution is aspirated into syringe.
15. if air bubbles enter syringe, gently flick syringe
barrel with fingers of dominant hand; keep a finger on
end of plunger; continue holding vial with non-
dominant hand.
16. Push plunger in until air is out of syringe.
17. withdraw additional solution if needed.
18. Pull needle out of bottle while keeping a finger on
end of plunger. Apply sterile needle to syringe if
IM/SQ or ID injections will be given.
19. If bubbles remain in syringe:
- hold syringe vertically (with needle pointing up if
attached).
- Pull back slightly on plunger and flick syringe with
fingers.
Slowly push plunger up to release air, but not to the
point of expelling the solution.
20. Recheck amount of solution in syringe comparing
with drug volume required.
21. Compare drug label with medication record or
electronic record.
22. Change needle, if used to withdraw the solution
from the vial and drug is known to be irritating to
tissue; replace cap.
23. Label syringe with drug name and amount of
drug.
24. Place syringe, medication record, and additional
alcohol swabs on medication tray.
25. Discard or restore all equipment appropriately.
26. Perform hand hygiene
ATTITUDE
1. Accepts constructive suggestions and criticisms
2. Assume responsibility of his or her actions.

ADMINISTERING INTRADERMAL
MEDICATIONS
PROCEDURE
Perform hand hygiene.
Prepare drug to be administered according to
the five rights of drug administration.
Identify client by checking identification
bracelet and by addressing client by name.
Explain procedure and purpose of medication
to client.
Verify allergies listed on medication record or
electronic medication record.
Don gloves.
Select injection site on forearm if no other site
is required by agency policy or doctor’s
orders; use alternative sites if forearm cannot
be used.
Position client with forearm facing up
Cleanse site with alcohol, using a circular
motion starting from the center and working
outward. Allow alcohol to dry.
Remove needle cap.
Place non dominant thumb about 1 inch below
insertion site and pull skin down (town hand).
Talk to client and warn of impending
needlestick.
With bevel up and using dominant hand, insert
needle just below the skin at a 10-15-degree
angle.
Once entry into skin surface is made, advance
needle another 1/8 inch.
Inject drug slowly and smoothly while
observing for bleb (a raised welt) to form (the
bleb should be present).
Remove at same angle that it was inserted.
Gently remove blood, if any, by dabbing with
second alcohol swab.
Observe skin for redness or swelling; if this is
an allergy test; observe for systematic reaction
(e.g. respiratory difficulty, sweating, faintness,
decreased blood pressure, nausea, vomiting,
cyanosis).
Reassess client and injection site after 5
minutes, after 15 minutes, then periodically
while client remains in clinic.
Place and capped needle on tray. Remove
gloves.
Mark with blue or black pen around the bleb
and instruct client not to rub area.
Reposition client.
 Discard equipment appropriately.
Perform hand hygiene.
Document administration on medication
record.
ATTITUDE OF THE STUDENT
Accepts constructive suggestions and
criticisms.
Assumes accountability.
 ADMINISTERING INTRAMUSCULAR
MEDICATION
PROCEDURE
Perform hand hygiene.
Prepare medication adhering to the five rights of
drug administration.
Identify client by checking identification bracelet
and by addressing client by name.
Explain procedure and purpose of medication to
client.
Verify allergies listed on medication record or
electronic medication record.
Don gloves.
Select injection site appropriate for client’s size
and age.
Assist client into position for comfort and easy
visibility of injection site.
Cleanse site with alcohol swab.
Remove needle cap.
Pull skin taut by at insertion by using the
following sequence:
Place thumb and index finger of non-dominant
hand over injection site (taking care not to touch
cleaned area) to from a V.
Pull thumb and index finger in opposing direction
spreading fingers about 3 in
Talk to client and warn of impending needlestick
Quickly insert needle at a 90-degree angle with
dominant hand (as if throwing a dart).
Move thumb and first finger of non-dominant
from skin to support barrel of syringe; place
fingers on the barrel.
Pull back on plunger and aspirate for blood return
in syringe.
If blood does return when aspirating pulls the
needle out, apply pressure to the insertion site and
repeat injection steps.
If no blood returns, push plunger slowly and
smoothly; encourage client to talk or take deep
breaths.
Remove needle at the same angle as it was
inserted.
 Massage and lean insertion are with second
alcohol wipe (if contraindicated for drug, apply
firm pressure instead).
Place needle on tray; do not recap.
Remove gloves.
Reposition client; raise siderails and place bed in
lowest position with call light within reach.
Discard equipment appropriately.
Perform hand hygiene.
Document administration on medication record.
ATTITUDE OF THE STUDENT
Accepts constructive suggestions and criticisms.
Assumes accountability.