MEDICATION

ADMINISTRATION
(Parenteral Drugs Preparation
and Administration)

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
OBJECTIVES
Demonstrate the correct methods and best practice
for safe medication administration.

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
Preparing Parenteral Medication:
AMPULE

(1) Tap top of ampule lightly and quickly with finger until
fluid moves from neck of ampule

(2) Place small gauze pad or unopened alcohol swab

just above neck of ampule

(3) Snap neck of ampule quickly and firmly away from

hands

(4) Draw up medication quickly, using filter needle long

enough to reach bottom of ampule.

(5) Hold ampule upside down or set it on a flat surface

with filter needle in center of ampule opening. Do not
allow needle tip or shaft to touch rim of ampule.
By: Hannah P. Alegarme, MAN
Faculty, College of Nursing, Midwifery, and Radiologic Technology
Preparing Parenteral Medication:
AMPULE
(6) Aspirate medication into syringe by gently pulling back on
plunger

(7) Keep needle tip under surface of liquid. Tip ampule to

bring all fluid within reach of needle.

(8) If air bubbles are aspirated, do not expel air into ampule.

(9) To expel excess air bubbles, remove needle from ampule. Hold
syringe with needle pointing up. Tap side of syringe to cause
bubbles to rise toward needle. Draw back slightly on plunger and
push plunger upward to eject air. Do not eject fluid.

(10) If syringe contains excess fluid, use sink or other specially designated area for medication
disposal. Hold syringe vertically with needle tip up and slanted slightly toward sink. Slowly
eject excess fluid into sink. Recheck fluid level in syringe by holding it vertically.

(11) Cover needle with its safety sheath or scoop needle to recap. Replace filter needle
with safety needle or needleless access device for injection.
By: Hannah P. Alegarme, MAN
Faculty, College of Nursing, Midwifery, and Radiologic Technology
Preparing Parenteral Medication:
VIAL CONTAINING SOLUTION
(1) Remove cap covering top of unused vial to expose sterile rubber seal, keeping
rubber seal sterile. If a multidose vial has been used before, cap is already
removed. Firmly and briskly wipe surface of rubber seal with alcohol swab and
allow it to dry
(2) Pick up syringe and remove needle cap or cap covering needleless vial
access device. Pull back on plunger to draw amount of air into syringe equal to
volume of medication to be aspirated from vial.

(3) With vial on flat surface, insert tip of needle with beveled tip entering first or
needleless access device through center of rubber seal. Apply pressure to tip of
needle during insertion.

(4) Inject air into the airspace of the vial, holding on to plunger. Hold plunger with
firm pressure; air pressure within the vial sometimes forces the plunger
backward.

(5) Invert vial while keeping firm hold on syringe and plunger. Hold vial between thumb
and middle fingers of nondominant hand. Grasp end of syringe barrel and plunger with
thumb and forefinger of dominant hand to counteract pressure in vial.
By: Hannah P. Alegarme, MAN
Faculty, College of Nursing, Midwifery, and Radiologic Technology
Preparing Parenteral Medication:
VIAL CONTAINING SOLUTION
(6) Keep tip of needle below fluid level.

(7) Allow air pressure from vial to fill syringe gradually with medication. If
necessary, pull back slightly on plunger to obtain correct amount of solution.

(8) When desired volume is obtained, position needle into airspace of vial; tap
side of syringe barrel carefully to dislodge any air bubbles. Eject any air
remaining at top of syringe into vial.

(9) Remove needle from vial by pulling back on barrel of syringe.

(10) Hold syringe at eye level at 90-degree angle to ensure correct volume and
absence of air bubbles. Remove any remaining air by tapping barrel to dislodge air
bubbles. Draw back slightly on plunger; push plunger upward to eject air. Do not
eject fluid. Recheck volume of medication.

(11) If medication will be injected into patient’s tissue, change needle to

appropriate gauge and length according to route of medication.

(12) For multidose vial make label that includes date of mixing,
concentration of medication per milliliter, and your initials.
By: Hannah P. Alegarme, MAN
Faculty, College of Nursing, Midwifery, and Radiologic Technology
Preparing Parenteral Medication:
VIAL CONTAINING POWDER (RECONSTITUTING MEDICATIONS)

(1) Remove cap covering vial of powdered medication and cap

covering vial of proper diluent. Firmly swab both seals with
alcohol swab and allow to dry

(2) Draw up diluent into syringe.

(3) Insert tip of safety needle or needleless access device

through center of rubber seal of vial of powdered
medication. Inject diluent into vial. Remove needle

(4) Mix medication thoroughly. Roll in palms. Do not shake.

(5) Reconstituted medication in vial is ready to be drawn into

new syringe. Read label carefully to determine dose after
reconstitution.

(6) Prepare medication in syringe.

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
Administering Injection:
SUBCUTANEOUS

(1) For average-size patient, pinch skin with

nondominant hand.

(2) Inject needle quickly and firmly at 45- to 90-degree angle. Release
skin. Option: Continue to pinch skin and release after injecting
medications.

(3) For obese patient pinch skin at site and inject needle
at 90-degree angle below tissue fold.

(4) Inject medication slowly.

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
Administering Injection:
INTRAMUSCULAR

(1) Position ulnar aspect of your nondominant hand just below site and pull
skin approximately 2.5 to 3.5 cm (1.5 inches) down or laterally to administer
in a Z-track. Hold position until medication is injected. With dominant hand
inject needle quickly at 90-degree angle into muscle.

(2) Option: If patient’s muscle mass is small, grasp body of muscle

between thumb and fingers.
healthline.com

(3) Insert needle into the muscle using a smooth, steady motion. After needle
pierces skin, grasp lower end of syringe barrel with nondominant hand to
stabilize syringe. Continue to hold skin tightly with nondominant hand. Move
dominant hand to end of plunger. Do not move syringe.

(4) Pull back on plunger 5 to 10 seconds. If no blood appears, inject medicine

slowly, at a rate of 1 mL/10 seconds.

(5) Wait 10 seconds. Then smoothly and steadily withdraw

needle and release skin.

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
Administering Injection:
INTRADERMAL

(1) With nondominant hand stretch skin oversite with forefinger or

thumb.

(2) With needle almost against patient’s skin, insert it slowly with
bevel up at a 5- to 15-degree angle until resistance is felt. Advance it
through epidermis to approximately 3 mm ( 1 8 inch) below skin
surface. You will see needle tip through skin.

(3) Inject medication slowly. Normally you feel resistance. If not,

needle is too deep; remove and begin again. Nondominant hand can
stabilize needle during the injection.

(4) While injecting medication, notice that small bleb

approximately 6 mm ( 1 4 inch) in diameter (resembling
mosquito bite) appears on surface of skin. Instruct patient
that this is a normal finding.

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
REFERENCE
Potter, P. A., Perry, A. G., Stockert, P.,
& Hall, A. (2013). Fundamentals
of nursing (8th ed.). Mosby.

By: Hannah P. Alegarme, MAN

Faculty, College of Nursing, Midwifery, and Radiologic Technology
 By: Hannah P. Alegarme, MAN
Faculty, College of Nursing, Midwifery, and Radiologic Technology