FUNDAMENTALS OF NURSING PRACTICE LECTURE
Procedures Basic to Nursing Care
ASEPSIS & INFECTION CONTROL
Infection
 Growth of microorganisms in the body
tissue where they are not normally
found.
 An invasion of the body tissue by
microorganisms and their proliferation
there.
 Such microorganism is called an
infectious agent.
Types of Microorganisms that Cause Infection
 Virus – must enter the living cells in
order to reproduce
 Fungi – yeasts and molds
 Parasites – live on other living
organisms
 Bacteria – most common infection-
causing microorganisms.
Types of Infection
 Local Infection – limited to the specific
part of the body where the
microorganism remain.
 Colonization – process by which strains
of microorganisms become resident
flora. They grow and multiply but do
not cause a disease.
 Systemic Infection – microorganism
spread and damage different parts of
the body.
bacteremia
septicemia
Nosocomial & Health-care Associated
Infections
 Nosocomial infections – originate in the
hospital. It either develops during a
client’s stay in a facility or manifest
after discharge.
 Nosocomial microorganisms may also
be acquired by personnel working in the
facility.
 Sources – endogenous (from the client)
or exogenous (hospital
environment/personnel)
Factors that contribute to Nosocomial
Infection
 Iatrogenic infections
 Compromised host
 Insufficient hand hygiene
Stages of Infection
 Incubation period - entry of
microorganisms to the body to the
onset of signs & symptoms.
 Prodromal period - onset of non-
specific signs & symptoms to the
appearance of specific signs &
symptoms.
 Illness period – specific signs &
symptoms develop & become evident.
 Convalescent period – signs &
symptoms starts to abate until the
client returns to normal state of health.
The Chain of Infection
 Infectious Agent
 Reservoir
 Portal of Exit
 Mode of Transmission
 Portal of Entry
 Susceptible Host
INFECTIOUS AGENT / ETIOLOGIC AGENT
 Microorganisms
- bacteria
- virus
- fungi
- parasites
 The ability to cause a disease will
depend on its pathogenicity, virulence,
invasiveness & specificity.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE
RESERVIOR
 Humans (clients, visitors, HCP)
 Animals (insects, rats)
 Plants
 General environment (air, water, food,
soil)
PORTAL OF EXIT
 Respiratory tract: droplets, sputum
 GI tract: vomitus, feces, saliva, drainage
tubes
 Urinary tract: urine, urethral catheters
 Reproductive tract: semen, vaginal
discharge
 Blood: open wound, needle puncture
site
MODE OF TRANSMISSION
 Contact (direct or indirect), droplet
 Vehicle, airborne & vectorborne
(biologic or mechanical) transmissions Specific Defenses
PORTAL OF ENTRY
 This permits the organism to gain
entrance into the host.
Types of Immunization
 Pathogens can enter susceptible hosts
through body orifices. Break in the skin Active Immunization
or mucous membranes from wounds or
abrasions.
SUSCEPTIBLE HOST
 A person who is at risk for infection;
whose body defense mechanism, when
exposed, are unable to withstand the
invasion of pathogens.
Body Defenses Against Infection
Non-specific Defenses
Passive Immunization
a. Anatomic & Physiological Barriers
- intact skin & mucous membranes;
- nasal passages (moist mucous
membrane & cilia);
- body orifice;
- tears;
- Vagina;
- Urethra (urine)
b. Inflammatory response
- Inflammation – local & non-specific
defensive response of the tissues to
an injurious or infectious agent. It is
an adaptive mechanism.
- Characterized by:
(a) pain (dolor)
(b) selling (tumor)
(c) redness (rubor)
(d) heat (calor/color)
(e) impaired function of the part if
severe.
- Involves the immune system.
- Active or passive immunity.
 Antibodies are produced by the body in
response to infection.
 Natural – from active infection in the
body; lifelong (mumps, chickenpox)
 Artificial – antigens (toxoids & vaccines)
are administered to stimulate antibody
production. Requires booster
inoculation after many years. (tetanus
toxoid, OPV)
 Antibodies are produced by another
source, such as animal or human.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE
 Natural – transfer of antibodies from
the mother to her newborn through
placenta or in the colostrums.
 Artificial – immune serum (antibody)
from an animal or another human is
injected to a person.
Factors Influencing the Host’s Susceptibility
 First line of defense of the body – intact
skin & mucous membrane.
 Normal pH levels of the genito-urinary
tract help ward off microbial invasion.
 The body’s WBC influence resistance to
certain pathogens.
 Age, sex & race
 Immunization
 Fatigue, climate, general health status,
presence of pre-existing illness,
previous/current treatment & some
kind of medications
Principles of Medical & Surgical
Asepsis
Medical Asepsis
 Practices designed to reduce the
number and transfer of pathogens.
 Clean technique.
 Reduces number of pathogens
 Referred to as “clean technique”
 Used in administration of: Medications,
Enemas, Tube feedings, Daily hygiene
 Handwashing is number 1
Surgical Asepsis
 Practices that render and keep objects
and areas free from microorganisms.
 Sterile technique
 Eliminates all pathogens
 Referred to as “sterile technique”
 Used in: Dressing changes,
Catheterizations, Surgical Procedures
Principles Underlying Medical & Surgical
Asepsis
 Patient is the source of pathogenic
microorganisms.
 Patient’s microorganisms leave through
specific routes.
 There are always microorganisms in the
environment which in some individuals
and under circumstances can cause
illness.
 Microorganisms harmful to man can be
transmitted by direct or indirect
contact.
 Spread of infection from source to
others can be prevented by various
methods to stop the spread as close to
the source as possible.
 The effectiveness of medical/surgical
asepsis is dependent on the
conscientiousness of those carrying
them out.
 In observing medical asepsis, areas are
considered contaminated if they bear or
are suspected having pathogens.
 In observing surgical asepsis, areas are
considered contaminated if touched by
an any object that is not sterile.
NURSING MANAGEMENT
Assessment
 History
 Conduct of physical assessment
 Laboratory data
Physical Assessment
 Signs & symptoms of infection will vary
according to the body area involved.
 Infection of nose & sinuses; urinary
infection
 Signs of localized infection: localized
swelling, localized redness, pain or
tenderness with palpation or
movement, palpable heat at the
 FUNDAMENTALS OF NURSING PRACTICE LECTURE
infected area, loss of function of the
body part affected, depending on site &
involvement
 Open wounds may exude drainage of
various colors
 Signs of systemic infection: fever, ↑
pulse & RR if fever is high, malaise &
loss of energy, anorexia & in some
situations, nausea & vomiting,
enlargement & tenderness of the lymph
nodes that drain the area of infection
Laboratory Data
 Elevated leukocyte (WBC) count
 Increases in the specific WBC types
 Elevated ESR
 Cultures of urine, blood, sputum, or
other drainage
Nursing Diagnosis
 Risk for Infection
- State in which the an individual is at
increased risk for being invaded by
pathogenic microorganism.
 Risk Factors
- Inadequate primary defenses such
as broken skin, traumatized tissue,
decreased ciliary action, stasis of
body fluids, change in pH of
secretions or altered peristalsis
- Inadequate secondary defenses
such as leukopenia,
immunosuppression, ↓Hgb or
suppressed inflammatory response.
Related Nursing Diagnoses
 Potential Complication of Infection:
Fever
 Imbalanced Nutrition: Less than Body
Requirements
 Acute Pain
 Impaired Social Interaction or Social
Isolation
 Anxiety
Interventions
 Reduce the Risk of Infection
- Proper hand hygiene techniques
- Environmental controls 3. Sterile
technique if warranted
- Identification & management of
clients risk for infections.
SPECIFIC NURSING INTERVENTIONS
(Breaking the Chain of Infection)
Breaking the Chain of Infection
Etiologic Agent
 Correctly cleaning & disinfecting or
sterilizing articles before use.
 Educating clients & support persons
about appropriate methods to clean,
disinfect & sterilize articles.
Cleaning – the physical removal of visible dirt
and debris by washing, dusting or mopping
surfaces that are contaminated. Soap is used for
mechanical cleaning.
Disinfection – the chemical or physical
processes used to reduce the number of
potential pathogens on an object’s surface. But
spores of the pathogens are not necessarily
destroyed.
Sterilization – the complete destruction of all
microorganisms, including spores, leaving no
viable forms of organisms.
Methods of Sterilization
 Steam sterilization. Autoclaving is
sterilization using supersaturated steam
under pressure.
 Gas sterilization. Ethylene oxide is a
colorless gas that can penetrate plastic,
rubber, cotton or other substances. This
is used to sterilize oxygen or suction
gauges, BP apparatus, stethoscopes,
catheters.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE
 Radiation. Ionizing radiation penetrates
deeply into objects.
 Boiling water. The least expensive for
use in home.
Reservoir (source)
1. Changing dressings & bandages when
soiled or wet
2. Appropriate skin & oral hygiene
3. Disposing damp, soiled linens
appropriately
4. Disposing of urine & feces in appropriate
receptacles
5. Ensuring that all fluid containers are
covered & capped
6. Emptying suction & drainage bottles at
the end of the shift or before full or
according to agency policy
Portal of Exit
1. Avoid talking, coughing or sneezing over
open wounds or sterile fields
2. Covering the mouth or nose when
coughing or sneezing
Mode of Transmission
1. Proper hand hygiene
2. Instructing clients & support persons to
perform hand hygiene before handling
food, eating, after eliminating & after
touching infectious materials
3. Wearing gloves when handling secretions
& excretions
4. Wearing gowns when there is danger of
soiling clothing with body substances
5. Placing discarded soiled materials in
moistureproof refuse bags
6. Holding used bedpans steadily to avoid
spillage
7. Disposing of urine & feces in appropriate
receptacles
8. Initiating & implementing aseptic
precautions for all clients
9. Wearing masks & eye protection
Personal Protection Equipment (PPE)
 Barriers – techniques that prevent
the transfer of pathogens from one
person to another.
1. Masks
2. Caps & shoe covering
3. Gloves
4. Private rooms
5. Waterproof disposable bags for
linen & trash
6. Labeling & bagging of
contaminated equipment &
specimens
7. Control of airflow into the sterile
areas & out of contaminated areas
8. Googles or face shields
 Portal of Entry
1. Using sterile technique for
invasive procedures, when
exposing open wounds or
handling dressings
2. Placing used disposable needles
& syringes in puncture-resistant
containers for disposal
2. Providing all clients with own
personal items
 Susceptible Host
1. Maintaining the integrity of the
client’s skin & mucous membrane
2. Ensuring that the client receives a
balanced diet, adequate fluid, sleep
& free from stress
 FUNDAMENTALS OF NURSING PRACTICE LECTURE
3. Educating the client about the
importance of immunization
INFECTION PREVENTION & CONTROL
STANDARD PRECAUTIONS
 Universal Precautions & Body-
substance Isolation
 These precautions are intended to
prevent, transmission of
bloodborne & moist body substance
pathogens.
 Wear clean gloves when touching
1. Blood, body fluids, secretions &
excretions, & items containing
these body substances.
2. Mucous membrane
3. Non-intact skin
 Perform handwashing immediately
1. When there is direct contact with
blood, body fluids, secretions &
excretions or contaminated items.
2. After removing gloves.
3. Between patient contacts.
 Wear a mask, eye protection & face
shield during procedures & patient
care activities that are likely to
generate splashes or sprays of
blood, body fluids, secretions &
excretions.
 Wear a cover gown during
procedures & patient care activities
that are likely to generate splashes
or sprays of blood, body fluids,
secretions or excretions, or cause
soiling of clothings.
 Remove soiled protective items
promptly.
 Clean & reprocess all equipment
before reuse by another patient.
 Discard all single-use items
promptly in appropriate containers.
 Prevent injuries with used needles,
scalpels, & other sharp devices.
 Use a private room or consult with
an infection control professional for
care of patients who contaminate
the environment.
TRANSMISSION-BASED
PRECAUTIONS
 Airborne Precautions. These are use for
microorganisms transmitted by small-
particles droplets that can remain
suspended & become widely dispersed
by air currents. Example: TB, varicella,
measles
 Droplet Precautions. These are use for
microorganisms transmitted by larger-
particle droplets (through coughing,
sneezing, or talking) which disperse
through air currents.
 Contact Precautions. These are used
with organisms that can be transmitted
by hand or skin to skin contact, such as
during client care activities or when
touching client’s environmental
surfaces or care items.
PROTECTIVE ISOLATION
 Implemented to prevent infection for
people whose resistance to infection /
body defenses are lowered or
compromised. Example: clients with low
WBC count; on immunosuppressive
medications like cancer chemotherapy;
with extensive burns
 Reverse isolation
SAFETY, SECURITY & EMERGENCY
PREPAREDNESS
SAFETY
Safe Environment
 One where the likelihood of being ill or
injured is reduced.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

 A place in which people can function  Occupational safety among health care
safely and can have a sense of security. practitioners – especially nurses who
are with patients 24 / 7.
Characteristic of a Safe Environment
Workplace
1. Adequate lighting
 Occupational hazards: machinery,
2. Neat and clean
industrial belts & pulleys & chemicals
3. Safe equipment may create danger, worker fatigue,
noise & air pollution, working at great
4. Noise level is comfortable heights.
5. Cleanliness  Nurses work environment maybe
unsafe like exposure to infectious
6. Medication is kept separately agents, lifting patients, exposure to
7. Temperature hazardous compounds & needlesticks.

8. Free of pollution (air, water and noise) Home

Factors that Affect Safety  Structure of the home must be well-

maintained & secured.
1. Age & Development
Community
2. Lifestyle
 Adequate street lighting, safe water &
3. Mobility & Health Status sewage treatment & regulation of
sanitation.
4. Sensory-Perceptual Alterations
 Free from excess noise, crime, traffic
5. Cognitive Awareness congestion, dilapidated housing or
unprotected creeks & landfills.
6. Emotional State
Bioterrorism Attack
7. Ability to Communicate
 According to Centers for Disease
8. Safety Awareness
Control & Prevention (CDC), it is the
9. Environmental Factors deliberate release of viruses, bacteria or
other germs (agents) used to cause
Environmental Factors illness or death in people, animals or
plants.
Health Care Setting
 It has 3 Categories (A, B & C), depending
 Incidence of medical errors which on how easily they can spread & the
results to the harm / death among our severity of illness or death they cause.
clients.
 Medical errors – Examples: medication Disaster Planning
errors (most common); diagnostic  Nurses need to be able to respond to
errors; communication errors
disasters in the community as well as
 If errors occur, how do we deal with it? keep safe clients who are already in the
health care setting.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

 They need to know the & understand
the chain of command. The line of
authority is different from that of day to
day operations.
 Know the organization’s disaster
response plan.
 Nurses must also care for themselves in
the event of disaster. It is imperative
that nurses set up their own emergency
action plans with their families.
3. Implement applicable NPSGs & associated
requirements by components & practitioner
sites.
4. Encourage the active involvement of patients
& their families in the patient’s care as a patient
safety strategy.
5. Prevent health-care associated pressure
ulcers.

Common Potential Hazards

NURSING MANAGEMENT
1. Developing Fetus
Assessing Clients at Risk for Injury:
2. Newborns & Infants
 Nursing history & physical examination
 Risk assessment tools 3. Toddlers
 Assessment of client’s home 4. Pre-schoolers
environment
5. Adolescents
National Patient Safety Goals
6. Older Adults
(NPSGs)
Common Potential Hazards:
1. Improve the accuracy of patient
identification. Developing Fetus
2. Improve the effectiveness of communication 1. Exposure to maternal smoking, alcohol
among caregivers. consumption, addictive drugs.

3. Improve the safety of using medications. 2. X-rays (1st Trimester)

4. Reduce the risk of health care 3. Certain pesticides

associatedinfections.
Common Potential Hazards:
5. Accurately & completely reconcile medication Newborns & Infants
across the continuum of care.
1. Falls
6. Reduce the risk of patient harm resulting to
falls. 2. Suffocation in cribs

National Patient Safety Goals 3. Choking from aspirated milk or ingested

objects
(NPSGs)
4. Burns from hot water or other spilled hot
1. Reduce the risk of influenza & pneumococcal liquids
disease in institutionalized adults.
5. Motor vehicle crashes
2. Reduce the risk of surgical fires.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

6. Cribs or playpen injuries Nursing Diagnoses for Clients at Risk

7. Electric shock for Injury
8. Poisoning  Risk for injury: Vulnerable to physical
damage due to environmental
Common Potential Hazards: Toddlers conditions interacting with the
1. Physical trauma from falling, banging into individual’s adaptive & defensive
objects or getting cut by sharp objects resources, which might compromise
2. Motor vehicle crashes health.
 This is a broad label. It is suggested that
3. Burns more specific labels be used to provide
clearer direction for nursing care.
4. Poisoning
More specific diagnoses would include:
5. Drowning  Risk for Falls
 Latex Allergy Response
Common Potential Hazards:  Risk for Latex Allergy Response
Preschoolers  Risk for: Infection, Suffocation,
Poisoning, Trauma, Vascular Trauma,
1. Injury from traffic, playground equipment & Aspiration, Impaired Skin Integrity &
other objects Risk for Self-directed Violence
2. Choking, suffocation, & obstruction of airway Other Diagnosis:
or ear canal by foreign objects; poisoning  Deficient Knowledge (Accident
Prevention)
3. Drowning
Desired Outcomes for Clients with
4. Fire & burns
Safety Risks
5. Harm from other people or animals
1. Prevent injury
Common Potential Hazards:
2. Often need to change health behavior
Adolescents
3. Modify their environment
1. Motor vehicles or bicycle crashes
4. Desired outcomes depend on individual client
2. Recreational injuries
Measures to Ensure Safety of People
3. Firearms
of all Ages focus on:
4. Substance abuse
1. Observation or prediction of situations that
Common Potential Hazards: Older are potentially harmful.
Adults 2. Client education that empowers clients to
1. Falling safeguard themselves & their families from
injury.
2. Burns
COMPLEMENTARY & ALTERNATIVE
3. Motor vehicle crashes and pedestrian injury
THERAPIES
 FUNDAMENTALS OF NURSING PRACTICE LECTURE
What is CAM?
 Complementary Alternative Medicine
(CAM) … medical and health care
practices outside the realm of
conventional medicine, which are yet to
be validated using scientific methods.
 Complementary - together with
conventional practices.
 Alternative – in place of conventional
practices.
CAM is still …
 Unproven
 Generally unavailable in hospitals
 Not usually taught in medical schools
Legal Basis…
 Republic Act 8473 – Traditional and
Alternative Medicine Act (TAMA) of
1997
 An act creating the Philippine Institute
of Traditional and Alternative
Healthcare (PITAHC) to accelerate the
development of traditional and
alternative healthcare in the
Philippines, providing for a traditional
and alternative healthcare development
fund and for other purposes.
Basic Concepts of Alternative Practices
1) Holism
2) Humanism
3) Balance
4) Spirituality
5) Energy
6) Healing Environments
Basic Principles & Aims of Complementary
Therapies:
1. Relieve tension, pain and other symptoms
2. Relax, revitalize and nurture
3. Improve circulation and balance energy flow
4. Support psychoneuroimmunological
responses
5. Release negativity and affirm the positive
In conducting Complementary Therapy, it is
helpful to create a peaceful environment
taking into account all of the SENSES.
 SIGHT. All colors have an effect on how
we feel & have helpful attributes &
vibrations.
 SMELL. Aromas can evoke memories &
feelings & are therefore very personal.
 HEARING. Music can be helpful in
creating any mood.
 TOUCH. Is very important & is
demonstrated by the number of soft
toys & favorite items patient have
beside them.
 TASTE. In creating a particular space for
peace, taste is perhaps not a relevant
point but NUTRITION plays a key role in
palliative care & appetite is so often
poor when patients feel low.
Domains or Categories to Group
CAM
1. Alternative medical systems
• such as homeopathy and naturopathic
medicine
2. Mind-body interventions
• such as meditation and prayer
3. Biologically based treatments
• such as herbal products and dietary
supplements
4. Manipulative and body based methods
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

• such as massage and chiropractic - used to treat kidney stones, wounds and cuts,
manipulation rheumatism, anti-diarrhea, anti spasms, colds
and coughs and hypertension
5. Energy therapies

• such as Reiki and qi gong

ALTERNATIVE MEDICAL SYSTEMS

HOMEOPATHY
NATUROPATHY – Naturopathy is the treatment
of illness by using diet, herbs, exercises, etc.,
without using standard drugs or surgery.
BIOLOGICALLY BASED TREATMENTS
HERBAL MEDICINES
1. Akapulko - “ringworm bush or schrub”
- to treat tinea infections, insect bites,
ringworms, eczema, scabies and itchiness.
8. Tsaang Gubat - ”Wild tea”
- to treat skin allergies including eczema,
scabies and itchiness wounds in child birth
9. Ulasimang Bato | Pansit-Pansitan - use to
treat arthritis and gout.
10. Yerba Buena – Peppermint
- is used in Philippine herbal medicine as
analgesic to relive body aches and pain due to
rheumatism and gout, coughs, colds and insect
bites

2. Ampalaya - “bitter melon ” or “bitter gourd ” MANIPULATIVE AND BODY BASED

- treatment of diabetes (diabetes mellitus),
METHOD
hemorrhoids, coughs, burns and scalds, and  MASSAGE
being studied for anticancer properties.  CHIROPRACTIC
3. Bawang - “Garlic” ENERGY THERAPIES
- to treat infection with antibacterial, anti-
 Reiki
inflammatory, anti-cancer and anti-
 Qi Gong
hypertensive properties.

4. Bayabas – “Guava” MEDICATIONS

- used as antiseptic, anti-inflammatory, anti- Terms related to Medication Administration
spasmodic, antioxidant hepatoprotective, anti- 1. Medication
allergy, antimicrobial, anti-plasmodial, anti-
cough, antidiabetic. 2. Prescription

5. Lagundi – “5-leaved chaste tree” , to treat 3. Pharmacology

cough, colds and fever, asthma & pharyngitis, 4. Pharmacy
rheumatism, dyspepsia, boils, and diarrhea.
5. Pharmacodynamics
6. Niyog-niyogan - “Chinese honey suckle”.
6. Pharmacokinetics
- used to eliminate intestinal parasites. Lagundi
Prescription
7. Sambong -“Ngai camphor or Blumea
camphor” 1) Generic name
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

2) Trade or brand name 9) Time of administration

3) Chemical name

4) Official name

Principles of Medication
Therapeutic Actions of Drugs
Administration
1) Palliative – relieves the symptoms of a
1. Observe the 12 RIGHTS in Drug
disease but not affect the disease itself.
Administration
2) Curative – treats the disease condition.  Client. Identify the patient by:
Checking the ID band, asking
3) Supportive – sustains body functions until
him to state his name.
other treatment of the body’s response can
 Drug. Read the label 3 times.
take over.
 Dose. Know the usual dose of
4) Substitutive – replaces body fluids or the drug. Calculate the correct
substances. amount.
 Route
5) Chemotherapeutic – destroys malignant cells  Time
6) Restorative – returns the body to health.  Method of Administration /
Approach
Terms related to Actions Medications on the  Assessment
Body:  Education / Health Teaching
1) Onset of action  Documentation
 To Refuse the Medication
2) Peak plasma level  Evaluation
 Preparation
3) Drug half-life
The Right Medication
4) Plateau
 When administering medications, the
Factors affecting Medication Action
nurse compares the label of the
1) Developmental factors medication container with medication
form.
2) Gender
 The nurse does this 3 times:
3) Culture & Ethnicity a) Before removing the
container from the drawer or
4) Genetics shelf
5) Diet
b) As the amount of medication
6) Environment ordered is removed from the
7) Psychological factors container

8) Illness & disease c) Before returning the

container to the storage
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

Client’s Right Related to Medication o The nurse who prepares the drug
Administration administers it. Only the nurse who
prepares the drug knows what the drug
 To be informed of the medication’s
is. Do not accept endorsement of
name, purpose, action, and potential
medication.
undesired effects.
o If the client vomits after taking the
 To refuse a medication regardless of the
medication, report this to the nurse in
consequences
charge or physician.
 To have a qualified nurses or physicians
o Preoperative medications are usually
assess medication history, including
discontinued during the postoperative
allergies
period unless ordered to be continued.
 To be properly advised of the
o When a medication is omitted for any
experimental nature of medication
reason, record the fact together with
therapy and to give written consent for
the reason.
its use
o When the medication error is made,
 To received labeled medications safely
report it immediately to the nurse in
without discomfort in accordance with
charge or physician. To implement
the six rights of medication
necessary measures immediately. This
administration
may prevent any adverse effects of the
 To receive appropriate supportive
drug.
therapy in relation to medication
o Always the medication’s expiration
therapy
date.
 To not receive unnecessary medications
Parts of Legal Doctor’s Order

 Name of Patient
o Practice Asepsis. Wash hands before &
 Date and Time
after preparing medications.
 Name of the Drug
o Nurse who administer medications are
 Dose of the Drug
responsible for their own actions.
 Route of Administration
Question any order that you consider
 Time or Frequency
incorrect (may not be unclear or
 Signature of the Physician
inappropriate)
o Be knowledgeable about the Types of Medication Orders
medications that you administer.
o Keep narcotics in locked place.  STAT order
o Use only medications that are clearly  Single order or one-time order
labeled containers. Relabeling of drugs  Standing order
is the responsibility of the pharmacist.  PRN order
o Return liquid that are cloudy in color to
the pharmacy.
o Before administering medication,
identify the client correctly
o Do not leave the medication at the
bedside. Stay with the client until he
actually takes the medications.
 FUNDAMENTALS OF NURSING PRACTICE LECTURE

Common Dosage Administration Parenteral Administration

Schedule
Dosage Abbreviation
Schedule
(Meaning)
Before meals AC, ac
As desired ad lib
Twice each BID, bid
day or 2 Topical Administration
times a day
After meals PC, pc  Inhalation- sprays or powders for lungs
Whenever prn  Topical administrations: e.g. creams,
there is a ointments, lotions for skin: solutions,
need or if suspensions, ointments for ear or eye.
necessary
Every qam Process of Administering Medications
morning,
 When administering medication,
every AM
regardless of the route of
Every hour qh
administration, the nurse must:
Every day daily
Every 4 hours Q4h a) Identify the client
4 times a day QID, qid
Give STAT, stat b) Inform the client
immediately
3 times per TID, tid c) Administer the medication
day
d) Provide adjunctive interventions as
indicated
Routes of Medication Administration
e) Record medication administered
Oral Administration
f) Evaluate the client’s response to the
 The medication is swallowed. It is the
medication
most common, least expensive, and
most convenient route for most clients.

Sublingual Administration

 A medication placed under the tongue,

where it dissolves.

Buccal Administration

 “Pertaining to the cheek”. A medication

is held in the mouth against the mucous
membranes of the cheek until the drug
dissolves.