Fundamentals of Nursing

Kozier & Erb's
Fundamentals of Nursing
Concepts, Process, and Practice
TENTH EDITION, GLOBAL EDITION
CHAPTER 35
Medications
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Kozier & Erb's Fundamentals of Nursing, Tenth Edition, Global Edition
Pearson Education Limited
Audrey Berman | Shirlee Snyder | Geralyn Frandsen
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Learning Outcomes
1. Define selected terms related to the

administration of medications.
2. Describe legal aspects of administering
medications.
3. Describe actions of drugs on the body.
4. Identify factors affecting medication action.
5. Describe various routes of medication
administration.
continued on next slide

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Learning Outcomes
6. Identify essential parts of a medication

order.
7. List examples of various types of medication
orders.
8. State systems of measurement that are
used in the administration of medications.
9. Describe four formulas for calculating drug
dosages.

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Learning Outcomes
10.List six essential steps to follow when

administering medication.
11.State the “rights” to accurate medication
administration.
12.Describe the physiologic changes in older
adults that alter medication administration
and effectiveness.

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Learning Outcomes
13.Verbalize the steps used in administering

oral medications safely.
14.Outline the steps required for nasogastric
and gastrostomy tube medication
administration.
15.Identify equipment required for parenteral
medications.

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Learning Outcomes
16.Verbalize the steps used in:

a. Preparing medications from ampules.
b. Preparing medications from vials.
c. Mixing medications in one syringe.
17.Identify the sites used for:
a. Intradermal injection.
b. Subcutaneous injection.
c. Intramuscular injection.

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Learning Outcomes

parenteral medications by the following
routes:
a. Intradermal
b. Subcutaneous
c. Intramuscular.
19.Verbalize the steps used in:
a. Adding medications to intravenous fluid
containers
b. Administering intravenous medications using IV
push
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Learning Outcomes

the following topical medications:
a. Dermatologic
b. Ophthalmic
c. Otic
d. Nasal
e. Vaginal
f. Rectal
g. Respiratory inhalation.

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Learning Outcomes
21.Recognize when it is appropriate to delegate

medication administration to unlicensed
assistive personnel.
22.Demonstrate appropriate documentation
and reporting of medication administration
skills.
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Introduction
• Medication
 Substance administered for diagnosis,
cure, treatment, or relief of symptom or
for prevention of disease
• Drug
 Same as medication but also refers to
illicitly obtained substance
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Introduction
• Prescription
 Written direction for preparation and
administration of a drug
• Generic name
 Name used throughout the drug's
lifetime
• Trade (brand) name
 Given by drug manufacturer
 Identifies it as property of that company
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Introduction
• Official name
 Name by which drug is listed in official
publications
• Chemical name
 Name by which a chemist knows it
 Describes constituents of the drug
precisely
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Introduction
• Pharmacology
 Study of effect of drugs on living
organisms
• Pharmacy
 Prepares, makes, and dispenses drugs
as ordered
• Pharmacist
 Person who prepares, makes, and
dispenses drugs as ordered
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Drug Standards
• Drugs can be made from plants,

minerals, or animals, or be produced
synthetically.
• Standards ensure drugs are pure and of
uniform strength, uniform quality.
• U.S. Pharmacopeia describes drug
sources, properties, tests done, storage
methods, assay category, normal
dosages.
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Table 35–2 U.S. Drug Legislation
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Legal Aspects of Administering
Medications
• Nursing practice acts
• Recognizing limits of own knowledge
and skill
• Take responsibility for actions
• Question any order that appears
unreasonable
• Refuse to give medication until order is
clarified
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Legal Aspects of Administering
Medications
• Controlled substances
 Kept under lock
 Special inventory forms
 Documentation requirements
 Procedures for discarding
 End-of-shift counts of controlled
substances
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Figure 35–1 Some narcotics are kept in specially designed packages or plastic containers that are sectioned
and numbered.
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Effects of Drugs
• Therapeutic effect
 Desired effect
 Reason drug is prescribed
• Side effect
 Secondary effect
 Unintended, usually predictable
 May be harmless or harmful
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Effects of Drugs
• Adverse effect
 More severe side effect
 May justify discontinuation of a drug
• Drug toxicity
 Results from overdose, ingestion of
external-use drug, or buildup of drug in
blood
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Effects of Drugs
• Drug allergy
 Immunologic reaction to drug
 Mild to severe reactions
• Anaphylactic reaction, anaphylaxis
• Drug tolerance
 Unusually low physiological response
 Requires increases in the dosage to
maintain a given therapeutic effect
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Effects of Drugs
• Drug tolerance
 Cumulative effect
• Increased effect resulting from rate of
dosage being higher than rate of
excretion
 Idiosyncratic effect
• Unexpected; may be individual to client
• Drug interaction
 One drug alters effect of other drug(s).
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Effects of Drugs
• Potentiating effect
 One or both drugs is increased.
 Additive
• Two of same types of drugs increase
action of each other.
 Synergistic
• Two different drugs increase action of
one or another.
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Effects of Drugs
• Inhibiting effect
 Effect of one or both drugs is decreased.
• Iatrogenic disease
 Disease unintentionally caused by
medical or drug therapy
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Drug Misuse
• Improper use of common medications

• Drug abuse
• Drug dependence
 Physiological dependence
 Psychological dependence
• Drug habituation
• Illicit drugs
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Actions of Drugs on the Body
• Half-life
 Time interval required for body's
elimination processes to reduce the
concentration of the drug in the body by
one-half
• Onset of action
• Peak plasma level
• Drug half-life (elimination half-life)
• Plateau
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Figure 35–2 A graphic plot of drug concentration in the blood plasma following a single dose.
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Pharmacodynamics
• Mechanism of drug action and

relationships between drug
concentration and the body's responses
• Receptor
 Drug's target
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Pharmacodynamics
• Agonist
 Same response as endogenous
substance
• Antagonist
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Pharmacokinetics
• Study of absorption, distribution,

biotransformation, and excretion of
drugs
• Absorption
 Process by which drug passes into
bloodstream
 Rate is variable
• Depends on food, acid medium
 Drug bypassed if injected
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Pharmacokinetics
• Distribution
 Transportation of a drug from its site of
absorption to its site of action
• Biotransformation
 Also called detoxification or metabolism
 Process by which a drug is converted to
a less active form
 Metabolites
• Products of this process
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Pharmacokinetics
• Excretion
 Process by which metabolites eliminated
 Mostly through urine
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Factors Affecting Medication
Action
• Developmental factors
 Risks during pregnancy
 Infants require smaller dosages.
 Older adults experience decreased
gastric motility
• Gender
 More drug research done on men
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Action
• Cultural, ethnic, and genetic factors
 Pharmacogenetics
 Ethnopharmacology
• Study of the effect of racial, ethnic
responses to prescribed medication
• Diet
 Nutrients can affect action of a
medication
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Action
• Environment
 Especially affects drugs used to alter
behavior and mood
• Psychological factors
 Expectations
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Action
• Illness and disease
 Action altered in clients with circulatory,
liver, or kidney dysfunction
• Time of administration
 Some drugs absorbed more quickly if
stomach is empty, some when stomach
is full
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Routes of Administration
• Oral
 Most common, least expensive, most
convenient
• Sublingual
 Not to be swallowed, but dissolved
• Buccal
 Cheek
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Figure 35–3 Sublingual administration of a tablet.
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Figure 35–4 Buccal administration of a tablet.
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• Parenteral
 Subcutaneous (hypodermic)
 Intramuscular (IM)
 Intradermal (ID)
 Intravenous (IV)
 Less common
• Intrathecal/intraspinal
• Epidural
• Intracardiac
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• Topical
 Dermatologic
 Installations and irrigations
 Inhalations
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Medication Orders
• Ordered by physicians
 Sometimes nurse practitioners,
physician assistants depending on state
laws and agency policies
• Verbal and telephone orders
• Abbreviations, acronyms, and symbols
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Types of Medication Orders
• Stat order
 Such as morphine sulfate 10 milligrams
IV stat
• Single order
 Such as Seconal 100 mg hs before
surgery
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Types of Medication Orders
• Standing order
 Indefinitely, such as multiple vitamins
daily
 Specified number, such as KCl twice
daily × 2 days
• PRN order
 Such as Amphojel 15 mL prn
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Essential Parts of a Medication
Order
• Full name of client
• Date and time order is written
• Name of drug to be administered
• Dosage of drug
• Frequency of administration
• Route of administration
• Signature of person writing the order
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Figure 35–5 A prescription filled out by a primary care provider.
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Box 35–2 Parts of a Prescription
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Communicating Medication Orders
• Written on chart, provided by phone or

verbally
• Copied to Kardex or MAR, or on
computer printout
• If an order seems inappropriate
 Contact primary care provider
 Document in notes when PCP called,
what was communicated, how PCP
responded
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Communicating Medication Orders
• If an order seems inappropriate

 Or, document attempts to reach PCP
and reason for withholding drug
 If medication given, document client
condition before and after dose
 If needed, document factual information
on incident report
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Systems of Measurement
• Metric system
 Devised by the French
 Logically organized into units of 10
 Meter, liter, gram basic units
• Apothecaries' system
 Older than metric system
 Grain, minim basic units
 Do not use; unfamiliar to many
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Figure 35–7 Basic metric measurements of volume and weight.
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Systems of Measurement
• Household system
 May be used when more accurate
systems not required
 Drops, teaspoons, tablespoons, cups,
and glasses
 Pints and quarts defined as
apothecaries' measures
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Converting Units of Weight and
Measure
• Converting weights within the metric
system
 Gram (g), milligram (mg), and
microgram (mcg) only units used for
dosages
 Divide or multiply and move decimal
points
 Put a 0 in front of decimal point if less
than 1 (0.5 g)
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Measure
• Converting weights and measures
between systems
 Nurse may need to convert from
systems used by pharmacies
• Converting units of volume
 Fluid drams, ounces used in liquid
medications
 Liters, milliliters used for enemas,
irrigations, and solutions for wounds
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Measure
• Converting units of weight
 Milligrams to grains
• Milligram is smaller than a grain
• 1 grain = 60 mg
 Pounds to kilograms
• 2.2 lb = 1 kg
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Table 35–7 Approximate Volume Equivalents:
Metric, Apothecaries', and Household Systems
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Methods of Calculating Dosages
• Basic formula
 (D × V) / H
 D (desired dose)
 H (dose on hand)
 V (vehicle or form of drug)
• Ratio and proportion method
 H : V :: D : x
 Considered to be the oldest method
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• Fractional equation method

 (H / V) = (D / x)
 Cross multiply and solve for x
• Dimensional analysis
1.Identify dose on hand
2.Identify desired dose
3.Write down conversion factor

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• Dimensional analysis
4. Set up equation
5. Cancel units that appear in numerator
and denominator
6. Multiply numerator; multiply
denominator; divide the products
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• Calculating for individualized drug

dosage
 Clients receiving chemotherapy, critically
ill clients required individualized dosages
 Body weight
• Convert pounds to kilograms.
• Determine drug dose per body weight by
multiplying drug dose × body weight ×
frequency

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• Calculating for individualized drug

dosage
 Body weight
• Choose method of drug calculation to
determine amount to administer
 Body surface area
• Ratio of child's body surface area to that
of an average adult
• (Surface area of child (m2) / 1.7m2) ×
normal adult dose
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Administering Medications Safely
• Always assess health status

• Take medication history
 Include OTC drugs and supplements,
allergies, normal eating habits
• Include client's illness or current
condition, intended drug and route
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Administering Medications Safely
• Assess ability to self-administer

• Assess socioeconomic factors
 Transportation
 Money for medication
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Medication Reconciliation
• Most accurate list possible of all drugs

taken compared to primary care
provider's orders to provide continuity
of care
• Inadequate communication during
transitions accounts 50% of med errors
and 20% of adverse drug events
• Completed list provided to client and
next health care provider
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Medication Dispensing Systems
• Medication cart
 Mobile
• Medication cabinet
 Locked, in client's room
• Medication room
 Accessed by key, code
• Automated dispensing cabinet
 Reduces risk of error, theft
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Figure 35–11 The medication cart is kept locked when not in use. The nurse is using a key to access client
medications.
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Process of Administering
Medications
• Identify the client
• Inform the client
• Administer the drug
• Provide adjunctive interventions as
indicated
• Record the drug administered
• Evaluate the client's response to the
drug
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Box 35–6 Ten “Rights” of Medication
Administration
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Figure 35–13A A sample bar code.

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Figure 35–13B The nurse scans the bar code on the medication package.

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Figure 35–13C The nurse scans the the bar code on the client's wristband before administering the
medication.

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Developmental Considerations
• Growth and development especially

important in administering medication
to very young and very old
• Infants and children
 Most often provided in sweetened liquid
form
 Do not mix into milk or orange juice
 Be honest about injections hurting
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• Older adults
 Altered memory
 Decreased visual acuity
 Decrease in renal function
 Less complete and slower absorption
from gastrointestinal tract
 Increased proportion of fat to lean body
mass

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• Older adults
 Decreased liver function
 Decreased organ sensitivity
 Altered quality of organ responsiveness
 Decrease in manual dexterity
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Oral Medications
• NPO “nothing by mouth” or Latin “nil

per os”
• Oral most common route
• Preferred unless digestive problem
(e.g., nausea and vomiting)
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Skill 35–1 Administering Oral Medications

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Skill 35–1 (continued) Administering Oral
Medications

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Medications

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Medications

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Medications

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Medications

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Medications

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Medications

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Medications
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Nasogastric and Gastrostomy
Medications
• Nasogastric tube, gastrostomy tube
• Practice guidelines
 Check with pharmacist a liquid form
 Check to see if medication can be
crushed
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Medications
 Crush tablet into fine powder and
dissolve in at least 30 mL of warm water
 Open capsules and mix contents with
water only if pharmacist says it is safe

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Medications
 Do not administer whole or undissolved
medications
 Assess tube placement
 Aspirate stomach contents and measure
residual volume
 Check agency policy if residual volume
is more than 100 mL

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Medications
 When administering medication:
• Remove plunger from the syringe
• Connect syringe to pinched or kinked
tube
• Put 15–30 mL (5–10 mL for children) of
water into syringe barrel to flush the
tube

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Medications
• Pour liquid or dissolved medication into
syringe barrel and allow to flow by
gravity into the enteral tube
• Administer each medication separately
and flush with 15–30 mL of tap water
between each medication

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Medications
• After administration of all medications,
flush with another 15–30 mL of warm
water (5–10 mL for children) to clear the
tube
 If tube is connected to suction,
disconnect suction and keep tube
clamped for 20–30 minutes to enhance
absorption
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Parenteral Medications
• Parenteral administration is a common

nursing procedure.
• Absorbed more quickly than oral route
 Careful and accurate administration
• Aseptic technique
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Figure 35–14 The three parts of a syringe.
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Equipment
• Syringes
 Parts
• Tip, which connects with needle
• Barrel
• Plunger
 Hypodermic
• Syringes vary

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Figure 35–15 Three kinds of syringes: A, 3-mL syringe marked in tenths (0.1) of milliliters and in minims; B,
insulin syringe marked in 100 units; C, tuberculin syringe marked in tenths and hundredths (0.01) of 1 milliliter
(mL) and in minims.
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Equipment
• Syringes
 Insulin
• Common problems with insulin pen
• Needlestick injuries
• Errors in technique
• Using the pen like a vial
• Using the pen for more than one client
 Tuberculin
• Narrow
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Equipment
• Syringes
 Luer-Lok syringe
• Requires needle to be twisted onto it
 Non-Luer-Lok syringe
• Has smooth graduated tip
• Needles are slipped onto it

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Figure 35–18 Tips of syringes: A, Luer-Lok syringe (note threaded tip); B, non–Luer-Lok syringe (note the
smooth graduated tip).
A B
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Figure 35–19 A 60-mL non–Luer-Lok syringe, which can be used for irrigation of tubes or wounds.
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Equipment
• Syringes
 Prefilled unit-dose systems
• Prefilled syringes ready for use
• Prefilled sterile cartridges and needles
that require attachment of reusable
holder before use
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Equipment
• Needles
 Stainless steel
 Most disposable
 Parts
• Hub
• Cannula or shaft
• Bevel
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Equipment
• Needles
 Characteristics
• Slant or length of bevel
• Length of shaft
• Gauge (diameter) of shaft
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Figure 35–22 The parts of a needle.
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Equipment
• Preventing needlestick injuries

 Needles and sharps present one of
greatest dangers to health care workers.
 Passive devices
• Retracts immediately
 Active devices
• Requires nurse to activate safety feature
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Figure 35–26 Passive safety device. The needle retracts immediately into the barrel after injection.
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Figure 35–27 Active safety device. The nurse manually pulls the sheath or guard over the needle after
injection.
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Figure 35–28 A needleless system can extract medication from a vial.
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Box 35–8 Avoiding Puncture Injuries

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Box 35–8 (continued) Avoiding Puncture Injuries
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Preparing Injectable Medications
• Ampules and vials

 Ampule
• Glass container designed to hold a single
dose of a drug
• Must be broken at constricted neck to
access medication
 Vial
• Small glass bottle with sealed rubber cap

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• Ampules and vials

 Vial
• Must be pierced with needle and air must
be injected before medication is
withdrawn
 Reconstitution
• Adding diluents to powdered drug to
reconstitute
 Single- or multi-dose
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Skill 35–2 Preparing Medications from Ampules

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Skill 35–2 (continued) Preparing Medications
from Ampules

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from Ampules

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from Ampules

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Skill 35–3 Preparing Medications from Vials

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from Vials

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from Vials

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from Vials
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• Mixing medications in one syringe

 Can be done with compatible drugs
(e.g., two types of insulin)
 Push amount of air equal to dose into
first vial
 Push amount of air equal to dose of
second drug into second vial

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• Mixing medications in one syringe

 Withdraw correct amount of drug from
second vial
 With newly attached, sterile needle,
carefully withdraw correct amount of
drug from first vial
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Skill 35–4 Mixing Medications Using One Syringe

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Skill 35–4 (continued) Mixing Medications Using
One Syringe

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One Syringe

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One Syringe
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Intradermal Injections
• Very small amounts administered just

below epidermis
• Allergy testing
• Tuberculosis
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Figure 35–32 Body sites commonly used for intradermal injections.
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Skill 35–5 Administering an Intradermal Injection
for Skin Tests

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Skill 35–5 (continued) Administering an
Intradermal Injection for Skin Tests

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Subcutaneous Injections
• Injected just beneath skin

• Vaccines, insulin, heparin
• Syringe depends on medication given,
thickness of skin fold
• Sites need to be rotated in an orderly
fashion to minimize tissue damage, aid
absorption
• Aspiration no longer recommended
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Figure 35–33 Body sites commonly used for subcutaneous injections.
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Skill 35–6 Administering a Subcutaneous Injection

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Skill 35–6 (continued) Administering a
Subcutaneous Injection

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Intramuscular Injections
• Absorbed more quickly than

subcutaneous because muscle more
vascular
 Large volumes can be tolerated.
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• Size of syringe varies.

 Adult standard is 1.5 inches, 21 or 22
gauge.
• Factors determining size and length
 Muscle
 Type of solution
 Adipose tissue
 Age of client
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• Ventrogluteal site
 Preferred
• No large nerves, vessels
• Sealed off by bone
 Side-lying position most accessible
• Vastus lateralis site
 Best for infants, young children
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Figure 35–35 Landmarks for the ventrogluteal site for an intramuscular injection.
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Figure 35-37 The vastus lateralis muscle of an infant's upper thigh, used for intramuscular injections.
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Figure 35–40 Landmarks for the rectus femoris muscle of the upper right thigh, used for intramuscular
injections.
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• Dorsogluteal site
 Not preferred, should be avoided
 Close to sciatic nerve and superior
gluteal nerve
• Complications have occurred.
• Numbness
• Pain
• Paralysis
 Subcutaneous tissue
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• Rectus femoris site

 Easily accessible to clients who
administer their own injection
 May cause discomfort for some people
• Deltoid site
 Close to radial nerve, artery
 No more than 1 mL of solution can be
administered
 Hepatitis B vaccine
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Figure 35–41 A method of establishing the deltoid muscle site for an intramuscular injection.
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Intramuscular Injection Technique
• Also called Z-track

• Less painful
• Decreases leakage of irritant
medication into subcutaneous tissue
• Traps medication in muscle layer
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Skill 35–7 Administering an Intramuscular
Injection

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Intramuscular Injection

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Intravenous Medications
• Route appropriate for rapid effect (direct

to bloodstream) or for medication that
irritates tissue
• Large-volume infusions
 Safest, easiest
 Main danger is hypervolemia
• Intermittent intravenous infusions
 Tandem
 Piggyback
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Figure 35-45 Secondary intravenous lines: A, a tandem intravenous alignment; B, an intravenous piggyback
(IVPB) alignment.
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Skill 35–8 Adding Medications to Intravenous Fluid
Containers

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Skill 35–8 (continued) Adding Medications to
Intravenous Fluid Containers

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• Volume-controlled infusions
 Set such as Buretrol, Soluset, Volutrol,
and Pediatrol
 Often used with children, older clients
when volume administered is critical
and must be carefully monitored
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• Intravenous push
 Or bolus
 Undiluted and used in emergency
 Errors may not be corrected and drug
may irritate lining of blood vessels
• Intermittent infusion devices
 For clients receiving long-term therapy
 SASH flushing procedure
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Skill 35–9 Administering Intravenous Medications
Using IV Push

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Skill 35–9 (continued) Administering Intravenous
Medications Using IV Push

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Topical Medications
• Percutaneous
• Transdermal patch
• Skin applications
 Clean skin before applying
 Wear gloves
 Use surgical asepsis in presence of open
wound
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Topical Medications
• Ophthalmic medications
 Liquid or ointment medication into eye
• Irrigation
• Instillation
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Skill 35–10 (continued) Administering
Ophthalmic Instillations

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Topical Medications
• Otic medications
 Administer medication to external
auditory canal
• Irrigation
• Instillation
 Position of canal varies with age.
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Skill 35–11 Administering Otic Instillations

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Skill 35–11 (continued) Administering Otic
Instillations

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Instillations

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Instillations

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Instillations
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Topical Medications
• Nasal medications
 Shrink swollen mucus membranes
 Loosen secretions and facilitate drainage
 Treat infections of nasal cavity and
sinuses

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Topical Medications
• Nasal medications
 For self-administration:
• Suggest that client should blow nose first
• Client in seated position with head tilted
back
• Client holds tip of container just inside
the nares
• Inhales as spray enters the nasal passage
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Figure 35–51 Position of the head to instill drops into the ethmoid and sphenoid sinuses.
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Figure 35–52 Position of the head to instill drops into the maxillary and frontal sinuses.
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Topical Medications
• Vaginal medications
 Creams, jellies, foams, or suppositories
 Infections or discomfort
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Skill 35–12 Administering Vaginal Instillations

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Skill 35–12 (continued) Administering Vaginal
Instillations

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Instillations

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Instillations
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Topical Medications
• Rectal medications
 Inserting a rectal suppository
• Assist client to left lateral or left Sims
position
• Upper leg flexed
• Expose buttocks
• Put glove on hand used to insert the
suppository
• Unwrap suppository
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Topical Medications
• Lubricate smooth rounded end
• Lubricate gloved index finger
• Encourage client to relax by breathing
through the mouth
• Insert suppository gently into the anal
canal

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Topical Medications
• Avoid embedding in feces
• Press buttocks together for a few
minutes
• Ask client to remain in left lateral or
supine position for at least 5 minutes
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Figure 35–53 Inserting a rectal suppository beyond the internal sphincter and along the rectal wall.
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Inhaled Medications
• Nebulizers
 Fine spray (fog or mist)
• Metered-dose inhaler
 Extender, extender spacer
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Figure 35-55 Delivery of medication to the lungs using a metered-dose inhaler extender.
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Inhaled Medications
• Metered-dose inhaler (MDI)

 Client teaching
• Remove mouthpiece cap
• Exhale comfortably
• Hold canister upside down
• Press down once and inhale slowly and
deeply through the mouth
• Hold breath for 10 seconds or as long as
one can
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Inhaled Medications
• Metered-dose inhaler (MDI)

 Client teaching
• Remove inhaler away from mouth
• Exhale slowly through pursed lips
• Repeat inhalation if ordered
• Rinse mouth with tap water
• Clean MDI mouthpiece after each use
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Irrigations
• Irrigation (lavage)
• Stream of water or other fluid
 Clean body cavity
 Remove foreign object, secretions
 Apply heat/cold
 Apply antiseptic
 Reduce inflammation
 Relieve discomfort
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Figure 35–59 Four types of syringes used for irrigations: A, Asepto; B, rubber bulb; C, piston syringe; D,
Pomeroy.
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Fundamentals of Nursing

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Kozier & Erb's

1. Define selected terms related to the

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6. Identify essential parts of a medication

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10.List six essential steps to follow when

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13.Verbalize the steps used in administering

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16.Verbalize the steps used in:

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18.Verbalize the steps used in administering

20.Verbalize the steps used in administering

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21.Recognize when it is appropriate to delegate

• Drugs can be made from plants,

• Improper use of common medications

• Mechanism of drug action and

• Study of absorption, distribution,

• Written on chart, provided by phone or

• If an order seems inappropriate

• Fractional equation method

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• Calculating for individualized drug

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• Calculating for individualized drug

• Always assess health status

• Assess ability to self-administer

• Most accurate list possible of all drugs

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• Growth and development especially

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• NPO “nothing by mouth” or Latin “nil

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• Parenteral administration is a common

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• Preventing needlestick injuries

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• Ampules and vials

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• Ampules and vials

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• Mixing medications in one syringe