D.

1
MEDICATIONS
 PURPOSE OF MEDICATIONS
• The term drug or medication refers to a
substance or mixture (other than food) that is
used to do one or more of the following:
 Maintain health
 Treat disease
 Relieve symptoms
 Prevent disease
 Alter body processes
 Diagnose disease
10/29/2022 2
 RESPOSIBILITY OF THE NURSE
Preparation

Administration

Teaching

Evaluating response
10/29/2022 3
 PRINCIPLES IN GIVING
MEDICATIONS
1. Wash hand before and after preparing the
medication to reduce transfer
of microorganisms and put on gloves if needed.
2. Nurse who administer the medications are
responsible for their own action.
3. Be knowledgeable about the medication that
you administer
( Therapeutic use, normal dosage, routes/
forms, potential side effects, contra-indications)
10/29/2022 4
Follow & apply the “Ten Rights” of drug  administration.
– when administering medications, the nurse compares the label of the medication
container with medication form. The nurse does this 3 times:–

Before removing the container from the drawer or shelf –

As the amount of medication ordered is removed from the container –

Before returning the container to the storage

10/29/2022 5
 Right Medication

• The medication given was the medication ordered.

10/29/2022 6
 Right Dose

• The dose ordered is appropriate for the client

• Give special attention if the calculation indicates multiple pills or tablets
or a large quantity of a liquid medication. This can be an indication that
the math calculation may be incorrect.
• Double-check calculations that appear questionable.
• Know the usual dosage range of the medication.
• Question a dose outside of the usual dosage range.
10/29/2022 7
 RIGHT TIME

 The nurse must know why a medication is ordered for certain times of the

day and whether the time schedule can be altered
 Give the medication at the right frequency and at the time ordered
according to agency policy.
 Medications should be given within the agency guidelines.
 Each institution has are commended time schedule for medications ordered
at frequent interval. Medication that must act at certain times are given
priority (e.g. insulin should be given at a precise interval before a meal).
10/29/2022 8
 RIGHT ROUTE

Give the medication by the ordered route.

Make certain that the route is safe and appropriate for the client.
If a prescriber’s order does not designate a route of administration, the
nurse consult the prescriber.
 Likewise, if the specified route is not recommended,
the nurse should alert the prescriber immediately.

10/29/2022 9
 RIGHT CLIENT

 Medication is given to the intended client.

Check the client’s identification band with each administration of a
medication.
Know the agency’s name alert procedure when clients with the same or
similar last names are on the nursing unit.

10/29/2022 10
 RIGHT CLIENT
EDUCATION

 Explain information about the medication to the

client (e.g., why receiving, what to expect, any
precautions).

10/29/2022 11
 RIGHT DOCUMENTATION

• Documentation is an important part of safe medication administration. Document

medication administration after giving it, not before.
• If time of administration differs from prescribed time, note the time on the MAR and
explain the reason and follow-through activities (e.g. pharmacy states medication
will be available in 2 hrs) in nursing notes.
• The documentation for the medication should clearly reflect the client’s name, the
name of the ordered medication, the time, dose, route and frequency.
• Sign medication sheet immediately after administration of the drug. If a medication
is not given, follow the agency’s policy for documenting the reason why.
10/29/2022 12
 RIGHT TO REFUSE

• Adult clients have the right to refuse any medication.

• The nurse’s role is to ensure that the client is fully informed of the
potential consequences of refusal and to communicate the client’s
refusal to the healthcare provider.

10/29/2022 13
 RIGHT ASSESSMENT

• Some medications require specific assessments prior to

administration (e.g., apical pulse, blood pressure, laboratory
results).
• Medication orders may include specific parameters for
administration (e.g. do not give if pulse less than 60
or systolic blood pressure less than 100.)

10/29/2022 14
 RIGHT EVALUATION

• Conduct appropriate follow-up (e.g., was the desired effect

achieved or not? Did the client experience any side effects or
adverse reactions?)

10/29/2022 15
RIGHTS

10/29/2022 16
 GUIDELINES FOR CORRECT DRUG
ADMINITRATION
• PREPARATION
Check for drug allergies; check the assessment history and kardex
Check medication order with healthcare providers, medication sheet &
medication card
Check expiration date on drug
Pour tablet or capsule into the cap of the drug container
Pour liquid at eye level
Dilute drugs that irritate gastric mucosa or give with meals
10/29/2022 17
 GUIDELINES …
• ADMINISTRATION
Administer only those drugs that you have prepared. Do not prepare
medications to be administered by another
Identify the client by ID band or photo.
When possible give bad medication first followed by pleasant tasting
liquids
Assist the client to an appropriate position
depending on the route of administration
10/29/2022 18
 GUIDELINES…
• ADMINISTRATION
Stay with the client until the medications are taken
Administer no more than 2.5 to 3 ml of solution intramuscularly at one site and no more
than 1 ml subcutaneously. Never recap needles (universal precautions).
Discard needles and syringes in appropriate containers.
Store the medication appropriately
Write date and time opened the vial and amount of dilution and initials on the label
Report drug error immediately to clients health care provider and to the nurse manager

10/29/2022 19
 GUIDELINES…
• RECORDING
Charting: record drug given, dose time, route, and your
initials
Report to health care provider and record drugs that were
refused with reason for refusal
 Record the amount of fluid taken with medications on input
and output chart
10/29/2022 20
 BEHAVIORS TO AVOID DURING
MEDICATION ADMINISTRATION
1. Do not be distracted when
preparing medications
2.Do not give drugs poured by others
3.Do not pour drugs from containers
with labels that are difficult to read
or whose labels are partially
removed
4.Do not pour drugs into the hand
5.Do not give medications for which
expiration date has passed
6.Do not use drugs that have sediment,
are discolored or cloudy.
7. Do not leave medications at the
bedside
8.Do not give drugs if the client says he
has allergies to the drug or drug
group 10/29/2022 21
 CLIENT’S RIGHT RELATED TO
MEDICATION ADMINISTRATION
To be informed of the medication’s To received labeled medications
name, purpose, action, and
potential undesired effects.
To refuse a medication regardless of
the consequences
safely without discomfort in
accordance with the six rights
of medication administration
To have a qualified nurses or
physicians assess medication
history, including allergies
 To not receive unnecessary
medication
10/29/2022 22
 MEDICATIONS ERROR

• Wrong patient
• Wrong medication
• Wrong dosage
• Wrong route
• Wrong time
10/29/2022 23
 FACTORS AFFECTING THE DOSE and
ACTION of DRUGS
1. Age
2. Sex
3. Body weight
4. Severity of disease
5.Route of administration
6.Simultaneous administration of
two or more drugs
10/29/2022 24
 MEDICATION ROUTE

Definition: 
Medication route refers to the way
that a drug is introduced into
the body.

10/29/2022 25
 ROUTES of ADMINISTRATION

• Oral • Vaginal
• Buccal • Rectal
• Sublingual • Dermal
• Eye (Opthalmic) • Respiratory (Inhalation)
• Ear (Otic) • Nasal
10/29/2022 26
ROUTES FOR ADMINISTRATION
(TIME UNTIL EFFECT)

10/29/2022 27
 COMMON FORMS OF ORAL
MEDICATIONS
• Tablet Definition:
• Syrup • Oral medication is defined as the
administration of medication by
• Capsules mouth.
• Suspensions
• Solutions
•  An adequate amount of water should
be given to lubricate or dissolve the
• Liquids solid medications or to dilute the liquid
forms for swallowing
10/29/2022 28
 ADVANTAGES

1. Easy
2. safe
3. and convenient route

10/29/2022 29
 DISADVANTAGES
1. Delayed action
2. Irritant drugs can not be given
3. Some drugs are destroyed by gastro- intestinal enzymes ex. insulin,
penicillin etc.
4. Absorption may be uncertain
5. Cannot be administered to an unconscious patient
6. Cannot be given to patients having gastrointestinal upset such as
diarrhea and vomiting
10/29/2022 30
• Verify the medication order using the client’s kardex.
• Check any inconsistencies with Dr. before administration
• Prepare one client’s medication at a time
Liquid medications:
Measure liquid medications by holding the medicine cup at eye level and
reading the level at the bottom of the meniscus.
• One client’s medication at a time

10/29/2022 31
• Crush pills if the client is unable to swallow them: Place the pill in a pill
crusher and crush the pill until it is in powder form

❖NursingAlert❖
• Do not crush time-release capsules or enteric-coated tablets

• Dissolve substance in water or juice, or mix with applesauce to mask the taste

• If no need to crush, cut tablets at score mark only

10/29/2022 32
10/29/2022 33
 DOSE FORMS FOR TOPICAL
ADMINISTARTION
• Lotion
• Gel
• Ointments
• Creams
• Transdermal Patches

10/29/2022 34
10/29/2022 35
 TOPICAL DOSE FROMS
(EYE or EARS)
• Ointments • Eye(ophthalmic) medications are
• Solutions put into the eye by means of a
dropper (liquids) or a tube
• Suspensions (ointments).
• Squeeze the amount of
medication as prescribed into the
eye dropper

10/29/2022 36
 EYE DROPPER
• With dominant hand, hold eye dropper ½ to
¾ inch above the eye ball, the rest hand is on
patient forehead to stabilize
• lace non dominant hand on cheek bone and
expose lower conjunctival sac by pulling on
cheek while applying slight pressure to the
inner chantus
• Instruct the patient to look up and drop the
drops into center of conjunctival sac

10/29/2022 37
• Do not instill medication drops
directly into the cornea
• If the patient blinks and the drops
land on the outer lid or eyelash,
repeat the procedure
• Instruct patient to close and move
eyes gently

10/29/2022 38
 EAR MEDICATIONS
• Ear (otic) medications can be placed into the ear by means of a dropper.

10/29/2022 39
• Rub the medicine bottle between the palms of your hands or
place in warm water to warm the drops.
• Feel a drop to make sure drops aren't too hot or too cold.
• Ask the child to lie down or sit with the affected ear facing up.
• Observe for any discharge (thick yellow or green substance),
pus (cloudy)

10/29/2022 40
FOR CHILDREN UNDER 3 Years old

• a. Gently pull the outer flap

of the affected ear
downward and backward to
straighten the ear canal.
• b. Look for ear canal to
open.

10/29/2022 41
 FOR CHILDREN UNDER >3 Years old

• a. Gently pull the outer flap of

the affected ear UPWARD and
backward to straighten the ear
canal.
• b. Look for ear canal to open.

10/29/2022 42
• Ask the child to remain lying down for
about 1-2 minutes so the medicine will be
absorbed.
• Gently rub the skin in front of the ear to
help the drug flow to the inside of the ear.
• Place a cotton ball in the childʼs affected
ear to avoid leakage of the medicine.
Replace the cotton ball each time the
medicine is given. 10/29/2022 43
 VAGINA

• Tablet
• Creams
• Ointments

10/29/2022 44
 RECTAL

• Ointments Medications are administered in

the form of suppositories;
• Solutions creams and ointments.

• Suppositories Absorption is through the

mucous membrane lining.
• Creams

10/29/2022 45
 PURPOSE
• Rectal medications are
administered for a localized
effect on the rectum or for a
systemic effect when a
patient is vomiting, unable
to swallow, or unconscious

10/29/2022 46
 ADMINISTERING SUPPOSITORY
• Ensure privacy, covering patient with a
blanket to maintain dignity and prevent
embarrassment
• Wash your hands, put on a disposable
apron and gloves to reduce the potential
transfer of micro-organisms
•. Position, keeping lower leg straight and
upper leg bent forward
• Ask the child to take slow deep
breaths to relax the anal
sphincter
• Ask patient to hold medication
for at least 10–15 minutes after
instillation to enhance
medication absorption
10/29/2022 47
TRANSDERMAL PATCH

10/29/2022 48
 MEDICATIONS SENSITIVE TO THE
SUN
• What medications can cause photosensitivity?
• These common medications can make you more sensitive to
the sun:
• Antibiotics,
particularly tetracyclines like doxycycline and fluoroquinolon
es like ciprofloxacin
• Tricyclic antidepressants like amitriptyline and nortriptyline
• Older antihistamines like promethazine
• Griseofulvin, an antifungal medication 10/29/2022 49
 MEDICATIONS SENSITIVE TO THE
SUN
• Quinine and other antimalarial medications
• Acne medications like Accutane (isotretinoin) and Retin-
A (tretinoin)
• Methotrexate, which is used for certain autoimmune conditions
and cancers
• Sulfonylurea drugs for diabetes like glyburide, glipizide,
and glimepiride
• Hydrochlorothiazide (HCTZ) and other thiazide diuretics
• Some heart medications for arrhythmia, including amiodarone,
which can cause a blue-gray discoloration of the skin 10/29/2022 50
PROPER DISPOSAL OF MEDICATIONS

• People will need to dispose of any medication that is:

• past the expiry date
• unwanted
• unused
• damaged or contaminated in any way
• unidentified

10/29/2022 51
 Disposing medicines in household trash:  These
include prescription and over-the-counter (OTC) drugs in
pills, liquids, drops, patches, and creams
• Remove the drugs from their original containers and mix them
with something undesirable, such as used coffee grounds, dirt,
or cat litter. This makes the medicine less appealing to children
and pets and unrecognizable to someone who might
intentionally go through the trash looking for drugs.

10/29/2022 52
 Disposing medicines in household trash:  These
include prescription and over-the-counter (OTC) drugs in
pills, liquids, drops, patches, and creams
• Put the mixture in something you can close (a re-sealable zipper storage
bag, empty can, or other container) to prevent the drug from leaking or
spilling out.
• Throw the container in the garbage.
• Scratch out all your personal information on the empty medicine
packaging to protect your identity and privacy. Throw the packaging away.

10/29/2022 53
 MEDICAL ABBREVIATIONS in
MEDICATIONS
1. a.c- before meals 9. PO – (per orem) by mouth
2. ATC – Around the clock 10. QID or q.i.d – (L: ‘’quarter in die’’) once a
3. AU – each ear, both ears day

4. BID or b.i.d – (L: ‘’bis in die’’) 11. q_h – (‘’q’’ quaque ‘’h’’ hours) every hours
12. qhs – (L: quaque hora somni) every
5. 2x a day
bedtime
6. Cap – capsule 13. Tab – tablet
7. D/C or DC – discontinue or disscharge 14. TID or t.i.d – (L: ‘’ter in die’’) 3x a day
8. DX – diagnosis 15. TX – treatment, therapy, transplant
10/29/2022 54
 MEDICAL ABBREVIATIONS in
MEDICATIONS
1. qod-every other day 11. h.s- at bedtime
2. qAM – each morning 12. npo- nothing by mouth/nothing per orem
3. qPM – each evening 13. prn- as needed
4. R/O – rule out 14. O.D – right eye
5. UA or u/a – urinalysis 15. O.S – left eye
6. U or u – unit 16. O.U – (oculo unitas) both eyes
7. ml – millilitres 17. q.d –each day
8. IU – international units 18. q2h –every 2 hours
9. oz – ounce
19. q3h – every 3 hours
10. L – liters
10/29/2022 55
Thank you!

10/29/2022 56