Administering oral medication

R.Janagi lakshmi
Nursing tutor,
KVCN.
DEFINITION:
 Administration of medication by
mouth. Oral medication administration
includes buccal(cheek) and
sublingual(under tongue).
PURPOSE:
 To prevent the disease.
 To cure the disease.
 To promote the health.
 To give palliative treatment.
 To give as a symptomatic treatment.
CONTRAINCATIONS:
 Alteration in normal functions of
gastrointestinal tract like vomiting.
 Reduced gastrointestinal motility(after
general anesthesia, bowel
inflammation,etc.).
 Surgical resection of a portion of
gastrointestinal tract.
 Inabilityto swallow (e.g. patient’s with
neuromuscular disorder, esophageal
strictures, mouth lesions).
 Patients with gastric suction/aspiration.
 Prior to certain tests/surgery.
 Unconscious/confused patients.
 Patients with poor gag reflex.
ARTICLES REQUIRE:
1. Medication card/patient’s files.
2. Medication tray.
3. Small plastic cups/paper cups/bottle caps.
4. Glass of water.
5. Calibrated disposable cups/ouncle glass for liquid
medications.
6. Mortar and pestle.
7. Scissors.
8. Kidney tray.
9. Paper towel/tissue paper( for liquid medication.
PROCEDURE:
1. Assess for any contraindication.
2. Determine patient’s preferences and physician’s
order for fluid restriction,if any.
3. Prepare needed supplies and articles.
4. Check medication card/form with physicians written
order for accuracy, completeness,etc.
5. Check patient’s name, name of drug, dose, route and
time of administration. Clarify any doubt. Report any
discrepancy to charge nurse and physician.
6.Prepare drug.
Wash hands.
Arrange medication tray in nurse’s station(optional).
Prepare medicine of one patient at a time, keeping
medication card and forms together.
Select correct drug container from stock while
checking label with name of drug in medication card
and expiry date(first check).
 Calculatecorrect drug dose. Take time and double
check calculation.
 For tablets/capsules,pour required number from
bottle into bottle cap and transfer to medication
cup. Do not touch with fingers. Extra
tablets/capsules may be returned to bottle. For
packaged tablet/capsule, place packaged
tablet/capsule directly over cup and remove without
touching it (retain strip) check medication before
removing from bottle or strip (second check).
 Placeall tablets to be given at the same time
in one cup (except those requiring pre-
administration assessment, e.g. vital signs.
 If patient has difficulty in swallowing, grind
tablets in a mortar with pestle. Crush it to a
fine powder and mix it with small amount of
water.( do not crush enteric coated
tablet/sustained action tablet).
Prepare liquids.
1. Shake bottle.
2. Hold bottle with label against palm of hand when
pouring .
3. Hold medication cup to eye level and fill it to desired
level.
4. Discard if there is excess liquid in cup into sink,wipe
mouth of bottle with paper towel. Excess medication
should not be returned to medication container.
5. For volume less than 5ml/10ml, a syringe without
needle can also be used to measure the quantity of
medication.
 Do not leave drug unattended.
 Returndrug container back to cupboard after
checking label.(third check).

6. Administer drug.
Take medication to patient at correct time.
Identify patient by comparing name on card
with the name patient gives when asked.
 Perform necessary per-administration
assessment for specific medication (e.g.
blood pressure,pulse,etc.).
 Explain to patient the medication to be
given and allow patient to clarify doubts.
 Assist patient in sitting or side lying
position.
 Administer drug properly
● Ask if patient wishes to hold
medication in cup/hand before placing
in mouth.
● Administer only one drug at a time.
● Offer a glass of water with the drug to
be administered.
● Place medication under tongue and allow it
to disslove completely in case of sublingually
administered medication caution patient
against swallowing.
● Instruct patient to place the medication in
mouth against cheeks until it dissolves
completely in case of buccal administration.
● Prepare powdered medication at bed side
and give to client
● Caution patient chewing or swallowing
lozenges.
● Give effervescent tablets immediately after
dissolving.
● If patient is unable to hold medication in
hand,place cup to the lip And transfer each drug
into mouth one at a time using a spoon. Do not
rush.
 Iftable/capsule falls on the floor, discard it
and repeat tablet preparation.
 Stay with patient until each table is
swallowed. Ascertain that all tablets are
swallowed.
 Assist patient to comfortable position.
 Dispose off solied supplies and wash hands.
 Returnmedication cards, forms/printouts
to appropriate files for next administration.
 Clean work area.
 Record the medication administration with
date, time and signature.
 Return within 30 minutes to evaluate
effectiveness of medication.
SPECIAL CONSIDERATIOS:
 Administermedications which can irritate the
stomach mucosa with a light snack or following
a meal, e.g. aspirin, brofen.
 Administer medications with a light snack or
following a meal if required (e.g. aspirin).
 Administer medication with water and avoid
fruit juice, milk,etc.
 Donot administer water after giving cough
syrup.
ADVANTAGE:
 This method is safe and convenient.
 It is efficient method.
 There is no pain while administering the drug.
 Allergic reaction are very less.
DISADVANTAGES:
 Some times the patient may not swallow
the medicine.
 The drug may only be partially observed.
 Itmay irritate the gastric mucosa and can
cause vomiting or diarrhea and the effect is
lost.
NURSES RESPONSIBILITY:
 Check the diagnosis and age of the patient.
 Check the purpose of medication.
 Checkthe identification of the patient the name
and bed number.
 Check the physician’s order for the correct name
of the drug, dosage and method of administration.
 Check the nurse record for the time at which the
last dose was given.
 Check for any contraindications present in the patient
for an oral intake of the medicines such as nausea,
vomiting unconsciousness, etc.
 Checkthe character of the drug- whether it can be
taken safely by the oral method.
 Check
the form of the dues available and the correct
method of administration.
 Check the level of consciousness of the patient and
ability to follow instructions.
 Checkthe ability and limitations in swallowing the
medications.
Thank you☺☺☺