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Medication

AdministrationWe must get it right the first and

every time!

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Five Rights of Administration

Right patient

Right

medication

Right dosage

Right routeRight time

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Oral MedicationsMost commonly used route.Absorption through stomach and

small intestine.

Must first determine clients ability toswallow medication, and aspiration

risk.

Anxiety, knowledge deficits, and non-

compliance in taking medications

should all be assessed.

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A few tips when preparing oral

medications: Prepare medications for

one patient at a time.

Do not open wrapper untilat the bedside.

Recheck each medicationpackage or preparationwith the order as it ispoured.

After medications areprepared, recheck themonce again with orderbefore taking to client.

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More tips for oral medications:

See that the client receives themedications at the correcttime.

Identify the patient carefullyespecially if they are verbally

compromised! Remain with the patient until

each medication is swallowed.NEVER leave the medicationat the patients bedside.

Check patient within 30minutes to verify response tomedication!

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Know your medications!

Before administering any unfamiliarmedications, know the following:

Mode of action and purpose of medication

Side effects of and contraindicationsAntagonist of medication

Safe dosage range for medication

Interactions with other medications Precautions to take prior to administration

Proper administration technique

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Calculating Dosage:

You have a client who is to have 400mg of

antibiotic, and you have 200mg tablets.

Formula is the following:

Dose on hand = Dose desired

Quantity on hand X

Cross you heart you will never forget!

200 mg = 400mg 200X=400 X=2 tablets

1 tablet X

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When using the needle/syringe

technique: Note the needle gauge

(e.g. 18,20). The biggerthe number, theSMALLER the bore size.

Note the need length(e.g. 1, 11/2). Determinelength needed by whattype of tissue you aretrying to reach.

Size of syringe isdetermined by amount ofmedication.

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Angles of different types of

injections

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Sites for subcutaneous injection

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Subcutaneous injections

Should contain no more than 1 ml of fluid Give at 45-90 degree angle.

Sites are as follows:

Outer aspect of upper arm Abdomen

Anterior aspects of thigh

Upper back

Upper ventral or dorsogluteal area.

Insertion site depends on patients preference,

nurses preference, and type of medication.

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Intramuscular Injections

Should contain nor more than 3-5ml offluid

Normal angle of insertion is 72-90

degrees. Injections sites include:

Vastus lateralis

Ventrogluteal Deltoid

Dorsogluteal

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Sites for intramuscular injections

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Insulin and working with vials:

A vial is a glass

bottle, with a self-

sealing stopper.

Swab top with

antimicrobial swab

before entering

with a needle.

Inject air. Inject air into the

vials to allow fluid

to be pulled out.

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Insulins If insulin is a suspension

(NPH, Lente) roll andagitate the vial to mix itwell.

Regular (Actrapid) insulinshould never becontaminated with NPHor any insulin modifiedwith added protein

(medium and long-actinginsulins).

Inject air into both vialswhen they are sitting flat,so that the insulin doesnttouch the needle tip.

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Insulin preparation Draw up the Regular

(Actrapid) insulin first,and make sure it isnot contaminated with

the other types ofinsulin.

Roll the cloudy insulinbetween your hands

to mix, and then drawup without over-drawing (haveanother R.N. observe

you doing this).

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Tap while upside down to

remove bubbles

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Clean area, and bunch up skin

to inject

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Inject the insulin

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Massage site after subcutaneous

but not with clexane or heparins

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For lab this week:You will need to work through

worksheets on pages 23, 26, 27, 28,30, 31, 32-33.

Have your lab partner/peer sign youoff for each of the above sheets.

You may also be able to get someworksheets signed off when you arein clinical.