Safe Drug Administration

Nelia B. Perez RN, MSN

Northeastern College – Nursing Department

Santiago City, Philippines 3311

RIGHTS IN DRUG ADMINISTRATION

• Right Patient

• Right Route

• Right Drug

• Right Frequency

• Right Dose

• Right Approach

• Right Assessment

• Right to refuse

• Right Education

• Right Evaluation

• Right Documentation

Nursing Management

• Nursing : An Art and a Science

• The Nursing Process

1. Assessment

2. Nursing Diagnosis

3. Planning

4. Interventions

5. Evaluation

ASSESSMENT

• History

- chronic conditions

- Drug Use

- Allergies

- level of education- level of understanding of Disease and therapy

- Social Supports

- Financial Supports

- Pattern of Health Care

- Physical Assessment

1. weight

2. age

3. Physical Parameters r/t disease or drug effects

NURSING DIAGNOSIS

• IT MAY BE:

1. two part

2. three part

• Should be based on NANDA

PLANNING

• Should be SMART

• Can be short term or long term

INTERVENTIONS• 7 points to Proper Drug Administration

1.Drug

2.Storage

3.Route

4.Dosage

5.Preparation

6.Timing

7. recording

Comfort measures

• Placebo effect

• Managing adverse effects

• Lifestyle adjustment

• Patient and Family Education

KEY ELEMENTS TO PATIENT EDUCATION

• Name, Dose and action of Drug• Timing of Administration• Special Storage and preparation

instructions• Special comfort or safety measures• Safety measures• Specific points about drug toxicity• Special warnings about drug

discontinuation

EVALUATION

• The evaluation is an integral part in the nursing process.

• The effectivity of the drug therapy is determined through evaluation.

DOSAGE CALCULATIONS

• Measuring Systems

- Metric System

- Apothecary System

- Household system

Converting between Systems

• Ratio and proportion

Calculating Dosage

• Oral Drugs

• Parenteral Drugs

• Intravenous solutions

• Pediatric considerations

GENERAL FORMULA

Dosage X quantity

stock

ORAL DRUGS

• Amt of drug available = amt of drug prescribed

one tablet or capsule no. of tabs or caps

PARENTERAL DRUGS

Amt of drug available = amt of drug prescribed

volume available volume to administer

Intravenous Solution

Drops/min = mL of sol pres/hr x drops delivered / mL

60 minutes / 1 hour

1. Clark's Rule for Infants or Children:Clark’s rule is based upon the weight of the child. To determine the proper dosage for children, divide child’s weight in pounds by 150 to get the correct fraction of adult dose. Example: For a 50 pound child give 50/150 (or 1/3) of the adult dose. Therefore, if the adult dose is 30 drops taken 3 times per day, the child’s dose will be 10 drops taken 3 times per day (not 30 drops taken 1 time per day!)

(Weight in pounds x (Adult dose)

150

(That's: Child's weight in pounds times adult dose divided by 150)

2. Fried's Rule for Infants and Children up to 1 to 2 Years:

(Age in Months) x (Adult Dose)

150

(That's: Child's age in months times adult dose divided by 150)

3. Young's Rule for Children from 1 year to 12 Years:Young’s rule is based upon the age of the child, regardless of its weight. It is a “rule of the thumb” method for calculating the dose of medicine to be administered to a child. The child’s age divided by age plus 12 represents the fraction of the adult dose suitable for the child.

(Age in Years) x (Adult Dose) Age + 12

(That's: Child's age in years times adult dose divided by child's age plus 12)

Problems

• Change to equivalents within the system:

1. 100 mg = ______g

2. 1500 g = ______kg

3. 0.1 L = _______ mL

4. 500 mL = _______L

Convert to units in the metric system• 150 gr = _________ g

• ¼ gr = ________mg

• 45 min = ______mL

• 2 qt = ______L

Convert to units in the household system• 5 mL = __________tsp

• 30 mL = _________tbsp

Convert the weights in the following problems• A patient weighs 170 lb. What is

the patient’s weight in kilograms?

• A patient weighs 3200 g. What is the patient’s weight in pounds?

• Robitussin cough syrup 225 mg PO is ordered. The bottle reads: 600 mg in 1 ounce. How much cough syrup should be given?

• A postoperative order is written for ¼ gr codeine every 4 hours as needed for pain. Each dose given will contain how many milligrams of codeine?