Chapter 53: Medication Administration

The “Rights” of Administration

• Right patient

• Right medication

• Right dose

• Right route

• Right time

• Right documentation

• Right to refuse

• Right technique

• Right reason

• Right response

When to check mediation:

1. When taking it from storage

2. Before preparing it

3. Before administering it

General Guidelines

• Calculate dosage carefully—ask for verification if unsure.

• Never return unused medication to its container.

• Always identify the patient using full name and date of birth.

• Document immediately after administering.

Oral

Swallowed (tablet, capsule, liquid)

Buccal

Between cheek and gum (not GI-absorbed)

Sublingual

Under tongue (no food or drink until dissolved)

Topical

On skin (e.g. ointments, creams)

Transdermal

Latch form

Inhalation

Inhaled through nose/mouth

Rectal

Into rectum (e,g, suppository or enema)

Vaginal

Suppository or douche

Urethral

Instilled via catheter

Parenteral

Any injection route

Intradermal

Intradermal, Upper skin layer (forearm/back) ~15°, TB & allergy tests

Subcutaneous

Fat layer (thigh, upper arm), 45°–90°, Insulin, heparin

Intramuscular (IM)

Muscle (deltoid, vastus lateralis), 90°, Vaccines, antibiotics

Z-track IM

Pull skin aside before injection, 90°, For irritating meds like Imferon

Intravenous (IV)

Into vein, 25°, Fastest absorption

Ampule

Sealed glass container

Vial

Bottle with rubber diaphragm

Insulin

Administered with special syringe (measured in units)

Epinephrine

Given during anaphylaxis

Retention Enema

Insert tube ~1.5 inches, apply pressure to prevent urge

Vaginal Suppository

Inserted angled toward sacrum (~2 inches)

How long for IV absorption?

15-30 seconds

What happens if patient vomits after medication?

Readminister if vomited within 5 minutes and visible in vomit

When should you update the mediation list?

Every visit

Diluent

liquid used to dissolve meds

Solution

Homogenous liquid mixture

Scored tablet

Designed to be broken easily

Ointment

Topical salve

Infusion

IV drip administration

Buccal

Between cheek and gum

Intradermal

Between upper layers of skin

Intravenous

Directly into blood stream

Syringe Parts: Plunger

Pulls/pushes mediation

Syringe parts: Barrel

Holds the liquid

Syringe parts: Needle

Delivers mediation

Syringe parts: Hub

Connects needle to syringe