Medication Administration Practice Flashcards

A comprehensive set of vocabulary flashcards covering the principles of medication administration, the seven rights, injection techniques, and various calculation/safety protocols based on the NR224 SV lecture.

The Right Medication

Compare the healthcare provider's medication order to the MAR (or eMAR), use the MAR to prepare and administer medications, and follow the three checks system.

The Right Dose

Confirm appropriateness of dose using a drug reference, verify math calculations or conversions with another nurse, and prepare the dose using standards of measurement.

The Right Patient

Verify the patient's identity using at least $2$ identifiers and ask the patient to identify themselves.

The Right Route

Check the order and appropriateness of the administrative route, confirming the patient can take or receive the medication by that route.

The Right Time

Check the frequency of the ordered medication, ensure it is given at the correct time, and confirm when the last dose was given.

The Right Documentation

Immediate recording of medication after administration per agency policy, including any required preassessment data.

The Right Indication

Confirm the rationale for the ordered medication and ensure it correlates with the patient's history.

Three Medication Checks

Performed when the order is received (Review order with MAR), when retrieving/preparing the medication in the med room, and at the patient's bedside before administration.

Sublingual (SL)

Medication placed under the tongue to enter the bloodstream rapidly by bypassing the GI tract; patient should not eat or drink until dissolved.

Buccal

Medication placed between the gum and the inner cheek until dissolved; patient should not swallow or take food/water during this process.

Intradermal (ID) Injection

Injection administered at a $5^{\text{o}}$ to $15^{\text{o}}$ angle using a $25-27G$ needle ($1/2-5/8$ inch); commonly used for TB tests on the inner forearm.

Subcutaneous (SQ) Injection

Injection into tissue at a $45^{\text{o}}$ or $90^{\text{o}}$ angle using a $25-31G$ needle ($1/4-5/8$ inch); max volume is $3\text{ mL}$.

Intramuscular (IM) Injection

Injection at a $90^{\text{o}}$ angle into muscles such as the vastus lateralis, ventrogluteal, or deltoid using a $21-23G$ needle ($1/2-5/8$ inch); Z-track method often used.

Vastus Lateralis

IM injection landmark located in the lateral middle third of the thigh between the greater trochanter and the knee.

Ventrogluteal Site

IM injection landmark identified by placing the palm over the greater trochanter and forming a 'V' with fingers toward the iliac crest and anterior superior iliac spine.

Deltoid Landmarks

The acromion process; the injection site is approximately $2.5\text{ cm}$ to $5\text{ cm}$ (1-3 finger breadths) below this edge.

Ophthalmic Administration

Instilling drops or ointment into the conjunctival sac while the patient is supine and looking upward; press firmly on the lacrimal duct afterward.

Otic Administration (Child under $3$)

Procedure for ear drops where the pinna (auricle) is pulled down and back to straighten the ear canal.

Otic Administration (Adult/Child over $3$)

Procedure for ear drops where the pinna (auricle) is pulled up and back to straighten the ear canal.

Rectal Medication Administration

Lubricated suppository inserted past the internal anal sphincter (approx. $4\text{ inches}$) while the patient is in Sim's position (left side).

Nasal Medication Administration

Instructions include having the patient blow their nose first, tilt the head back, and breathe through the mouth during instillation.

Transdermal Patch

Topical medication applied to a clean, dry, hairless area; the old patch must be removed before the new one is applied and documented.

Insulin Mixing Sequence

The process of injecting air into the cloudy (NPH) vial first, then air into the clear (regular) vial, followed by withdrawing the clear insulin before the cloudy insulin.

Metered-Dose Inhaler (MDI)

Device requiring priming (if unused for $7$ days) and shaking for $2-5\text{ seconds}$; wait $5\text{ minutes}$ between different inhalation medications.

Dry-Powder Inhaler (DPI)

Inhaler that does not require shaking or breath-dose coordination; patient should hold breath for $10\text{ seconds}$ and perform a mouth rinse after use.

Medication Reconciliation

A safety process completed at each transition of care to prevent medication errors by reviewing the patient's complete medication list.