oral medications

controlled substance

Medication with the potential for addiction, misuse, and physical or mental injury are regulated by the Drug Enforcement Administration.

multi-dose

A form of packaging of a medication in which more than one dose is available. 

solution

A liquid made up of a diluent, such as water, and one or more dissolved medication compounds. 

automated dispensing system (AMDS)

A secure system used to manage medication inventory and dispensation.  

biometric identification

A method of verifying a person's identity using unique biological traits, such as fingerprints, facial recognition, or iris patterns.

Storage Areas for Medications

medication carts, medication rooms, locked medication cabinets in individual client rooms, and automated medication dispensing systems.

pharmacy bulk system

labeled container holds multiple doses of a medication.

unit-dose system

a method of medication delivery in which each dose of medication (unit) is packaged separately and labeled with the medication name and expiration date.

can contain tablets, capsules, troches, suppositories, or a pre-measured amount of a liquid medication

What is a tablet?

A medication compressed into a disk-like shape.

What is a scored tablet?

A tablet with a line that allows it to be divided into two equal parts.

Can you split a tablet that is not scored?

No.

Who should split a scored tablet if only part of the dose is needed?

The pharmacist.

What is an enteric-coated tablet?

A tablet coated to dissolve in the small intestine instead of the stomach.

Why are enteric-coated tablets used?

To prevent irritation of the stomach lining.

What is a troche (lozenge)?

A flat, round tablet that dissolves in the mouth and is not swallowed.

What is a capsule?

A medication enclosed in a gelatin shell.

What is a sustained-release capsule?

A capsule containing coated beads that release medication slowly over 12–24 hours.

What is the advantage of a sustained-release capsule?

Allows once- or twice-daily dosing.

What is a caplet?

A medication that combines features of a tablet and capsule and is easier to swallow.

What should be done if a client cannot swallow solid medications?

Use a liquid preparation if available.

If no liquid preparation is available, what can be done?

Some tablets may be crushed and mixed with a small amount of fluid or applesauce.

Which medications should NEVER be crushed or split?

Delayed-release, long-acting, enteric-coated tablets, capsules, or medications that irritate mucous membranes.

Who should the nurse consult before crushing or splitting a medication?

A drug reference or the pharmacist.

How should a troche (lozenge) be administered?

Allow it to dissolve completely in the mouth.

How long should the client avoid eating or drinking before and after a troche?

5 minutes before and 5 minutes after it has fully dissolved.

Where is a sublingual medication placed?

Under the tongue.

Why do sublingual medications work quickly?

They are absorbed directly into the bloodstream.

Where is a buccal medication placed?

Between the cheek and gum.

Why should the sides be alternated when administering buccal medications?

To prevent mucosal irritation.

What should clients NOT do with sublingual or buccal medications?

Do not chew or swallow them.

Can clients eat or drink before sublingual or buccal medications dissolve?

No.

What information is found on a unit-dose medication label? (Select all that apply.)

Generic name; Expiration date.

Which medications are administered orally? (Select all that apply.)

Metoprolol; Prilosec.

What instruction should the nurse give for a sublingual medication?

Allow the medication to dissolve completely.

Which medication forms should be swallowed? (Select all that apply.)

Sustained-release capsule; Enteric-coated tablet; Caplet.

How can the nurse prevent medication administration errors?

Compare the medication label with the MAR; Check the expiration date; Document the medication immediately after administering it.

What units are oral liquid medications prescribed in?

Micrograms (mcg), milligrams (mg), grams (g), and milliequivalents (mEq).

What units are liquid medications measured in for administration?

Milliliters (mL) and ounces (oz).

What measuring devices should clients use for liquid medications?

Calibrated dosing spoon, medication cup, oral syringe, or calibrated medication dropper.

Why should household teaspoons and tablespoons NOT be used to measure liquid medications?

They vary in size and are not standardized, making doses inaccurate.

What is an elixir?

A liquid medication containing water, alcohol, sweetener, and medication.

Example of an elixir?

Hydrocodone/acetaminophen.

What is a syrup?

A liquid medication containing water, concentrated sugar, and medication.

Example of a syrup?

Valproic acid.

What is a suspension?

A liquid medication with fine medication particles that do not completely dissolve in water.

What should the nurse do before administering a suspension?

Shake or stir immediately before administration.

Example of a suspension?

Ampicillin.

What is a solution?

A liquid medication in which the medication is completely dissolved in water or 0.9% sodium chloride.

Example of a solution?

Furosemide.

Why are liquid medications preferred for enteral feeding tubes?

They reduce the risk of clogging the tube.

Before crushing a medication for an enteral feeding tube, what should the nurse do?

Verify with the provider and pharmacist that the medication can be crushed.

If a medication must be crushed for an enteral feeding tube, what should the nurse verify?

The correct type and amount of liquid needed to dissolve the medication completely.

Should medications be mixed into enteral feeding formula?

No. Never mix medications with tube feeding.

When should the enteral feeding tube be flushed during medication administration?

Before medications, between medications, and after medications, according to provider order/policy.

Which measuring device is best for doses of 5–30 mL?

Medication cup.

What volume is a medicine spoon calibrated to measure?

1–10 mL.

Which measuring device should be used for doses less than 5 mL?

Calibrated oral syringe, calibrated dropper, or medicine spoon.

What is the first step before administering any liquid medication?

Calculate the correct dose.

What does the abbreviation "bid" mean?

Twice per day.

What does the abbreviation "tid" mean?

Three times per day.

What does the abbreviation "qid" mean?

Four times per day.

What does the abbreviation "q" ( q8h) mean?

Every (every 8 hours).

What does the abbreviation "PRN" mean?

As needed.

What does the abbreviation "IM" mean?

Intramuscular.

What does the abbreviation "IV" mean?

Intravenous.

What does the abbreviation "Subcut" mean?

Subcutaneously.

What does the abbreviation "SL" mean?

Sublingual.

What does the abbreviation "PO" mean?

By mouth (orally).

What does the abbreviation "NPO" mean?

Nothing by mouth.

What does the abbreviation "pc" mean?

After meals.