310 Lab - Medication Administration

Medication Administration Overview

Week Plan for Medication Administration

  • Timeline: Within three weeks, administration training will commence after validating competency on November 12.

  • Tasks:

    • Same structured approach as previous tasks (wound care and Foley insertion).

    • Participants will administer medications following a specified protocol.

Medication Administration Rights

  • Six Rights: These are essential checks before administering any medication.

    1. Right Patient:

    • Confirm patient identity using name and date of birth.

    • Utilize hospital wristband scanning systems for verification.

    1. Right Medication:

    • Double-check drug packaging against the medication record (MAR).

    • Reverify medication at the bedside after retrieving it from the med room.

    1. Right Dose:

    • Ensure the prescribed dose matches the available medication. Example: If prescribed 12.5 mg, and available is a 25 mg tablet, a half tablet must be administered.

    1. Right Time:

    • Administer medications within a 30-minute window (before or after the scheduled time).

    • Consider previous doses that may affect subsequent timings, ensuring to adjust appropriately.

    1. Right Route:

    • Confirm the method of administration (e.g., oral, IV). Ensure the selected route corresponds with medication's available forms.

    1. Right Documentation:

    • Document every administration in real-time. Include patient scans for verification.

Medication Administration Checks

  • Three Checks: Integral to ensuring accuracy in the medication process.

    1. Check when removing medication from the storage machine (e.g., Pyxis).

    • Verify drug, dose, route, and time before administration at the bedside.

    1. Final check at the bedside before administration.

    2. Document everything immediately after administration.

Medication Administration Routes

  • Common Routes of Administration:

    1. Sublingual:

    • Medication placed under the tongue for absorption. Example: Nitroglycerin.

    1. Oral (PO):

    • Consult drug guidelines for food interactions and side effects.

    • Administer with minimal food/beverage for better absorption.

    • Be mindful of contraindicated foods (e.g., grapefruit juice) that interfere with drug absorption.

    • Understand patient swallowing abilities.

    1. Transdermal:

    • Patch application on hairless skin areas.

    • Use gloves for application/removal to avoid self-exposure to medication.

    1. Topical:

    • Apply using gloves and suitable tools (e.g., tongue blade).

    1. Eye Drops:

    • Aseptic technique, position patient correctly, apply drops without touching the eye.

    • Wait 5 minutes between different eye medications.

    1. Ear Drops:

    • Aseptic technique, align ear for proper administration, instruct patient to remain on their side post-application.

    1. Inhalation:

    • Utilize proper inhaler techniques with patient instruction.

    • Rinse mouth after corticosteroid inhalers to prevent infections.

    1. Suppository:

    • Follow specific manufacturer guidelines for administration.

    • Position patients correctly for effective delivery.

Dosage Calculations and Administration

  • Conversions:

    • Understand the conversions between grams, milligrams, micrograms, liters, and milliliters.

    • 1 gram = 1000 milligrams = 1,000,000 micrograms.

    • 1 kilogram = 2.2 pounds.

  • Rounding Rules:

    • Round only at the end of calculations to avoid errors during progression.

    • Always include leading zeros and avoid trailing zeros in documentation (e.g., 0.5 mg is preferable to .5 mg).

  • Formulas:

    • Desired Dose Formula: Dose<em>desired=Dose</em>orderedDoseavailable×VolumeDose<em>{desired} = \frac{Dose</em>{ordered}}{Dose_{available}} \times Volume

    • Rounding: If the digit before the rounded number is 5 or greater, round up. If less than 5, keep the same.

IV Flow Rate Calculations

  • IV Administration:

    • Determine rate using total volume and time.

    • Convert minutes to hours when programming IV pumps.

    • Example: For 1 L over 6 hours, infuse 167 mL/hour.

  • Drip Factor:

    • Use drip factor for calculating drops per minute; example involving a volume (
      $$Volume = \text{mL} ) divided by time in minutes.

Practice Problems

  • Follow-up Activity:

    • Practice and calculate typical medication dosage problems and IV flow rates based on the scenarios presented (common calculations provided).

Important Reminders

  • Collaborate with respiratory therapists for medication management and inhalation treatments if required.

  • Keep practicing calculations and medication administration knowledge for proficiency in clinical settings.