Medication Administration in Radiography

MEDICATION ADMINISTRATION IN RADIOGRAPHY

General Overview

  • Course: RAD 165 - Spring 2026

  • Referenced Texts:

    • Chapter 15 - Patient Care in Radiography Ehrlich

    • Chapter 22 Adler

Key Topics

  • Correct method of assisting with drug administration in radiology

  • Understanding and listing the “6 rights” of medication administration

  • Factors affecting drug administration

  • Common routes for drug administration

  • Common abbreviations used in medication administration

  • Procedure for drawing medication from vials and ampules

  • Symptoms and management of infiltration

  • Procedure for discontinuing IVs

Responsibilities in Drug Administration

  • Must know how to monitor systems

  • Be able to locate medications in emergencies

  • Familiarity with rules governing medication administration at state and institutional levels

Physician Orders

  • Physician selects:

    • Drug

    • Route

    • Exact Dosage

  • Orders may be:

    • Written

    • Verbal

    • Standing orders

  • Note:

    • Verbal orders may not be acceptable in all states or institutions. If given, they should be promptly written or countersigned by the physician.

Written Orders Definition

  • Defined as: "Written directions for a specific medication or procedure, signed by a physician, used only under specific conditions stated in the order."

  • Orders can be found in Policy and Procedure Manuals or Standing Order books.

  • Example order includes:

    • Examination requiring meds

    • Name and amount of drug

    • Time of administration

    • Conditions precluding the order

Medication Administration Process (6 Steps)

  1. Check 2 patient identifiers:

    • Full name & birthdate

    • Check armband

  2. Check the order:

    • Consult with doctor about any dosage or administration method questions

  3. Verify medication:

    • Check and confirm the medication’s expiration date

  4. Perform hand hygiene.

  5. Prepare medication:

    • Use the 6 rights to prevent errors

  6. Notion:

    • No medication should EVER be given WITHOUT a physician’s order

The “6 Rights” of Medication Administration

  1. The RIGHT dose/amount

  2. Of the RIGHT medication

  3. To the RIGHT patient

  4. At the RIGHT time

  5. By the RIGHT route

  6. With the RIGHT documentation

Dosage Considerations

  • Usual and safe dosage ranges are found in:

    • Package inserts

    • Online resources

  • Physicians can prescribe dosages that vary from standard due to specific medical justification.

  • In case of unusually high orders, always verify before administration.

Drawing Medication from Vials and Ampules

Procedures for Vials

  • Vial Details:

    • Closed system requires equal air injection as fluid removal.

  • Steps:

    1. Check label

    2. Pull off the vial cap exposing the rubber stopper (don't contaminate)

    3. Do not remove outer ring

    4. Remove needle cover

    5. Insert needle into stopper

    6. Inject air into the bottle

    7. Invert bottle

    8. Ensure needle is below fluid level

    9. Pull plunger to the desired level

    10. Check for and dislodge any bubbles

    11. Replace needle cover

    12. Label syringe if not immediately administered

Procedures for Ampules

  • Ampule Details:

    • Glass containers with narrow necks, opened by breaking glass. Filtration needle is necessary to prevent glass shards in the syringe.

  • Steps:

    1. Protect hands with gauze

    2. Break ampule away from the face

    3. Insert filtration needle tip below the liquid level

    4. Withdraw the required amount

    5. Check for air bubbles, holding syringe upwards, tap to release bubbles by applying gentle pressure to plunger.

    6. Replace filtration needle with an injectable needle

    7. Verbally confirm and show the physician the ampule and syringe

Routes of Medication Administration

  • Enteral Route:

    • Oral: Common, with medications available as tablets, capsules, granules, and liquids. Absorption time is longer due to full GI tract passage. Enteric-coated tablets must be swallowed whole.

    • Rectal:

    • Used when patients are nauseated and unable to swallow. Unreliable dosage via suppositories or enemas.

    • Nasogastric tubes offer an effective alternative.

  • Inhalation Route:

    • Used particularly for respiratory conditions; medications are vaporized and inhaled, e.g., Albuterol for asthma.

  • Topical Route:

    • Medications applied directly to skin or membranes for localized or systemic effects. Examples include transdermal patches for nicotine or Fentanyl.

  • Sublingual and Buccal Routes:

    • Under the tongue or inside the cheek for better absorption, e.g., Nitroglycerin for angina.

  • Parenteral Routes:

    • Injections: Directly into the body bypassing GI tract.

    • Various methods:

    • Intradermal: TB tests

    • Subcutaneous: Into fatty tissue

    • Intramuscular: Injection into muscle (avoid anterior thigh)

    • Intrathecal: Spinal canal injections

    • Intravenous (IV): Into a vein

    • Intraarterial: Into an artery

Administration Techniques

  • Ensure proper equipment: syringe, needle, alcohol wipes.

  • Critical Checks:

    • Read the label three times:

    1. When selecting the container

    2. While preparing the dose

    3. Just prior to injection

  • IV Medication Administration:

    • Options include existing IV lines or direct IV injections via hypodermic needles. Compatibility must be confirmed for any medications administered with existing IVs.

IV Monitoring and Management

  • Regularly check the chart and consult with the RN for the correct rate of administration. Adjustments to drip rates must be communicated.

  • Correct height of the IV bag is crucial:

    • 18-20 inches above vein level to prevent blood backflow or infiltration.

  • Injection site monitoring for signs of infiltration:

    • Cool, swollen, boggy areas indicate possible infiltration.

Infiltration and Extravasation

  • Definitions:

    • Infiltration: Fluid diffusion into surrounding tissues.

    • Extravasation: Fluid leakage outside the vessel; both are painful and dangerous.

    • Vesicant agents can cause blistering if infiltrated into subcutaneous tissues.

  • Signs to Monitor: Check for backflow of blood, immobilize the catheter if discomfort is reported, and stop the injection immediately if swelling is observed.

Response to Infiltration

  1. Remove IV/needle.

  2. Assure the patient that any pain is temporary.

  3. Maintain pressure until bleeding stops.

  4. Apply hot or cold compress based on the drug type:

    • Hot for non-corrosive drugs, cold for corrosive drugs.

  5. Document the incident and advise the patient to contact a physician if discomfort persists.

Discontinuing an IV Line

  • Always wear gloves and handle items that might be contaminated with blood carefully. Dispose of used syringes and needles in puncture-proof containers immediately.

  • Follow established aseptic techniques, read labels three times, and document all relevant information:

    • Date, time, drug name, dosage, route of administration, identifier of person administering, expiration date, and lot number.

Documentation of Medications

  • Charting must include necessary details as outlined above.

  • Any adverse reactions must be reported promptly and documented in incident reports.