Med Administration

Introduction

• Instructor: Miss Thomas

• Topic: State Medication Administration

Responsibilities as a Nurse

• Sole Responsibility: As a nurse, you are solely responsible for administering any medication. This includes:

  • Any dose you give is your responsibility.

  • Errors in medication can harm the patient.

Critical Thinking in Medication Administration

• Example Scenario:

  • Medication: Tylenol prescribed for a fever of 101-104°F.

  • Patient reports pain 30 minutes later.

  • Question: Can you give Tylenol again?

  • Answer: No.

    • Why?

    • It's prescribed for fever, not pain.

  • Important Note: Always strictly adhere to the doctor's order. If medication is needed for different symptoms (e.g., pain), a new order is required.

• Medication Properties:

  • Medications may be effective for multiple symptoms (e.g., Tylenol for both fever and pain).

  • Must know indications for each medication you administer, including potential side effects and interactions.

Six Rights of Medication Administration

• Verify the following before administering medication:

  1. Right Medication

  2. Right Documentation

  3. Right Time

  4. Right Dose

  5. Right Route (e.g., topical, IV)

  6. Right Patient: Ensuring that the medication is administered to the correct individual, verifying their identity through multiple identifiers such as name and date of birth.

• 7 Parts of an Order:

• 1. Patient’s Name - Identifies who will receive the medication. Ex: John Doe

  2. Date and Time of Order - Shows when the order was written; helps track validity. Ex: 10/09/2025, 0900

  3. Name of the Medication - The exact drug to be administered (generic or brand). EX: Lisinopril

  4. Dosage - The exact amount to be given per dose. Ex: 10 mg

  5. Route of Administration - How the drug will be delivered (oral, IV, IM, etc.). Ex: PO (by mouth)

  6. Frequency / Time - How often and when to administer the medication. Ex: Once daily

  7. Prescriber’s Signature - Legally validates the order — must include provider’s signature or electronic authentication. Ex: Dr. Smith, MD

Preparing for Medication Administration

• Administration Techniques:

  • Method of Giving Medication:

  • Check if it is topical or intravenous (IV).

  • For IM injections, use Z-track method to prevent leaking.

  • Documentation: Document what you administer immediately. If it’s not documented, it is considered not given.

  • Assess for any medications that are supposed to be given, checking if they were charted by previous shifts.

  • Safety:

  • No medications should be stored at the patient's bedside to prevent unauthorized access (e.g., children).

  • Observe the patient take their medication if self-administered.

Medication Checks

• Triple Check:

  • Check medication during the following stages:

  1. Before pulling from the medication room.

  2. After preparing the medication.

  3. At the bedside before administration.

• Patient Rights:

  • Patients have the right to know their medication and may ask questions.

  • They also have the right to refuse medication, which must be documented. Include the patient's reasons for refusal when possible.

Dispensing Systems

• Description of various systems in hospitals, including:

  • Ordering: Medications must have a prescription from a physician.

  • Need patient's name, medication name, dose, frequency, and doctor’s signature.

  • Additional Considerations:

  • For narcotics, include the VA number in the order.

  • An order cannot be administered if it is missing vital information (e.g., dose, route, frequency).

Oral Medications Administration

• Guidelines for administering oral medications:

  • Ensure correct measuring device for liquid medications.

  • Eye Level: Pour medications at eye level to ensure accuracy.

  • Avoid expired medications (should not give if expired more than 30 days).

• Types of Oral Administered Drugs:

  • Buccal: Placed in the cheek.

  • Sublingual: Placed under the tongue.

  • Both have rapid absorption; must remain in place until dissolved.

  • Pill Form Medications: Administer with gloves and ensure the patient is sitting up to prevent aspiration.

  • In cases where patients are unable to swallow, consider alternative methods or routes (e.g., crushing pills—where appropriate).

NG Tube Management

• Insertion and Verification:

  • Proper method for placement verification: listening for a swoosh sound in the abdomen after instilling air into the tube.

  • Flushing Protocol: Flush with 30ml water before and after administering medication, and 5-10ml in between doses if giving multiple medications.

• Patient Positioning: Keep the patient in a Fowler's position for at least 30 minutes; avoid suctioning during medication delivery.

Special Considerations for Medication Types

• Contraindications:

  • NPO patients or those at risk for aspiration may require alternative routes for medication administration.

• Skin Medications: Assess the skin for lesions or irritations.

  • Use gloves when applying ointments or creams to prevent absorption through the caregiver's skin.

• Inhaled Medications: Utilize nebulizers or inhalers ensuring correct technique and that no contamination occurs (e.g., not touching dropper tips).

• Ophthalmic and Otic Medications:

  • Dosage precision is critical and procedures must be adhered to for safety and efficacy.

Features of Syringes and Needles

• Syringe Types:

  • Luer Lock vs. Non-Luer Lock.

  • Prefilled systems, retractable needles, and other safety measures.

  • Importance of choosing the right syringe based on dose.

• Needle Specifications:

  • Be aware of gauge and lengths suitable for different injection sites and routes—always the smallest suitable needle should be chosen.

Injection Sites and Techniques

• Types of Injection Routes:

  • Subcutaneous, Intramuscular, Intravenous, and Intradermal.

• Parameters for Injection:

  • Following specific guidelines for each site including maximum volumes and angles of entry (45-90 degrees depending on subcutaneous versus intramuscular).

• Patient Safety:

  • Follow proper emergency protocols and clear documentation if a mistake occurs in medication administration.

Summary of Key Points

1. Always adhere to physician orders and confirm rights of medication administration.

2. Ensure proper techniques and patient education to minimize risk of complications.

3. Continuous assessment and documentation are necessary to provide quality patient care.

4. Stay updated with institutional protocols for medication administration and disposal of used materials.

5. Engage patients in their care through education, ensuring they know their rights.

💉 Injection Routes and Correct Angles