Medication Administration
Terms
Therapeutic: clinical usefulness
Pharmacological: pathophysiology
Nursing Indications/Implications: your patient
Prescription v OTC
Dose Range v BID
ADE
Compatibility
Drug Toxicity: overdose
peak and trough lab tests
Unit Dose: pyxis
Medication reconciliation
Drug Allergies
History
Identify by armband
chart and wristband each time
Pharmacy RN
The nurse needs to ask each patient
Allergy vs Dislike
Common allergic manifestations: signs and symptoms
Medication Order
Date
Client’s name
Name of drug
Dose
Frequency
Route
Signature/ RBTO (Read back the order)
Six Rights of Medication (PDDTRR)
Right Patient
Right Drug
Right Dose
Right Time
An hour before or after the designated time
PRN: as needed, but has to be at a minimum of the hour ordered
Right Route
Right Reason
“Please don’t drop the red roses”
Safe Administration of Drugs
Prep: Med cups, pill crusher, scorer, proper syringe, needle, alcohol pad, MAR
Administration: Name & DOB, MRN and 6 Rs.
Open at beside, safety and education
HOB
Developmental stage
Illnesses/deficits
Assessment of current status
Common Errors
Administering PRN meds too early
Giving full pill instead of a half
Omission 6 Rs and 3 checks
Talking at the pyxis
Administration Routes
Oral
Sublingual
Buccal
Eye
Ear
Vainga
Rectal PR (Left, lubricate 2-3inch)
Topical: transdermal patches/cream
Inhalation- Nebulizer or inhaler
Parenteral IV solutions, IV piggybacks
Controlled Substances
If disposing a narcotic, needs to be documented by two people
Gerontologic Considerations
Renal insufficiency
Low weight
chronic illnesses >6
Meds/day >12
PMHX: previous adverse drug reactions
“lots of cooks in the kitchen”
Multiple providers prescribing the same meds
Systems are slower
Strategies to Avoid Polypharmacy
Identify indication for each med
Still present??
Check for duplicates
Meds for adverse reactions?
Therapeutic doses?
Significant reactions
Education given
Inhalation is the quickest-acting medication
When giving meds, take the vital signs beforehand.
Check labs before medicating.
Frequencies
QD: Everyday [9 am]
BID: 2x/ day [9 am and bedtime (HS)]
TID: 3x/day [around meals]
QID: 4x/day [Meals and HS]
Finger sticks
AC: before meals and HS: bedtime
Insulin is high alert medication
Terms
Therapeutic: clinical usefulness
Pharmacological: pathophysiology
Nursing Indications/Implications: your patient
Prescription v OTC
Dose Range v BID
ADE
Compatibility
Drug Toxicity: overdose
peak and trough lab tests
Unit Dose: pyxis
Medication reconciliation
Drug Allergies
History
Identify by armband
chart and wristband each time
Pharmacy RN
The nurse needs to ask each patient
Allergy vs Dislike
Common allergic manifestations: signs and symptoms
Medication Order
Date
Client’s name
Name of drug
Dose
Frequency
Route
Signature/ RBTO (Read back the order)
Six Rights of Medication (PDDTRR)
Right Patient
Right Drug
Right Dose
Right Time
An hour before or after the designated time
PRN: as needed, but has to be at a minimum of the hour ordered
Right Route
Right Reason
“Please don’t drop the red roses”
Safe Administration of Drugs
Prep: Med cups, pill crusher, scorer, proper syringe, needle, alcohol pad, MAR
Administration: Name & DOB, MRN and 6 Rs.
Open at beside, safety and education
HOB
Developmental stage
Illnesses/deficits
Assessment of current status
Common Errors
Administering PRN meds too early
Giving full pill instead of a half
Omission 6 Rs and 3 checks
Talking at the pyxis
Administration Routes
Oral
Sublingual
Buccal
Eye
Ear
Vainga
Rectal PR (Left, lubricate 2-3inch)
Topical: transdermal patches/cream
Inhalation- Nebulizer or inhaler
Parenteral IV solutions, IV piggybacks
Controlled Substances
If disposing a narcotic, needs to be documented by two people
Gerontologic Considerations
Renal insufficiency
Low weight
chronic illnesses >6
Meds/day >12
PMHX: previous adverse drug reactions
“lots of cooks in the kitchen”
Multiple providers prescribing the same meds
Systems are slower
Strategies to Avoid Polypharmacy
Identify indication for each med
Still present??
Check for duplicates
Meds for adverse reactions?
Therapeutic doses?
Significant reactions
Education given
Inhalation is the quickest-acting medication
When giving meds, take the vital signs beforehand.
Check labs before medicating.
Frequencies
QD: Everyday [9 am]
BID: 2x/ day [9 am and bedtime (HS)]
TID: 3x/day [around meals]
QID: 4x/day [Meals and HS]
Finger sticks
AC: before meals and HS: bedtime
Insulin is high alert medication
