Medication Administration

Nursing Responsibilities:
 Assessment of patient and a clear understanding of why patient is
receiving the medication. Certain assessments are required before
meds can be given. Ie: An apical pulse must be taken before
administration of a heart medication.
 Preparation of medication
 Accurate dosage
 Administration of medication
 Documentation
 Monitoring of reaction
 Patient education

Medication Order – should always contain:

 Patient name
 Date and time of order Different types of medication orders
 Drug name will appear on different kinds of med
 Dosage sheets. Ie: Routine orders, PRN
orders, One-time orders, etc.
 Route
 Frequency
 Signature

Medication Administration Record

1. The order is transcribed to MAR and verified by RN (usually the
charge nurse) – initials are put next to the order if they have been
properly transcribed.
2. The nurse giving the medication is still responsible for verifying the
order if they are unsure about it.

Medication Supply
1. Stock – kept in mass quantities. Ie: Tylenol, etc.
2. Individual – each patient has his or her name on a drawer in the
med cart. The pharmacy fills the drawer once per day with the
necessary medications for the day.
3. Narcotic – controlled substances like Valium, morphine, Demerol,
etc. These meds are counted every shift and are kept locked in the
cabinet at all times. When you take one, you have to write your
name, how many you took, how many are left. If you dispose of a
narcotic, you must have a witness to verify.
Routes of Administration
 Oral – by mouth
 Enteral – via a feeding tube
 Sublingual – under the tongue
 Buccal – in the cheek
 Parenteral – directly intravenously (PPD, IV)
 Topical – lotions, potions, vaginal and rectal suppositories
 Instillation – put into the eyes, ears, nose
 Irrigation – to cleanse the eyes, ears, nose
 Inunction – to rub into the skin
 Transdermal – to put on the skin (don’t rub it in)
 Pulmonary – inhaled

Administering Medications
There are THREE CHECKS necessary to verify a drug
1. When you take it out of the drawer or closet.
2. When you take it out of the container or put it into a med cup
3. Before bringing it into the patients room (have all the meds and the med
sheet with you)
There are SIX RIGHTS when giving medication
1. Give the Right medication (doing your three checks)
2. To the Right patient (check the bracelet against the MAR sheets to verify
name and patient ID) MAR = medication administration record
3. In the Right dosage (verify off the MAR)
4. Via the Right route (verify off the MAR)
5. At the Right time (verify off the MAR)
6. And do the Right documentation

Administering Eye Medications

 Tilt the patients head backward and ask them to look up
 Pull lower lid down to reveal lower conjunctival sac
 Instill drops into lower conjunctival sac (the inner part of the eye)
 Ointments are applied from inner to outer canthus
 Do not touch the applicator to the eye
 Apply gentile pressure to the inner canthus

Administering Nasal Drops

 Ask patient to hyperextend their head
 Insert applicator into nares approx 1/3”
 Instill drops into nares
 Have patient remain with head tilted for a few minutes to prevent
escape of the solution

Administering Otic (Ear) Solutions

 Have the patient lay on the opposite side of the ear needing medication
  Straighten auditory canal by gently pulling the pinna up and back
(adults), straight back (school aged children) or downward (infants).
 Apply drops into side of auditory canal
 Gently push tragus
 Keep patient side-lying for 5 minutes

Administering Inhaled Medications

 Position patient in sitting position
 Shake canister
 Hold inhaler/spacer two fingers away from mouth
 Instruct patient to exhale and put thee inhaler/spacer into their mouth
 Instruct patient to depress the inhaler while inhaling slowly, and to hold
their breath for 10 seconds.
 Wait 2 minutes between puffs.

Administering Transdermal Medications

 Remove old patch
 Apply new patch (rotating sides) to a clean dry area of smooth skin
 Refer to handout.