Basics of med.

administration
ADM. OF ORAL, TUBE, EYE, EAR, AND TOPICAL
MED. FOR CPNE

3 CHECKS The 6 RIGHTS:

Check The Medication Label Against The MAR;

1) when removing med. from drawer
2) before opening to dispense
3) when returning med to cart or as adm. To pt.

6 rights
1) right pt. ID pt. X 2 name, birth date or pt. #
2) right med. check against MAR X3 (check expiration date)
3) right dose
4) right route
5) right time within 30 minutes of ordered time
6) right documentation (within 30 minutes of giving)

ASSESSMENTS MAY BE NEEDED.

PRIOR to adm.
1) assess related labs prior to administration
2) assess vitals signs if needed
3) assess pt for signs or symptoms that would contradict giving
AFTER administration
1) assess for therapeutic effects
2) assess for side effects
a) PO med. 30 min.
b) Subcutaneous or IM 20-30 min.
c) IV 5-20 min.
THIS IS AN AVERAGE CHECK MED. REFERENCE FOR ONSET/PEAK

KNOWING THE MED. YOUR GIVING.

 Therapeutic effect
 Normal dose range
 Special NSG considerations
Complete needed ASSESSMENTS PRIOR TO ADMINISTERING
Check for allergies AP< 60, BP parameters, PT or PTT times, sx of
bleeding, blood glucose, signs sx hypo/hyperglycemia hospital policy
on double checking certain meds. (Heparin, coumadin, insulin)
 adverse effects
ex. Administer NSAIDS with food, iron suspension through
a straw
 contraindications
 incompatibilities
 onset/peak so you can assess the effect (ie; pain med.
insulin)
MED. ADMINISTRATION
 PO by mouth
1) swallowed – may be liquid, tablet, capsule
 BUCCAL
1) between gums and cheek absorbed completely
2) tell pt. not to drink until a few minutes after med.
absorbed
 sublingual
1) under tongue until absorbed completely
2) tell pt not to drink until a few min. after med. absorbed.
 trouche
1) sucked (ex; cough drop)
ORAL MED. (tid bits)
 hold liquid med. bottles with label against palm when
pouring
 read measurement from bottom of meniscus
 open unit dose packages at bedside
 explain to pt what med. is and its purpose
 assist pt to upright position to take med.
 pt. preference one at a time or all @ once from soufflé cup
or in hand.
 Offer water or allowed fluid (add to I and O if its monitored
 Watch pt take med.
 Doc. Administration, refusals, or held med. MAR
 Report held or refused med. to primary
PEDIATRIC TIPS PO med.
 use syringe or dropper to adm. Liquids to infants – place it
between gum and cheek adm (slowly) to prevent aspiration
 crush uncoated tabs or empty soft capsules in to food
 don’t mix meds with a child’s favorite food (you’ll wreck it
for them)
 popsicle before giving numbs tongue- if flavor is
objectionable to older peds pt.
 Praise the child for a job well done after they take the med.
 Teach the parent how to measure and give.

MEDS VIA FEEDING TUBE

 follow 3 checks & 6 rights
 know your medication
 adm. Liquids at room temp
 HOB elevated
 Suction and feeding off
 CHECK PLACEMENT
 Flush 15-30 ml adults 5-10 ml children
 Give meds
1) separately with 30 cc warm water
2) flush between each drug & after the last
 NG suction
1) clamp tube – suction disconnected X 30
 gastric feeding
1) do NOT turn off cont. feeding without MD order
(source EXCELSIOR’S skills online)
2) turn feeding off source CPNE chat
 document on MAR and add fluids to intake record if
assigned

CHECKING PLACEMENT PH
Check color and pH of aspirate
 color
1) GASTRIC FLUID GREEN, OFF-WHITE OR TAN,
BROWN
 2) Intestinal fluid yellow or bile colored pH gastric 2-4
respiratory >6

 pH
1) GASTRIC FLUID 1.0-4.0 (ACIDIC)
2) Respiratory fluid > 6

MIXING PARENTERAL MED.

 know the meds
 Check compatibility of meds (valium) & limited compatibility
(must be adm. Within certain time of being drawn up
 Check expiration date & date/time opened on vial ampule or
syringe
 Check med. for precipitate cloudiness (disguard – in
syringe this is a sign of incompatibility)
PROPER ORDER TO WITHDRAW
 Multiuse vial to single use vial
 Vial to ampule
 Insulin clear to cloudy
 Don’t mix more than 2 meds in 1 syringe
ADMINISTERING EYE DROPS
 glove
 have tissue handy
 pull down the cheek, stabilize hand with dropper on pt’s
forehead, have pt look up, and place the drop in the
conjunctival sac.
 Apply gentle pressure with tissue to inner canthus to
prevent systemic effect.
 NOTE; resting the hand with the dropper on the pt’s face
prevents accidentally contaminating the dropper and/or
injuring eye.
ADMINISTERING EYE OINTMENT.
 glove
 have pt look up, pull lower lid down
 place a ribbon of med. in the conjunctival sac
 apply from INNER canthus to OUTER
  stabilize the hand with the med tube on the pt’s forehead
prevents contamination
 twist the tube to break off the ribbon of med. when med.
reaches outer canthus
 have pt keep eye closed briefly to aid in dispersing med.

ADMINISTERING EAR DROPS

 position pt. to promote drainage of med into ear canal
 pull the pinna up and back to straighten the ear canal in an
adult
 CHILD LESS THAN 3 YEARS OLD == pull the pinna down
and back to straighten the ear canal in
 Do NOT contaminate the dropper by touching the pt.
TOPICAL MEDICATIONS
 cleanse skin before applying a topical
 do NOT apply a transdermal patch to excoriated tissue,
scars, or hairy area
 glove for topical applications
 avoid touching the med. area of patches could absorb med.
 LABEL patches initial and date/time

FYI ESTROGEN PATCH should NEVER be applied to the breast area