| A basic nursing function that involves skillful technique and consideration of the patient's development and safety. | Medication administration |
| Common terms: is substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease. | Medication |
| Common terms: A written for the preparation and administration of a drug | Prescription |
| Common terms: Is given before a drug becomes official | Generic name |
| Common terms: The name under which is is listed in one of the official publications | Official name |
| Common terms: The name given by the drug manufacturer | Chemical name |
| Common terms: The name given by the manufacturer | Brand name/Trade name |
| Common terms: The study of the effects of drugs on living organism | Pharmacology |
| Common terms: The study of dosage or amount of drugs given in the treatment of disease | Posology |
| Common terms: The art of preparing, compounding, dispensing drug | Pharmacy |
| Common terms: A person licensed to prepare and dispense drugs and to make up prescriptions | Pharmacist |
| medications for patients must be ordered by licensed physicians
Placing an order for a medication or treatment is known as issuing a? | Prescription or Drug Order |
| Drug order: Must contain: | Patient's full name
Date
Drug name
Route of administration
Dose
Duration of the order
Signature of the prescriber |
| Types of Medication Orders: | Stat order
Standing order
PRN order |
| Types of Medication Orders: Generally used in emergency basis
The drug is to be administered as soon as possible but only once.
Ex. Diazepam 10 mg IV stat | Stat order |
| Types of Medication Orders: Medication is to be given for a specified number of doses
May also indicate that the drug is to be administered until
discontinued at a later date.
Ex. Cefazolin 1g q 6 h x 4 doses | Standing order |
| Types of Medication Orders: Standing order: Kinds of standing order:
1. OD - once a day
a.) 8 a.m./6 a.m.
b.) 8 p.m./- h.s. | White ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
2. B.I.D. - twice a day; 2x/day
8 a.m.-6 p.m. | Yellow ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
3. T.I.D. - thrice a day; 3x/day
8 a.m.-1 p.m. -6 p.m. | Pink ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
4. Q.I.D. - four times a day; 4x/day
8 a.m. - 12 nn - 4 p.m. - 8 p.m. | Blue ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
5. Every 4h
12 mn, 4 am, 8 am, 12 nn, 4 pm, 8 am | Green ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
6. Every 6 hours
12 mn, 6 am, 12 nn, 6 pm | Orange ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
7. Every 8 hrs.
12 - 8 - 4 | Pink ticket |
| Types of Medication Orders: Standing order: Kinds of standing order:
8 Every 12 hrs.
12 - 12 | Dunno what ticket |
| Types of Medication Orders: Administer as needed
Allows the nurse to judge when the medication should be administered based on the patient's needs
Red ticket | PRN order |
| 11 Rights of medications: | 5 Traditional rights
6 Additional rights |
| 11 Rights of medications: 5 Traditional rights: | Right client/ patient
Right drug
Right dose
Right time
Right route |
| 11 Rights of medications: 6 Additional rights: | Right approach
Right assessment
Right documentation
Right to client education
Right evaluation/ Response
Right to refuse |
| 8 rights: Checks the name on the order and the patient.
used 2 identifiers:
Ask patient to identify himself/herself
When available, use technology (for example, bar-code system). | Right patient |
| 8 rights: Checks the medication label
Checks the doctor's order | right medication |
| 8 rights: Checks the order
Confirm appropriateness of the dose using a current drug reference.
If necessary, calculate the dose and have another nurse calculate the dose as well. | Right dose |
| 8 rights: Again, checks the order and appropriateness of the route ordered.
Confirms that the patient can take or receive the medication by the ordered route | Right route |
| 8 rights: Checks the frequency of the ordered medication.
Double-checks that you are giving the ordered dose at the correct time.
Confirms when the last dose was given | Right time |
| 8 rights: Patients Drug allergies or food
The expected actions, dose range, side effects and any precaution to be taken.
The developmental stage of the infant/child/adolescent patient.
Any alterations in the patients condition or functional status which interferes with their physical capacity to take medications Example: inability to take oral meds.
The child and family's level of understanding and knowledge of each medication. (Right to client education) | Right Assessment |
| 8 rights: Documents administration AFTER giving the ordered medication.
Charts the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug. | Right documentation |
| 8 rights: Confirms the rationale for the ordered medication.
What is the patient's history? Why is he/she taking this medication?
Revisit the reasons for long-term medication use. | Right reason |
| 8 rights: Makes sure that the drug led to the desired effect.
If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
Be sure to document your monitoring of the patient and any other nursing interventions that are applicable. | Right response |
| Route of Administration:
Advantages:
- Most convenient
- Usually less expensive
- Safe, does not break skin barrier
Disadvantages:
- Inappropriate for client with nausea and vomiting
- Drugs may have unpleasant taste or odor
-Inappropriate if client cannot swallow or is unconsciour
- Cannot be used before certain diagnostic test or surgical procedures
- Drug may discolor teeth, harm tooth enamel
- Drug may irritate gastric mucosa
- Drug can be aspirated by serious ill clients | oral |
| Route of Administration: Oral: Powdered drug compressed into hard small disc; some are readily broken along a scored line.
It comprises a mixture of active substances and usually in powder form, pressed or compacted from a powder into a solid dose. | Tablet |
| Route of Administration: Oral: A drug enclosed in a soluble case | Capsule |
| Route of Administration: Oral: A solid form, shaped like a capsule, easily swallowed | Caplet |
| Route of Administration: Oral: A finely ground drug or drugs; oval, round or flattened shape | Pill |
| Route of Administration: Oral: Flat, round or oval preparation that dissolves & releases a drug when held in the mouth | Lozenges |
| Route of Administration: Oral: Tablets that are coated with a substance that enables them to pass through the stomach and into the intestine unchanged
contains drug that are destroyed by the acids of the stomach
Should not be crushed before administration
Do not administer with antacids, milk, or other alkaline substance | Enteric coated |
| Route of Administration: Oral: Encased substance that is further enclosed with smaller casing to deliver a drug dose on an extended period of time. | Time-released capsule/ Sustained-release tablets or capsules/ modified-release |
| Route of Administration: Oral: B. Liquid: An aqueous solution of sugar often used to disguise unpleasant taste | Syrup |
| Route of Administration: Oral: B. Liquid: Finely divided, undissolved drugs (e.g., powders for suspension) dispersed in liquid | Suspension |
| Route of Administration: Oral: B. Liquid: Fine droplets of one liquid are dispersed in another liquid to disguise the taste of oil
Most creams and lotions are like this | Emulsion |
| Route of Administration: Oral: B. Liquid: A sweetened and aromatic solution of alcohol used as a vehicle for medical agents | Elixir |
| A drug that is placed under the tongue where it dissolves
Advantages:
- Same as oral, plus-
- Can be administered for local effect
- Rapidly absorbed into the bloodstream
- Ensures greater drug potency
Disadvantage:
- If swallowed, drug can be inactivated by gastric juice
- Must remain in the mouth against the mucus membrane until it dissolved and absorbed. | Sublingual |
| medication is held in the mouth against the mucous
membrane of the cheek until the drug dissolves.
Advantages:
• Same as oral, plus-
• Can be administered for local effect
• Rapidly absorbed into the bloodstream
• Ensures greater drug potency
Disadvantages:
• If swallowed, drug can be inactivated by gastric juice
• Must remain in the mouth against the mucus membrane
until it dissolved & absorbed | Buccal |
| application of medications to a circumscribed area of the body.
Includes dermatological medications, irrigations and instillations
Dermatologic
• Lotion
• Liniments
• Ointments
• Paste
• Transdermal patches | Topical |
| Dermatologic procedure: | 1. Wash & pat dry area well before application to
facilitate absorption of the drug
2. Use surgical asepsis when open wound is present
3. If skin has lesion, wear gloves or use tongue
depressor to apply medication
4. Remove previous medication before the next
application of medication
5. Apply only a thin layer of medication |
| Ophthalmic: to provide an eye medication the client requires | Instillation |
| Ophthalmic: to clear the eye of noxious or other foreign material or excessive secretions | Irrigation |
| Ophthalmic procedure: | 1. Position client either sitting or lying
2. For irrigations, tilt the client’s head toward the affected side
3. Use sterile technique
4. Clean the eyelid & eyelashes w/ sterile cotton balls moistened w/
sterile normal solutions; wipe from inner canthus to outer canthus
5. Instill the eye drops in the lower conjunctival sac
6. Instill eye ointment into the lower conjuntival sac from the inner
canthus to the outer canthus
7. Instruct patient to close eyes gently
8. For liquid eye medications, press firmly on the nasolacrimal duct
at least 1-2 minutes. |
| Otic: to soften earwax
To reduce inflammation
Treat infection; relieve pain | Instillation |
| Otic: To remove cerumen or pus
To apply heat
To remove a foreign object | Irrigation |
| Otic: Procedure: | 1. Warm the solution at body temperature
2. Position the patient in side-lying position w/ the ear being treated
uppermost
3. Clean the pinna of the ear w/ cotton-tipped applicator
4. Straighten the ear canal
5. 0-3 years old – pull the pinna downward & backward
6. > 3 y.o. – pull the pinna upward & backward
7. Press gently but firmly a few times
8. Ask patient to remain in side-lying position for about 5 minutes
9. Insert a small piece of cotton ball loosely for about 15-20 minutes. |
| • Usually instilled for their astringent effect
• To loosen secretions & facilitate drainage
• To treat infections of nasal cavity or sinuses | Nasal |
| Nasal procedure: | 1. Have the client blow the nose prior to nasal
instillation
2. Position client so that the head can be tilted
back to aid in gravitational flow or in specific
position to reach sinuses
3. Elevate the nares slightly by pressing the
thumb against the client’s tip of the nose
4. Keep head tilted backward for about 5
minutes after instillation of nasal drops |
| use of nebulizers, metered dose inhalers
Procedure:
1. Semi or high fowler's position | Inhalation |
| Forms – tablet, cream, jelly, foam
Advantage – provides local therapeutic effect
Disadvantage – has limited use | Vaginal suppository |
| Vaginal suppository: procedure: | Procedure:
1. Empty bladder before the procedure
2. Position & drape the client
3. Client to remain in bed 5-10 minutes following administration of
vaginal suppository, cream, jelly or irrigation |
| Advantage – cab be used when the drug has objectionable taste
or odor
Disadvantage – dose absorbed is unpredictable | Rectal |
| Rectal: Procedure: | 1. Suppository tend to soften at room temperature;
need to be refrigerate
2. Use of gloves for insertion of suppositories
3. Patient to lie on left side and breathe through the
mouth to relax the anal sphincter |
