Medication Administration Basics

Medication Administration

• Medication: a substance administered for diagnosis, treatment, or relief of a symptom or prevention of disease.
• Prescription: a written direction for the preparation and administration of a drug.
• Official name: the name under which the drug is listed in official publications.
• Brand (trade) name: the name given by the drug manufacturer.

Types of Medication Preparations

• Aerosol spray or foam: a liquid powder or foam deposited in a thin layer of the skin by air pressure.
• Aqueous solution: one or more drugs dissolved in water.
• Caplet: a solid form, shaped like a capsule, coated and easily swallowed.
• Capsule: a gelatinous container to hold a drug in powder, liquid, or oil form.
• Ointment: a semisolid preparation of one or more drugs used for application to the skin and mucous membrane.

Common Abbreviations

• ac: before meals
• aq: water
• bid: twice a day
• cap: capsule
• gm: gram
• gtt: drop
• hs: at bedtime
• ID: intradermal
• IM: intramuscular
• IV: intravenous
• Kg: kilogram
• L: liter
• mcg: microgram
• mg: milligram
• OD: right eye
• OS: left eye
• OU: both eyes
• pc: after meals
• po: by mouth
• prn: when needed
• q: every
• qh: every hour
• q2h: every 2 hours
• q6h: every 6 hours
• qid: four times a day
• qod: every other day
• sc: subcutaneous
• stat: at once
• supp: suppository
• tab: tablet
• tid: three times a day

Three Checks for Safe Medication Administration

• First check: read the medication record and remove the medication(s) from the client's drawer; verify the client's name and room number match the medication record; compare the label of the medication against the medication record; and check the expiration date of the medication.
• Second check: while preparing the medication, look at the medication label and check against the medication record.
• Third check: recheck the label on the container against the medication record before returning to its storage place or before giving the medication to the client.

Ten "Rights" of Medication Administration

• Right medication
• Right dose
• Right time
• Right route
• Right client
• Right client education
• Right documentation
• Right to refuse
• Remove gloves and perform hand hygiene

Instilling Eye Medications

• Apply clean gloves.
• Hold cotton ball or clean tissue in nondominant hand on patient's cheekbone just below lower eyelid.
• With tissue or cotton resting below lower lid, gently press downward with thumb or forefinger against bony orbit, exposing conjunctival sac.
• Never press directly against patient's eyeball.
• Ask patient to look at ceiling.
• Rest dominant hand on patient's forehead; hold filled medication eyedropper approximately 1 to 2 cm above conjunctival sac.
• Drop prescribed number of drops into conjunctival sac.
• If patient blinks or closes eye, causing drops to land on outer lid margins, repeat procedure.
• Apply gentle pressure to patient's nasolacrimal duct with clean tissue for 30 to 60 seconds over each eye, one at a time.
• Avoid pressure directly against patient's eyeball.
• After instilling drops, ask patient to close eyes gently.
• Holding applicator above lower lid margin, apply thin ribbon of ointment evenly along inner edge of lower eyelid on conjunctiva from inner to outer canthus.
• Have patient close eye and rub lid lightly in circular motion with cotton ball if not contraindicated.
• Avoid placing pressure directly against patient's eyeball.
• If excess medication is on eyelid, gently wipe it from inner to outer canthus.

Instilling Ear Medications

• Perform hand hygiene.
• Apply clean gloves (only if drainage is present).
• Warm medication to room temperature by running warm water over bottle.
• Position patient on side (if not contraindicated) with ear to be treated facing up, or patient may sit in chair or at bedside.
• Stabilize patient's head with his or her own hand.
• Straighten ear canal by pulling pinna up and back (adult or child older than age 3) or down and back (child under age 3).
• If cerumen or drainage occludes outermost portion of ear canal, wipe out gently with cotton-tipped applicator.
• Instill prescribed drops holding dropper 1 cm above ear canal.
• Ask patient to remain in side-lying position for a few minutes.
• Apply gentle massage or pressure to tragus of ear with finger.
• If ordered, gently insert portion of cotton ball into outermost part of canal.
• Remove cotton after 15 minutes.
• Help patient to comfortable position after drops are absorbed.
• Dispose of soiled supplies in proper receptacle, remove and dispose of gloves, and perform hand hygiene.

Assessment Before Instilling Eye and Ear Medications

• Determine whether patient has any symptoms of eye or ear discomfort or visual or hearing impairment.
• Assess patient's medical history, history of allergies (including latex), and medication history.
• Assess patient's level of consciousness (LOC) and ability to follow directions.
• Prepare medications for instillation.
• Check label of medication against MAR 2 times.
• Check expiration date on container.
• Perform hand hygiene and arrange supplies at bedside.
• Identify patient using two identifiers (i.e., name and birthday or name and account number) according to agency policy.
• Discuss purpose of each medication, action, and possible adverse effects.
• Allow patient to ask any questions about the drugs.