Medication Administration

Medication Administration

• A medication is a substance administered for the diagnosis, treatment, or relief of a symptom or for prevention of disease.
• A prescription is a written direction for the preparation and administration of a drug.
• An official name is the name under which the drug is listed in official publications.
• A brand (trade) name is 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.

Types of Drug Preparations

• Powder: a finely grounded drug or drugs, some used internally and others externally.
• Suppository: one or several drugs mixed with a firm base such as gelatin and shaped for insertion into the body.
• Syrup: an aqueous solution of sugar often used to disguise unpleasant-tasting drugs.
• Tablet: a powdered drug compressed into a hard small disc.

Effects of Drugs

• Therapeutic effect: the desired effect, or the primary effect intended, that is the reason the drug is prescribed.
• Side effect: the secondary effect or unintended effect, which may be harmful or potentially harmful, and is usually predictable.
• Adverse effects: severe side effects.

Types of Medication Order

• Stat order: indicates that the medication is to be given immediately and only once.
• Single order: for medication to be given once at a specified time (e.g., before surgery).
• Standing order: may or may not have a termination date, and may be carried out indefinitely until an order is written to cancel or for a specified number of days.
• PRN order: or as needed order.

Essential Parts of a Drug Order

• The client's full name.
• Date and time the order is written.
• Name of the drug to be administered.
• Dose of the drug.
• Frequency of administration.
• Route of administration.
• Signature of the person writing the order.

Common Abbreviations

• ac: before meals.
• aq: water.
• bid: twice a day.
• c: with.
• Cap: capsule.
• G, gm, GM: gram.
• gtt: drop.
• hs: at bedtime.
• ID: intradermal.
• IM: intramuscular.
• IV: intravenous.
• Kg, Kg: kilogram.
• l or L: liter.
• mcg: microgram.
• mg: milligram.
• OD: right eye.
• OS: left eye.
• OU: both eyes.
• pc: after meals.
• Po, 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.

Check Three Times for Safe Medication Administration

• FIRST CHECK: read the medication record, verify the client's name and room number, 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.
• Right assessment.
• Right evaluation.

Instilling Eye and Ear Medications

• Eye medications are usually in the form of drops and ointments.
• Care must be taken to prevent instilling medication directly onto the cornea.
• The conjunctival sac is a more appropriate site for medication instillation.
• Ear medications are usually in a solution and instilled by drops.
• Administer eardrops at room temperature.
• Avoid forcing any solution into the ear.
• Check accuracy and completeness of each medication administration record (MAR) with the doctor's order.
• Review pertinent information related to medication.
• Assess the condition of external eye or ear structures.
• Assess patient's medical history, history of allergies, and medication history.
• Assess patient's level of consciousness and ability to follow directions.
• Prepare medications for instillation.
• Perform hand hygiene and arrange supplies at the bedside.
• Identify the patient using two identifiers.
• Discuss the purpose of each medication, action, and possible adverse effects.
• Allow the patient to ask any questions about the drugs.
• Instill eye medications by applying clean gloves, holding a cotton ball or clean tissue, and gently pressing downward with the thumb or forefinger against the bony orbit, exposing the conjunctival sac.
• Instill ear drops by warming the medication to room temperature and gently placing the prescribed number of drops into the ear canal.