Oral Medication Administration Guidelines

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Questions and Answers

What is the first step to take if there is a discrepancy about a physician’s order?

Refer to the patient's medical history.

Administer the medication while waiting for confirmation.

Go back to the original order and/or contact the prescriber. (correct)

Contact the pharmacist for clarification.

Which step is NOT part of the oral medication administration preparation?

Administer the medication immediately upon entry. (correct)

Perform hand hygiene and enter the patient’s room.

Identify the patient's allergies and diagnosis.

Retrieve medication from the dispensing system and check expiration date.

How can you properly identify a patient before administering medication?

Identify the patient by their physical appearance only.

Rely on the name on the medication bottle alone.

Use the patient’s room number and medication chart.

Check the name band and ask the patient to state their name. (correct)

Which factor should be included in a focused assessment related to oral medication administration?

Level of consciousness (LOC) and ability to swallow. Signup and view all the answers

What is an important safety check before administering oral medication?

Verify the expiration date of the medication. Signup and view all the answers

What is the first step in administering oral medication?

Perform the first medication safety check Signup and view all the answers

How many times should the medication label be checked during the preparation process?

Three times Signup and view all the answers

Which of the following is NOT part of the 5 rights of medication administration?

Correct supply date Signup and view all the answers

What must be done to the patient's head position during the administration of oral medication?

Elevate the head of the bed Signup and view all the answers

How should a nurse confirm the patient's identity before administering medication?

By verifying two identifiers including name band and birthdate Signup and view all the answers

What should be documented after administering medication?

The administration details, such as date and initials Signup and view all the answers

If a medication is refused, what is the first course of action?

Report to the Healthcare Provider Signup and view all the answers

When updating an I&O, what specific detail should be recorded regarding medications?

Amount of fluid taken when swallowing the medication Signup and view all the answers

What is the purpose of performing the third medication check?

To confirm that the drug and dose match the MAR at the bedside Signup and view all the answers

What should be done if a medication is missed during administration?

Circle the medication on the MAR and document the reason Signup and view all the answers

Which step is NOT part of the universal steps in preparing medication?

Assess patient’s ability to swallow Signup and view all the answers

When administering an oral medication, what should be done if a patient has unilateral weakness?

Place the medication in the stronger side of the mouth Signup and view all the answers

Which of the following is a safety measure when handling certain oral medications?

Wearing non-sterile gloves if necessary Signup and view all the answers

What should be measured at the BASE of when dispensing liquid medications?

The base of the meniscus Signup and view all the answers

In what situation should oral medications not be administered?

Patient diagnosed with dysphagia Signup and view all the answers

Which of the following forms of oral medication should NOT be crushed?

Enteric-coated pills Signup and view all the answers

What documentation is essential following the administration of oral medications?

Documenting the patient's response to medication Signup and view all the answers

How should medications be prepared in a busy clinical area?

In a quiet area, free of distractions Signup and view all the answers

Which of the following is an important aspect when educating older adults about medication?

Providing written material to simplify instructions Signup and view all the answers

What should be done if a patient is NPO before medication administration?

Consult with the prescriber for alternatives Signup and view all the answers

Study Notes

Administering an Oral Medication: Preparation

Medication safety checks are crucial and should be performed three times:
- First: at the medication preparation area
- Second: at the medication preparation area
- Third: at the bedside
The Five Rights should be checked during each medication check.
Calculate the correct dose of medication.
Place unopened medication into a medication cup.
Hand hygiene is essential as you enter the patient's room.

Administering an Oral Medication: Administration

Re-identify the patient with two identifiers:
- Check name band.
- Compare name band to MAR.
- Ask patient their name and birthdate.
- Confirm the medical record number.
Re-check allergies
Third medication check at the bedside:
- Compare oral medication packet with the MAR.
- Scan the patient’s barcoded ID band.
- Scan the medication barcode.
Place the medication into a clean medication cup.
Elevate the head of the bed for safety.
Assist the patient to take their medications.
Provide water/fluid to aid in swallowing.
Confirm that the patient has swallowed each medication.
Return the patient to a comfortable position.
Assess the patient’s response to the medication.
Dispose of equipment.
Perform hand hygiene.

Administering an Oral Medication: Documentation

Document the medication administration AFTER administration.
If a medication is refused or not taken:
- Follow hospital policy for documentation.
- Document in the nurse's notes area.
- Report to the healthcare provider.
Update intake and output (I&O): record the amount of fluid taken.

Administering an Oral Medication: Paper MAR

Place one single line through the time of the medication once it is administered.
Place your initials next to the time.
Initial and sign your full name and credentials at the bottom of the MAR.
Circle any medications refused/not given and document the reason.

Lab Practice and Competency Evaluation

Watch the Medication Administration Video to prepare for college lab practice
Log into the Lakeland MAR prior to competency evaluation.
Competency Evaluation: prepare and administer one PO and one injectable medication.
Implement the universal steps for every procedure.

Administering an Oral Medication: Review Physician’s Order

Review the MAR:
- Patient's name, allergies, diagnosis.
- Note the time the medication is due.
Verify the order with the original order if there are questions or discrepancies.

Administering an Oral Medication: Preparation (Universal Steps)

Retrieve oral medication and check the expiration date.
Perform hand hygiene and enter the patient's room.
Identify yourself.
Identify the patient:
- Look at the name band.
- Use two identifiers.
- Compare the name band to the MAR.
- Ask the patient to state their name and date of birth.
Explain the procedure.
Conduct a focused assessment:
- Level of consciousness (LOC).
- Ability to swallow.
- NPO status.
Gather equipment:
- Leave the room.
- Prepare medication.
- Perform hand hygiene while leaving the room.
- Gather supplies needed: soufflé cups, plastic medicine cups.

Administering an Oral Medication: Forms of Oral Drugs

Commonly used route: oral (by mouth or PO)
Know if the medication should be taken with or without food.
Other routes: buccal, sublingual, transmucosal
Forms of Oral Medications:
- Tablets
- Enteric-coated pills
- Capsules
- Powders
- Granules
- Sprays
- Liquids
- Syrups
- Suspensions

Administering an Oral Medication: Measuring Liquids

Use a plastic medicine cup to measure liquid medication.
Look at the base of the meniscus.
Place the cup on a flat surface.
Avoid using cups with abbreviations like "cc, oz, tsp, Tbs, drams."

Administering an Oral Medication: Measuring Small Amounts of Liquid Medication

Use special oral syringes.
Do not use these syringes for injections.

Administering an Oral Medication: Crushing Pills and Opening Capsules

Some patients cannot swallow whole pills.
Many pills cannot be crushed or capsules cannot be opened.
Before crushing or opening a capsule, be sure that it can be crushed or opened.
- Request an alternative form of medication if necessary

Administering an Oral Medication: Preventing Aspiration

Assess the patient’s ability to swallow, cough, and check for the presence of a gag reflex.
Prepare the medication in the form that is easiest to swallow.
Elevate the head of the bed.
Allow the patient to self administer if possible.
If there is unilateral weakness, place the medication on the stronger side of the mouth.
Administer pills one at a time.
Have the patient drink from a cup after administering the medication.

Administering an Oral Medication: Considerations

Some medications should be handled by the nurse wearing non-sterile gloves for the safety of the nurse.
- Ex: Nitroglycerin patches, Chemotherapy
Administer medications with caution if the nurse has an allergy to the medication.

Administering an Oral Medication: Focused Assessments

Do not administer oral medications to patients who have:
- Alterations in GI function.
- Dysphagia
- NPO status.
- Are comatose or unconscious.

Administering an Oral Medication: Safety with the Older Adult

Consult with prescriber to simplify the drug therapy plan if possible.
Keep instructions clear and simple.
Provide written material.
Assess functional status:
- Will the patient require assistance with medication preparation or taking meds?
Provide memory aids:
- Medication schedule, pill box.
Carefully monitor the patient’s response to medications.
Frequently review the medication history (including OTC medications).

Administering an Oral Medication: General Guidelines

Keep medication preparation area quiet and free of distractions.
Use the Workstation on Wheels.
Cleanse the workstation and place a paper towel on top for medical asepsis.
Access the Lakeland MAR.
Prepare one medication at a time.

Administering an Oral Medication: Competency Evaluation Sheet

Follow the Competency Evaluation Sheet.
Use the Medication Safety Checklist.
Universal steps:
- Follow the previously mentioned detailed steps listed above

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Description

This quiz explores the essential steps involved in administering oral medications, emphasizing the importance of medication safety checks and the Five Rights. Participants will learn about proper patient identification and dosage calculation while adhering to safety protocols. Perfect for healthcare professionals looking to refresh their knowledge in medication administration.