Oral Medication Administration PDF

Oral Medication Administration NURS 1090  Easiest and most commonly used route to administer medications if appropriate Oral = by mouth or PO (per os) Introductio Know if should be taken with or without food n Other routes:...

Oral Medication Administration NURS 1090  Easiest and most commonly used route to administer medications if appropriate Oral = by mouth or PO (per os) Introductio Know if should be taken with or without food n Other routes: Buccal, sublingual, transmucosal Giving a drug across mucous membranes in the mouth allows for rapid absorption by passing directly into bloodstream and bypassing gastric acid and liver metabolism  Tablets Enteric-coated pills Capsules Forms of Powders Oral Granules Drugs Sprays Liquids Syrups Suspensions  Liquid Medications Measuring liquids in plastic medicine cup ◦Look at the BASE of the meniscus ◦Place on a flat surface ◦Some cups may have these abbreviations which can be a Safety Issue: ◦cc, oz, tsp, Tbs, drams from the cups  Liquid Medications In acute care, liquid meds are generally dispensed in premeasured containers as a unit dose For measuring small amounts of liquid medications: ◦Only use special oral syringes ◦DO NOT use these syringes for injections ◦This prevents accidental administration of an oral medication in to the iv or as an injection  Crushing Pills or Opening Capsules Some patients cannot swallow a whole pill and may need the pill to be crushed There are MANY pills that cannot be crushed OR capsules that should not be opened ◦Before crushing, be SURE that the pill can be crushed ◦Before opening a capsule, be SURE the capsule can be opened You will need to have an alternate form of the medication ordered/dispensed  Priority: Assess patient’s ability to Assess swallow and cough and check for presence of gag reflex Prepare oral med in the form that is Prepare easiest to swallow Assure Assure head of bed is elevated Preventing Allow patient to self administer if Allow Aspiration possible If there is unilateral weakness, place Place med in the stronger side of mouth Administ Administer pills one at a time er Have Have patient drink from cup Other Considerations Some medications should be handled by the nurse wearing non-sterile gloves for the safety of the nurse This is because some medications can be absorbed through the nurse’s skin ◦Ex: Nitroglycerin patches, Chemotherapy ◦If the nurse has an allergy to the medication Administering an Oral Medication: Focused Assessments Do not administer oral medications to the patient who has/is: ◦Alterations in GI function ◦Dysphagia ◦NPO ◦Comatose or unconscious  oConsult with prescriber to simplify the drug therapy plan if possible oKeep instructions clear and simple oProvide written material Administerin oAssess functional status g an Oral ◦Will patient require assistance with Medication: medication preparing or taking meds Safety with oProvide memory aids the Older ◦Medication schedule, pill box Adult oCarefully monitor patient’s response to medications oFrequently review medication history (OTC too) Administering an Oral Medication: General Guidelines The medication preparation area should be quiet and free of distraction Use the Workstation on Wheels Cleanse and place a paper towel on top of the workstation for medical asepsis Access the Lakeland MAR Prepare one medication at a time  Administering an Oral Medication: Preparation Follow Competency Evaluation Sheet, Use Medication safety Checklist Universal Steps: 1. Review Physician’s Order ◦This will be MAR – If there is any question or discrepancy about the order you need to go back to the original order and/or contact the prescriber ◦Review MAR ◦Patient’s name, allergies, diagnosis (es) ◦Note time medication is due  Administering an Oral Medication: Preparation Universal Steps, cont… 2. Retrieve oral medication and checks expiration date. 3. Perform hand hygiene and enter patient’s room 4. Identify Self 5. Identify the patient – look at name band and use 2 identifiers while also looking and comparing to the MAR. Have the patient state name and DOB 6. Explain the procedure (what you will be doing) Administering an Oral Medication: Preparation Universal Steps, cont… 7. Focused assessment – as it relates to ORAL medication administration ◦LOC ◦Ability to swallow ◦NPO status 8. Equipment – Leave the room and prepare medication. ◦Hand Hygiene as you leave the room ◦Supplies needed: Soufflé cups, plastic medicine cups Administering an Oral Medication: Preparation ◦Retrieve medication from dispensing system and check expiration date. ◦Verify you have the correct medication and dose. ◦*This is not the first medication check Administering an Oral Medication: Preparation Perform required medication safety checks using the 5 rights and compare medication label to MAR Check medication label THREE times during the preparation process This means: performing the 5 rights with each check Correct patient, drug, dose, route, time ◦1st & 2nd Medication Safety Check: ◦Performed at the medication preparation area ◦Pause between first and second check ◦Calculate the correct dose of medication – MUST BE 100% CORRECT ◦Place unopened medication into medication cup ◦You will need a second medication cup to place the opened medication at the bedside Administering an Oral Medication: Administration eps continued… Hand hygiene as you enter patient’s room Steps h, I, j, k ◦Body Mechanics ◦Privacy - curtain ◦Safety – Patient positioning, ability to swallow ◦Medical Asepsis THE BEDSIDE RE-IDENTIFY the patient using 2 identifiers – COMPARE NAME BAND TO MAR ◦Ask patient their name and birthdate ◦Confirm Medical Record Number Re-check Allergies Administering an Oral Medication: Administration 3rd medication check (at the bedside) checks oral medication packet with MAR ◦Patient,drug, dose, route, time Scans patient’s barcoded ID (identification) band Scans medication barcode Opens and places medication into a clean medication cup Elevate head of bed for patient safety Assist patient to take meds ◦Provide water/fluid to aid in swallowing medication ◦CONFIRM that patient has swallowed EACH medication Administering an Oral Medication: Administration Return patient to position of comfort/safety ◦Call light, bed height, siderails Ask if patient needs anything else You will return to the room to assess the patient’s response to the medication ◦based on the onsite/peak action of the drug Completion of Procedure Dispose of equipment Hand Hygiene Document ◦Document medication administration AFTER administration  Administering an Oral Medication: Other If a medication is refused or not taken: Follow hospital policy for documentation Document in nurse’s notes area Report to Healthcare Provider Update I&O Amount of fluid taken Remember to return to reassess the patient Note any adverse reactions, take action and document  Administering an Oral Medication: Paper MAR or Downtime MAR Place one single line through the TIME of the med 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 Lab Practice: Watch the Medication Administration Video Log in to the Lakeland MAR to be sure you will be able to access it during College Lab, practice and competency evaluation Competency Evaluation You will be preparing and administering one PO medication and one Injectable medication during the one competency time You will have an opportunity to practice with your clinical instructor You will be expected to IMPLEMENT the universal steps for every procedure