1. Administration of Medications
Unit 2

2. Abbreviations & Symbols
Approved list per facility
See Calculate text pgs. 149 & 150 for standard approved abbreviations
See Calculate text pg. 151 for “DO NOT USE” abbreviations
Pgs. 156 & 157

3. Medication Order Components
Patient’s full name
Date & time of order
Drug name
Dose
Route
Frequency
Prescriber signature
Special instructions if necessary
Physician ID number & DEA number if controlled substance

4. Medication Orders Written / Electronic Verbal Telephone
Methods of receiving orders:
Written / Electronic
Verbal
Telephone

5. Types of Medication Orders
One time order – specific treatment; not repeated
PRN order – administer per pt request/need; requires nursing judgment
Routine orders – given to patient regularly
Self-terminating order – includes a specific time frame or number of doses to be administered
Standing order – provides standard protocol for possible or commonly occurring events in
patient care
Stat order – one-time order administered immediately

6. Verbal & Telephone Orders
LPN’s can take orders; follow policy of institution
3 Steps:
1. Write order exactly as heard
2. Read order back
3. Confirmation
Document all appropriate information
Nurse signature… physician cosign within 24 hrs.

7. Written & read in following order:
Interpret a Med order
Written & read in following order:
Name of medication
Dose
Route
Frequency
***BE Systematic***

8. Transcription Steps
After med order verified, order is written/typed onto a medication administration record (MAR)
MAR sheets should contain patient's information - name, DOB, medical record number, room number, allergies
Dates (when written, when to start, when to stop, etc)
Medication information
Administration times
Initials of person transcribing order
Special directions
When transcribed, follow policy of institution of noting orders

9. Drug Distribution Systems
Unit-dose system
Provides a single dose
Computer-controlled dispensing system
Automated dispensing cabinets
Bar coded medications

10. Read Medication Labels
Generic name
Trade name
Strength of med
Form
Route
Total volume
Total amount in container
Any directions
Precautions
Expiration date
Additional info
Controlled med labeling
Combination meds

11. 6 BASIC Rights Set of Safety Checks
RIGHT MEDICATION
RIGHT TIME
RIGHT DOSE
RIGHT PATIENT
RIGHT ROUTE
RIGHT DOCUMENTATION

12. ADDITIONAL SAFETY RIGHTS
Right Indication
Right to KNOW
Right to Refuse
Right Response

13. Medication Verification
Minimum 3 time check
When obtaining medication from drawer
When opening package or pouring medication
When returning medication to cabinet or before discarding wrapper

14. Medication Errors Patient safety evaluation IMMEDIATELY
Physician notification
Nursing Supervisor notification
Documentation

15. Routes of Administration
3 general ways medications enter body
Enteral (GI tract)
Percutaneous (skin / mucous membranes)
Parenteral (other than PO or GI tract)

16. Administration Routes
Oral
Tubal
Rectal
Topical
Instillation
Sublingual
Buccal
Inhalation
Intranasal
Parenteral

17. Medication Forms Tablet = Enteric coated = Capsule = Lozenge =
Suspension =
Emulsion =
Elixir =
Syrup =

18. Medication Forms Suppository = Enema = Transdermal = Ointment =
Lotion =
Inhalers =
Metered-dose inhalers =
Eye, ear, nose drops =

19. Equipment Medicine cup Soufflé cup Calibrated dropper Oral syringes
30 mL or 1 oz measurements; when < 5mL need another device for accuracy
Soufflé cup
Smaller paper or plastic cup
Calibrated dropper
Drop size varies so usually marked in mL
Oral syringes
Markings in mL & tsp
Gloves, lubricant, spacers

20. Medication Administration Guidelines
Oral tablets & capsules
Oral for liquid med
Tubal
Rectal suppositories
Topical
Eye drops & ointments
Ear drops
Nose drops
Nasal sprays
Sublingual & buccal
Inhalant

21. Pediatric Considerations
Oral
Do not use med cup, use nipple or dropper
Elevate head, give few drops at a time
DO NOT lay on back
Never hold their nose to force swallowing
Dilute tablets if allowed but not with too much liquid
Do mouth checks
Use a syringe to measure small amounts

22. Pediatric Considerations
Nose drops
Have help available
Suction before inserting drops if nose is congested
Lie child down with head tilted back
Ear drops
Warm drops to room temperature
Under the age of 3, pull ears down & back
Eye drops
Put drops in lower conjunctival sac

23. Other Special Considerations
Never allow med cart or tray out of sight
Never returned unwrapped or prepared med to cart
Check med. record if pt. questions you about his meds
Give liquid form of med if pt. unable to swallow whole tablet or capsule or if med can be crushed; need physician order for change of route

24. Calculate Medication Dosages
Best to convert to same unit / system that medication is available in
When measuring oral liquids, do not confuse dose strength
with total volume
Avoid using slash mark for “per; write it out →
40 mg per 2 mL
When pouring liquids, have label away
from the liquid