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Transcript of Medication Administration
By: Taylor Duke, Fernando Soler, Tashannyo English, Yoldine Branchedor
Types of Parenteral Medications
Why We Need Medication Safety:
1. Right Medication
2. Right Patient
3. Right Time
4. Right Dose
5. Right Route
6. Right Documentation
Important Things To Remember:
Administering Medications through a Enteral Feeding Tube:
Use liquid medications when possible.
If medication can be crushed, crush it and mix it with 15 mL of water.
Flush the tube with 30 mL water before giving the medication and immediately after.
Give multiple medications separately and flush between each drug.
If the tube is connected to suction, keep it disconnected for at least 30 minutes after administration to allow for absorption.
Injection sites: outer aspect of the upper arm, abdomen(2" away from umbilicus), anterior aspects of thigh.
Equipment: 25- 27 gauge, 3/8 to 5/8" needle
Procedure: Maximum 1 mL. The angle of insertion is 45-90 degrees depending on amount of subcutaneous fat and needle size.
Injection Sites: Vastus lateralis, Deltoid, Ventrogluteal
Equipment: 20-25 gauge, 1-1 1/2" needle
Procedure: 1-3mL max for best absorption.
The angle of insertion is 90 degrees.
Perform the Z-track method and aspirate to be sure not in vessel before administering.
Administering Intravenous Medications
The IV route is the most dangerous route of administration because the drug is placed directly into the bloodstream.
Observe aseptic technique when administering medications intravenously.
Assess IV site frequently for signs of infiltration, phlebitis, or any abnormality.
REMEMBER TO ALWAYS DISCARD NEEDLES INTO THE SHARPS CONTAINER!!!
Equipment: 25-27 gauge, 3/8-5/8" needle
Always Remember to Identify your Patient with 2 Identifiers.
Always Make Sure to Reassess your Patient After Giving Medications
The 6 Rights of
We all play a part!
These rights should be followed during each of the nurse's 3 checks with the MAR:
#1 When the nurse pulls the medication
#2 Immediately before preparing
# 3 Before administering to patient
Topical routes of administrating medications:
Instillations & Irrigations
* Used to administer insulin, heparin and certain immunizations.
Do not massage site! As it may cause irritation by allowing medication to leak back into the needle track.
Most common Injection Site: Inner aspect of the forearm and upper back.
Procedure: Less than 0.5 mL. The angle of insertion is 5-15 degrees and be sure the bevel of the needle is pointed up. A small bleb will appear under the dermis.
* Used for diagnostic purposes (eg., tuberculin screening, and allergy tests.
Never recap a used needle!
Oral medications should not be administered when a patient has difficulty swallowing, is unconscious, is NPO, or is vomiting.
You should always check that your patient has swallowed his or her medication.
The oral route is the easiest and most commonly used route.
Medications are given by mouth and swallowed with fluid.
Other methods to administer:
-Sublingual: Medication placed under tongue to dissolve.
-Buccal: Place medication against the mucous membranes of the cheek until dissolves.
Keep Pt in semi/high- fowlers for at least 30 min. after administering medication.
Parenteral Administration Tips:
Reduce discomfort to patient by selecting smallest needle gauge appropriate for site/solution.
Inject into relaxed muscle and do not hesitate.
Rotate injection sites!
Do not administer more solution than is recommended for the site.
Do not inject areas that feel hard or tender.
Applied to body cavities or orifices
Topical administration on clean and dry area
MDI multi-dose inhaler (with w/out spacer)
Prevent Medical Errors
Any order suspected to be in error should be questioned.
The nurse has the right to refuse to administer any medication that, based upon knowledge and experience, may be harmful to the patient.
Follow the three check system and the six rights for med preparation.
Patient Safety is the primary concern!
Medication administration is a highly complex process.
Many errors occurs either when a medication is ordered or when it is administered.
A medication error can cause or lead to inappropriate medication use or patient harm.
Steps to Prevent Medication Errors
Prepare medications for one person at a time with no distractions.
Follow the six rights of medication administration.
Perform all three checks and compare with the MAR.
Double check all calculations and clarify any obscure orders.
No distractions while pulling and preparing meds!!
Remember high alert drugs need to be verified by second nurse!