lOMoAR cPSD| 67756003
NUR 155 EXAM 4:
MED ADMINISTRATION:
• Six rights: ALWAYS CHECK PT ALLERGIES & MED EXPIRATION
DATE
• Right drug – verify using 3 checks:
When taking the drug out of the drawer/dispensing unit
When comparing drug with the MAR as the drug is being prepared
At the bedside immediately before administration
Right dose –
Verify calculation of the dose is correct & strength is correct
Dose prescribed is appropriate for the patient
Have another nurse check
Right time –
Administer within the right time frame (30 minutes before to 30
minutes after scheduled time)
Correct time system – USUALLY MILITARY TIME to avoid errors in
day/night
Right route – verify that the medication will be administered by the right route,
meds can ONLY be given the route that IS PRESCRIBED
PO – oral (by mouth)
SL – sublingual (under the tongue)
Buccal (against the cheek)
Parenteral (by injection or infusion)
PR – rectal
Vaginal
Topical (on skin or mucous membrane)
Transdermal
Subcutaneous
IM – intramuscular
Intradermal
IV
Inhalation (taken into body through respiratory tract)
Right patient –
Barcode scanning system OR verify patient using 2 identifiers (full
name & DOB)
NEVER use patients room number or physical location to verify
identity
, lOMoAR cPSD| 67756003
Right documentation –
ONLY document AFTER administering med to reflect administration,
refusal or withholding of prescribed med
Verify accuracy/complete
Note any adverse reactions/side effects
• Safety checks when giving meds: 3 checks in detail -
1st check – upon removal
Read the MAR and remove the medications
from the client’s drawer.
Verify that the clients name and room number match the MAR.
Compare the label of the medication against the MAR
If the dosage does not match the MAR, determine if you need to do a
math calculation
Check the expiration date of the medication
2nd check – when preparing
While preparing the medication (pouring,
drawing up or placing unopened package in a medicine cup), look at
the medication label and check against the MAR
3rd check – at
bedside Recheck the label on the container (vial, bottle or
unused unit-dose medication) against the MR before returning to its
storage OR before giving the medication to the client
6 rights & HIGH RISK SITUATIONS –
Right drug:
Incorrectly dispensing and giving a med with a name
similar to the one prescribed
Administer a med that the nurse did not prepare
Incorrectly identifying a medication
Not listening to a patient who reports that the medication looks
different from that given previously
Right dose:
Needing multiple tablets, capsules, or med cups to prepare
a single dose
Having a large change in prescribed dosage
Having a unit dose or dose supplied by the pharm that does not match
the prescribed dose
Not listening to a patient who states that the dose being offered is
different than that normally taken
Using unstandardized measuring devices (like a plastic spoon)
, lOMoAR cPSD| 67756003
Breaking tablets that are not scored into pieces or not using an
accepted cutting device to split tablet
Leaving part of a crushed med behind in the crushing device or the
patient not eating all the door or liquid the med is crushed into
Not knowing the usual or safe dosage range
Incorrect calculation of dose ordered compared with supplied
medication
Right time:
Giving all med at convenient times for the nurse instead of at the time
they are most effective
Not administering medications according to specific needs, such as
with food, or on an empty stomach
Missing doses and needing to reschedule times
Not adhering to prescribed frequency for PRN doses (giving more
frequent than permitted)
Right route:
Not knowing the meds usual route
Not looking up unfamiliar meds
Preparing parenteral doses that are not designated for the parenteral
route
Right patient:
Incorrectly identifying the patient with similar names
Bypassing the ID process and relying on memory of previous patient
interactions
Relying on unsafe ID means (like patient room number) Using a
smudged or illegible name band as ID
Right Documentation:
Using incomplete, inaccurate, or illegible med information
Lacking documentation of the assessment data required for med, such
as lab values and AP rate
Documenting administration before meds are administered
Failing to document the meds administers
Failing to document notification of provider when dose is not
administered
Failing to document the patient response to meds
• Patient rights:
• Right to be informed of the name, purpose, and potential side effects of the
medication
• Right to refuse medication
• Right to have an accurate medication history taken by qualified person
NUR 155 EXAM 4:
MED ADMINISTRATION:
• Six rights: ALWAYS CHECK PT ALLERGIES & MED EXPIRATION
DATE
• Right drug – verify using 3 checks:
When taking the drug out of the drawer/dispensing unit
When comparing drug with the MAR as the drug is being prepared
At the bedside immediately before administration
Right dose –
Verify calculation of the dose is correct & strength is correct
Dose prescribed is appropriate for the patient
Have another nurse check
Right time –
Administer within the right time frame (30 minutes before to 30
minutes after scheduled time)
Correct time system – USUALLY MILITARY TIME to avoid errors in
day/night
Right route – verify that the medication will be administered by the right route,
meds can ONLY be given the route that IS PRESCRIBED
PO – oral (by mouth)
SL – sublingual (under the tongue)
Buccal (against the cheek)
Parenteral (by injection or infusion)
PR – rectal
Vaginal
Topical (on skin or mucous membrane)
Transdermal
Subcutaneous
IM – intramuscular
Intradermal
IV
Inhalation (taken into body through respiratory tract)
Right patient –
Barcode scanning system OR verify patient using 2 identifiers (full
name & DOB)
NEVER use patients room number or physical location to verify
identity
, lOMoAR cPSD| 67756003
Right documentation –
ONLY document AFTER administering med to reflect administration,
refusal or withholding of prescribed med
Verify accuracy/complete
Note any adverse reactions/side effects
• Safety checks when giving meds: 3 checks in detail -
1st check – upon removal
Read the MAR and remove the medications
from the client’s drawer.
Verify that the clients name and room number match the MAR.
Compare the label of the medication against the MAR
If the dosage does not match the MAR, determine if you need to do a
math calculation
Check the expiration date of the medication
2nd check – when preparing
While preparing the medication (pouring,
drawing up or placing unopened package in a medicine cup), look at
the medication label and check against the MAR
3rd check – at
bedside Recheck the label on the container (vial, bottle or
unused unit-dose medication) against the MR before returning to its
storage OR before giving the medication to the client
6 rights & HIGH RISK SITUATIONS –
Right drug:
Incorrectly dispensing and giving a med with a name
similar to the one prescribed
Administer a med that the nurse did not prepare
Incorrectly identifying a medication
Not listening to a patient who reports that the medication looks
different from that given previously
Right dose:
Needing multiple tablets, capsules, or med cups to prepare
a single dose
Having a large change in prescribed dosage
Having a unit dose or dose supplied by the pharm that does not match
the prescribed dose
Not listening to a patient who states that the dose being offered is
different than that normally taken
Using unstandardized measuring devices (like a plastic spoon)
, lOMoAR cPSD| 67756003
Breaking tablets that are not scored into pieces or not using an
accepted cutting device to split tablet
Leaving part of a crushed med behind in the crushing device or the
patient not eating all the door or liquid the med is crushed into
Not knowing the usual or safe dosage range
Incorrect calculation of dose ordered compared with supplied
medication
Right time:
Giving all med at convenient times for the nurse instead of at the time
they are most effective
Not administering medications according to specific needs, such as
with food, or on an empty stomach
Missing doses and needing to reschedule times
Not adhering to prescribed frequency for PRN doses (giving more
frequent than permitted)
Right route:
Not knowing the meds usual route
Not looking up unfamiliar meds
Preparing parenteral doses that are not designated for the parenteral
route
Right patient:
Incorrectly identifying the patient with similar names
Bypassing the ID process and relying on memory of previous patient
interactions
Relying on unsafe ID means (like patient room number) Using a
smudged or illegible name band as ID
Right Documentation:
Using incomplete, inaccurate, or illegible med information
Lacking documentation of the assessment data required for med, such
as lab values and AP rate
Documenting administration before meds are administered
Failing to document the meds administers
Failing to document notification of provider when dose is not
administered
Failing to document the patient response to meds
• Patient rights:
• Right to be informed of the name, purpose, and potential side effects of the
medication
• Right to refuse medication
• Right to have an accurate medication history taken by qualified person
