M3 – Med Admin 1 (rights, checks, PO, alternative routes, dosages calc) (half of exam + 6 calc); CH 30
Describe basic principles of medication administration
5 rights: pt, med, dose, route, time (other – reason, assessment, data, documentation, education, refusal)
3 checks: med room, eMAR, bedside prior to admin
How to identify patient?
Right med and right pt
2 Identifiers – Name and DOB/Medical record #. NEVER room #
Types of Order (4)
Routine: given until canceled or replaced by another
Standing: specific set of orders ex. Tylenol, stool softeners
One-Time: given only once
Stat: given immediately
Part of a Med Order (7)
Patient info (name and DOB)
Date and time placed/ordered
Drug
Dose
Route
Frequency (time)
Signature of prescribing
Required Info – Controlled Substance (6)
Pt name (receiving)
Amount substance used
Hour given
Name of prescribing order
Name of nurse administering
2nd nurse – waste witness (if needed and have unused portion)
PO: oral route.
Solid – tablets, capsules, pills (Scored tablets can be cut)
Liquid – elixirs, spirits, syrups, suspensions
Syrup – sucrose solution. Preservatives unless prepared/used fresh
Suspensions – particles may be suspended. Can be viscous liquid (creates floppy layer)
Alternative routes: Enteral. Sublingual. Buccal. Topical (Inunction, Installation, Irrigation, Skin application,
Pulmonary). Ear and Eye drop. Parenteral (IM, SubQ, IV, Intradermal)
Oral – swallow po
Enteral – through tube
,Sublingual – under tongue (DON’T SWALLOW)
Buccal – between tongue & cheek (DON’T SWALLOW)
Topical – apply to skin or mucous membrane
Inunction – rubbing into the skin
Installation – direct contact w mucous membrane
Irrigation – irrigating/flushing the mucous membrane from debris etc.
Skin application – transdermal patch
Pulmonary – inhale
How to administer via enteral tube:
Check the type of tubes
Verify placement and drug form
IF crushed or opened capsule – mix w 30 mL of water
Flush the tube w at least 15 mL of water, BEFORE and AFTER administering meds
ALL meds = give INDIVIDUALLY. Give a break in between administration
IF on NGT suction (used for removing stomach contents), disconnect NGT from suction. Clamp the tube
(prevents any fluids or air from moving through tube), leave clamped for 30 min (allows for meds or fluids
administered to be absorbed)
Document the meds given AND total water given
How to administer Ear Drop:
Put on gloves
Clean external position of ear drainage
Pt lays on unaffected side
Do NOT touch the tip of med bottle to pt ear
Position pt (Infant – down & back, Child > 3 – straight back, adult – up & back)
Administer med
Gently press on the tragus a few times = helps move the med
Have pt remain lying flat, at least 5 min
How to administer Eye Drop:
Wear gloves
Give pt a tissue (for after administration)
Clean eyelid/lashes (if there is any drainage prior to administering)
Tilt pt head back (if not CI)
Do NOT touch the tip of med bottle to pt eye
Invert bottle of med
Have pt look up
Use 2 fingers to pull down gently on lower conjunctival sac
Administer eye drops on the lower conjunctival sac
Slowly release lower lid
Ask pt to close eye gently
Apply gentle pressure over inner canthus
Tell pt not to rub eye (may wipe excess med or tears that fall)
, What are types/ways for Med Errors:
Inappropriate prescription of drug
Extra, omitted, or wrong doses
Wrong patient
Wrong route or rate
Failure to admin w/in prescribed time
Incorrect preparation
Improper technique when administering
Med given, deteriorated (expired)
What to do during Med Error:
Check pt condition immediately & observe for AE
Notify the nurse manager & primary care MD
Complete the form used for reporting errors (as directed by facility policy)
What to teach pt – Med Admin:
Review – techniques for specific meds administration
Remind – to take meds as prescribed and for length that it’s prescribed
Instruct – not alter dosages w/o consulting MD
Caution – don’t share meds with anyone
Dosage calc:
1000mcg=1mg 1tsp=5ml
1000g=1kg 1tbsp=15ml
2.2lb=1kg 1000ml=1L
30ml=1oz 3tsp=1tbsp
1ml=1cc 2tbsp=1oz
Household Metric
Tablespoon tbsp 3tsp 15ml
Teaspoon tsp NA 5ml
Ounce oz 6tsp,2tbsp 30ml
Drops gtt NA NA
Cup NA 6oz/8oz 180ml/240ml
Pound lb 2.2lb 1kg
Discuss principles of medication administration and its relevance to working with medical insurers, calculating
dosages, and administering medication safety measures
Medical insurance – care team needs to be aware of which meds are covered by insurance so pt don’t face
higher costs. Some require prior auth
Calculating dosage – dosages may need to be converted between units, calculate based on prescription and
consider factors (weight, age, organ function + population – pediatrics or geriatric)
Describe basic principles of medication administration
5 rights: pt, med, dose, route, time (other – reason, assessment, data, documentation, education, refusal)
3 checks: med room, eMAR, bedside prior to admin
How to identify patient?
Right med and right pt
2 Identifiers – Name and DOB/Medical record #. NEVER room #
Types of Order (4)
Routine: given until canceled or replaced by another
Standing: specific set of orders ex. Tylenol, stool softeners
One-Time: given only once
Stat: given immediately
Part of a Med Order (7)
Patient info (name and DOB)
Date and time placed/ordered
Drug
Dose
Route
Frequency (time)
Signature of prescribing
Required Info – Controlled Substance (6)
Pt name (receiving)
Amount substance used
Hour given
Name of prescribing order
Name of nurse administering
2nd nurse – waste witness (if needed and have unused portion)
PO: oral route.
Solid – tablets, capsules, pills (Scored tablets can be cut)
Liquid – elixirs, spirits, syrups, suspensions
Syrup – sucrose solution. Preservatives unless prepared/used fresh
Suspensions – particles may be suspended. Can be viscous liquid (creates floppy layer)
Alternative routes: Enteral. Sublingual. Buccal. Topical (Inunction, Installation, Irrigation, Skin application,
Pulmonary). Ear and Eye drop. Parenteral (IM, SubQ, IV, Intradermal)
Oral – swallow po
Enteral – through tube
,Sublingual – under tongue (DON’T SWALLOW)
Buccal – between tongue & cheek (DON’T SWALLOW)
Topical – apply to skin or mucous membrane
Inunction – rubbing into the skin
Installation – direct contact w mucous membrane
Irrigation – irrigating/flushing the mucous membrane from debris etc.
Skin application – transdermal patch
Pulmonary – inhale
How to administer via enteral tube:
Check the type of tubes
Verify placement and drug form
IF crushed or opened capsule – mix w 30 mL of water
Flush the tube w at least 15 mL of water, BEFORE and AFTER administering meds
ALL meds = give INDIVIDUALLY. Give a break in between administration
IF on NGT suction (used for removing stomach contents), disconnect NGT from suction. Clamp the tube
(prevents any fluids or air from moving through tube), leave clamped for 30 min (allows for meds or fluids
administered to be absorbed)
Document the meds given AND total water given
How to administer Ear Drop:
Put on gloves
Clean external position of ear drainage
Pt lays on unaffected side
Do NOT touch the tip of med bottle to pt ear
Position pt (Infant – down & back, Child > 3 – straight back, adult – up & back)
Administer med
Gently press on the tragus a few times = helps move the med
Have pt remain lying flat, at least 5 min
How to administer Eye Drop:
Wear gloves
Give pt a tissue (for after administration)
Clean eyelid/lashes (if there is any drainage prior to administering)
Tilt pt head back (if not CI)
Do NOT touch the tip of med bottle to pt eye
Invert bottle of med
Have pt look up
Use 2 fingers to pull down gently on lower conjunctival sac
Administer eye drops on the lower conjunctival sac
Slowly release lower lid
Ask pt to close eye gently
Apply gentle pressure over inner canthus
Tell pt not to rub eye (may wipe excess med or tears that fall)
, What are types/ways for Med Errors:
Inappropriate prescription of drug
Extra, omitted, or wrong doses
Wrong patient
Wrong route or rate
Failure to admin w/in prescribed time
Incorrect preparation
Improper technique when administering
Med given, deteriorated (expired)
What to do during Med Error:
Check pt condition immediately & observe for AE
Notify the nurse manager & primary care MD
Complete the form used for reporting errors (as directed by facility policy)
What to teach pt – Med Admin:
Review – techniques for specific meds administration
Remind – to take meds as prescribed and for length that it’s prescribed
Instruct – not alter dosages w/o consulting MD
Caution – don’t share meds with anyone
Dosage calc:
1000mcg=1mg 1tsp=5ml
1000g=1kg 1tbsp=15ml
2.2lb=1kg 1000ml=1L
30ml=1oz 3tsp=1tbsp
1ml=1cc 2tbsp=1oz
Household Metric
Tablespoon tbsp 3tsp 15ml
Teaspoon tsp NA 5ml
Ounce oz 6tsp,2tbsp 30ml
Drops gtt NA NA
Cup NA 6oz/8oz 180ml/240ml
Pound lb 2.2lb 1kg
Discuss principles of medication administration and its relevance to working with medical insurers, calculating
dosages, and administering medication safety measures
Medical insurance – care team needs to be aware of which meds are covered by insurance so pt don’t face
higher costs. Some require prior auth
Calculating dosage – dosages may need to be converted between units, calculate based on prescription and
consider factors (weight, age, organ function + population – pediatrics or geriatric)
