ATI-Dosage Calculation 2:0: Desired Over Have
Administration Basics
Nurse Responsibilities
Preparing, administering medications
Evaluating client responses- ex. Follow up to determine if pain med decreases pain level
Maintaining up-to-date knowledge base
o Purpose, mechanism of action, route of administration, safe dosage range, side
effects, adverse effects, toxic responses
o Precautions, contraindications
Maintaining skills- ex. Where do you administer subcut med? How to mix 2 types of
insulin? How to prepare inj from an ampule?
Acceptable Practice
Being knowledgeable
Determining medication accuracy
Reporting errors
Safeguarding and storing medications
Rights of Administration
Right client
o Two identifiers
o Acceptable identifiers –name, assigned id number, phone #, birthdate, photo
o Bar code technology
o Long term care requires 2 identifiers the first time, then 1 identifier such as
facial recognition
Right medication
o Check prescription- read carefully, does it make sense
o Three checks- compare prescription with mar, 1. Before taking med from drawer
or shelf, 2. Once you remove it from container 3. Before administer
o Verify expiration date- if date is past may no longer have therapeutic effect
o Consult reference- med guide or pharmacist
o Never administer a medication another nurse prepared.
Right route
o Compare label with prescription and compare with container
o Clarification when necessary
o Liquid medications –be careful
Enteral- orally or tubes
Parenteral- injection or infusion
Right time
, o Intervals or specific time of day. Ex bedtime
o Follow facility guidelines
o Administer dosage within 30 min
o Stat- right away
o PC – 30 min after meal
o PRN- nursing judgment
Right Dose
o Match prescription
o Perform conversion
o Calculate dosages
Right documentation
o After administration- never before, never later on
o MAR
o Procedures for omitting, withholding- reason for time diff. ex client at radiology
will administer when return, follow up with time and administration
Types of Prescriptions
Routine
o In effect until cancellation
o Specific end date
o Time frames for renewal such as opioids, antibiotics
Single -One time
o Specified times
o Circumstances
o Clinical examples
STAT
o Immediate
o Once
o Emergency dose
o Document exact time given on MAR
PRN
o Medication, dose, route, frequency, circumstances
o Specific circumstances ex. Pain or temp above specified measurement
o Nursing judgement- clinical judgement and client report
o Client needs
Standing
o Protocol-based contain list of directives to implement in specific situations
o Regular, single, prn and other actions (diet)
o Multiple medications
o Other actions- assess frequently for appropriateness
Now
o Once
o Less urgent than stat
o Administer med within 90 min
Administration Basics
Nurse Responsibilities
Preparing, administering medications
Evaluating client responses- ex. Follow up to determine if pain med decreases pain level
Maintaining up-to-date knowledge base
o Purpose, mechanism of action, route of administration, safe dosage range, side
effects, adverse effects, toxic responses
o Precautions, contraindications
Maintaining skills- ex. Where do you administer subcut med? How to mix 2 types of
insulin? How to prepare inj from an ampule?
Acceptable Practice
Being knowledgeable
Determining medication accuracy
Reporting errors
Safeguarding and storing medications
Rights of Administration
Right client
o Two identifiers
o Acceptable identifiers –name, assigned id number, phone #, birthdate, photo
o Bar code technology
o Long term care requires 2 identifiers the first time, then 1 identifier such as
facial recognition
Right medication
o Check prescription- read carefully, does it make sense
o Three checks- compare prescription with mar, 1. Before taking med from drawer
or shelf, 2. Once you remove it from container 3. Before administer
o Verify expiration date- if date is past may no longer have therapeutic effect
o Consult reference- med guide or pharmacist
o Never administer a medication another nurse prepared.
Right route
o Compare label with prescription and compare with container
o Clarification when necessary
o Liquid medications –be careful
Enteral- orally or tubes
Parenteral- injection or infusion
Right time
, o Intervals or specific time of day. Ex bedtime
o Follow facility guidelines
o Administer dosage within 30 min
o Stat- right away
o PC – 30 min after meal
o PRN- nursing judgment
Right Dose
o Match prescription
o Perform conversion
o Calculate dosages
Right documentation
o After administration- never before, never later on
o MAR
o Procedures for omitting, withholding- reason for time diff. ex client at radiology
will administer when return, follow up with time and administration
Types of Prescriptions
Routine
o In effect until cancellation
o Specific end date
o Time frames for renewal such as opioids, antibiotics
Single -One time
o Specified times
o Circumstances
o Clinical examples
STAT
o Immediate
o Once
o Emergency dose
o Document exact time given on MAR
PRN
o Medication, dose, route, frequency, circumstances
o Specific circumstances ex. Pain or temp above specified measurement
o Nursing judgement- clinical judgement and client report
o Client needs
Standing
o Protocol-based contain list of directives to implement in specific situations
o Regular, single, prn and other actions (diet)
o Multiple medications
o Other actions- assess frequently for appropriateness
Now
o Once
o Less urgent than stat
o Administer med within 90 min
