• Stay with client until oral drugs have been swallowed. F.

Right Assessment
get baseline data before drug administration. G. Right Documentation
Immediately record appropriate info •Name, dose, route,time & date,
nurse’s initial or signature Client’s response: •narcotics

•analgesics

•antiemetics

•sedatives

•unexpected reactions to meds.

Use correct abbreviations & symbols. H.Right to Education Client teaching :

•therapeutic purpose

•side-effects

•diet restrictions or requirements

•skill of administration

•laboratory monitoring

Principle of Informed Consent I. Right Evaluation client’s response to meds.

o effectiveness o extent of side-effects or any adverse reactions. J.Right to
Refuse Nurse must do: • determine, when possible, reason for refusal. •
facilitate px’s compliance. • explain risk for refusing meds & reinforce the
reason for medication. • Refusal shld be documented immediately. • Head
nurse or health care provider shld be informed when omission pose threat to
px.

ALL MEDICATION ERRORS ARE SERIOUS OR POTENTIALLY SERIOUS!!!!!!!!

Medication Misadventures include:

1.administration of wrong medication & IV fluid.

2.incorrect dose or rate

3.administration to the wrong patient

4. incorrect route 5.incorrect schedule interval

6.administration of known allergic drug or IV fluid

7.omission of dose or discontinuation of med or IV fluid that was not

discontinued.
II.Guidelines for Correct Administration of Medications A. Preparation 1.Wash
hands before preparing meds.

2.Check for allergies.

3.Check medication order with physician’s orders, medicine sheet, &

medication card.

4.Check label on drug container 3 times.

5.Check expiration date on drug label.

6.Recheck drug calculation with another nurse.

7.Verify doses of drugs that are potentially toxic with another nurse or
pharmacist.

8.With unit dose, open packet at bedside after verifying client identification.

9.Pour liquid at eye level.

10.Dilute drugs that irritate gastric mucosa or give with meals.

B. Administration 11.Administer only those drugs that you have prepared.

12.Identify the client by ID band or ID photo.

13.Offer ice chips when giving bad tasting medicine.

14. Assist client to appropriate position.

15.Provide only liquids allowed on the diet.

16.Stay with client until meds are taken.

17.Administer no more than 2.5 to 3 ml of solution by IM at one site.

18.Infants receive no more than 1 ml of solution by IM at 1 site & no more
than 1 ml subcutaneously.NEVER recap needles.

19.Give drugs last to client who need extra assistance.

20.Discard needles & syringes in appropriate containers.

21.Follow appropriate drug disposal based on institution policy.

22.Discard unused solutions from ampules.

23.Store appropriately unused solutions from open vials.

24.Write date & time opened & initials on label. 25.Keep narcotics in a
double-locked drawer or closet. Med cart – locked at all times when nurse is
not around.

26.Keys to narcotics drawer must be kept by the nurse & not stored in
drawer.

27. Avoid contamination of one’s own skin or inhalation to minimize chances

of allergy.

C. Recording 28.Report drug error immediately to nurse manager &

physician. Complete an incident report.

29.Charting: record drug given, dose, time, route & your initials.

30.Record drugs promptly after given, esp STAT doses.

31.Record effectiveness & results of meds given, esp PRN meds.

32.Report to physician & record drugs that were refused with reason for
refusal.

33.Record amount of fluid taken with medications on input & ouput chart.

Behaviors to Avoid During Medication Administration: • Do not be distracted

when preparing meds. • Do not give drugs poured by others. • Do not pour
drugs from containers whose labels are partially removed or have fallen off. •
Do not transfer drugs from one container to another. • Do not pour drugs into
the hand. • Do not give expired medications. • Do not guess about drugs &
drug doses. Ask when in doubt. • Do not use drugs that have sediment, are
discolored, or are cloudy (& shld not be). • Do not leave medications by the
bedside or with visitors. • Do not leave prepared medications out of sight. •
Do not give drugs if the px says he has allergies to the drug or drug group. •
Do not call the px’s name as the sole means of identification. • Do not give
drug if the client states the drug is different from drug he has been receiving.
Check the order. • Do not recap needles. Use universal precautions. • Do not
mix with large amount of food or beverage that are contraindicated.
III.Forms& Routes for Drug Administration A.Tablets & Capsules • oral meds
not given to pxs who are: o vomiting o lack gag reflex o comatose