Drug

Administration

Prepared by:
JOAN F. AKUT, RN
What is medication administration?

A basic nursing function that involves

skillful technique and consideration of the
patient’s development and safety.
Common Terms:
 Medication – is substance administered for the diagnosis,
cure, treatment, or relief of a symptom or for prevention of
disease.
 Prescription – a written order for the preparation and
administration of a drug.

 Generic name- is given before a drug becomes official

 Official name – the name under which it is listed in one of
the official publications.
 Chemical Name – the name given by the drug manufacturer

 Brand Name/Trade Name – the name given by the

manufacturer

 Pharmacology – the study of the effects of drugs on living

organism

 Posology – the study of dosage or amount of drugs given in the

treatment of disease

 Pharmacy – the art of preparing, compounding, dispensing drug

 Pharmacist – a person licensed to prepare and dispense drugs

and to make up prescriptions

 The Drug Order
Medications for patients must be ordered by licensed physicians
Placing an order for a medication or treatment is known as issuing a
prescription.
Must contain:

> Patient’s full name

> Date
> Drug name
> Route of administration
> Dose
> Duration of the order
> Signature of the prescriber
 Types of Medication Orders

STAT ORDER

 Generally used in emergency basis

 The drug is to be administered as soon as possible but only once.

Ex. Diazepam 10 mg IV stat

STANDING ORDER

 Medication is to be given for a specified number of doses

 May also indicate that the drug is to be administered until
discontinued at a later date.

Ex. Cefazolin 1g q 6 h x 4 doses

 Kinds of Standing Order
• 1. OD –once a day • 6. Every 6 hrs.
• White ticket • Orange ticket
• a) 8 a.m./ 6 a.m. • 12mn,6am,12nn,6pm
• b) 8 p.m.- h.s. • 7. Every 8hrs.
• 2. B.I.D. – twice a day; 2x/day • Pink ticket
• Yellow ticket • 12 - 4 -8
• 8 a.m.- 6 p.m. • 8. Every 12 hrs.
• 3. T.I.D. – thrice a day; 3x/day • _____ - _____
• Pink ticket
• 8 a.m.- 1p.m.- 6p.m.
• 4. Q.I.D. – four times a day; 4x/day
• Blue ticket
• 8a.m.- 12n.n.- 4p.m.- 8p.m.
• 5. every 4h
• Green ticket
• 12mn,4am,8am,12nn,4pm,8am
PRN ORDER

 Administer as needed.
 Allows the nurse to judge when the medication
should be administered based on the patient’s need.
 Red ticket
 12 Rights of Medications

5 Traditional rights
7 Additional rights

 Right approach
 Right client/ patient
 Right assessment
 Right drug
 Right documentation
 Right dose
 Right to client education
 Right time  Right evaluation/ Response
 Right route  Right to refuse
 Right reason
• 1. Right patient
• Check the name on the order and the patient.
• Use 2 identifiers:
• Ask patient to identify himself/herself.
• When available, use technology (for example, bar-code system).
• 2. Right medication
• Check the medication label.
• Check the doctor’s order.
• 3. Right dose
• Check the order.
• Confirm appropriateness of the dose using a current drug reference.
• If necessary, calculate the dose and have another nurse calculate the
dose as well.
• 4. Right route
• Again, check the order and appropriateness of the route ordered.
• Confirm that the patient can take or receive the medication by the ordered
route.
• 5. Right time
• Check the frequency of the ordered medication.
• Double-check that you are giving the ordered dose at the correct time.
• Confirm when the last dose was given.
• 6. Right Assessment
• Patients Drug allergies or food
• The expected actions, dose range, side effects and any precaution to be taken.
• The developmental stage of the infant/child/adolescent patient.
• Any alterations in the patients condition or functional status which interferes
with their physical capacity to take medications ex: inability to take oral meds.
• 7. Right documentation
• Document administration AFTER giving the ordered medication.
• Chart the time, route, and any other specific information as
necessary. For example, the site of an injection or any laboratory
value or vital sign that needed to be checked before giving the
drug.
• 8. Right to Client Education
• The child and family’s level of understanding and knowledge of
each medication.
• 9. Right reason
• Confirm the rationale for the ordered medication. What is the
patient’s history? Why is he/she taking this medication?
• Revisit the reasons for long-term medication use.

• 10. Right response

• Make sure that the drug led to the desired effect. If an antihypertensive
was given, has his/her blood pressure improved? Does the patient
verbalize improvement in depression while on an antidepressant?
• Be sure to document your monitoring of the patient and any other
nursing interventions that are applicable.
ROUTE OF ADMINISTRATION
ORAL

Advantages:

• Most convenient
• Usually less expensive
• Safe, does not break skin barrier

Disadvantages:

• Inappropriate for client with nausea and vomiting

• Drugs may have unpleasant taste or odor
• Inappropriate if client cannot swallow or is unconscious
• Cannot be used before certain diagnostic test or surgical
procedures
• Drug may discolor teeth, harm tooth enamel
• Drug may irritate gastric mucosa
• Drug can be aspirated by serious ill clients
Drugs Forms for Oral Administration
A. Solid
 Tablet – powdered drug compressed into hard small disc;
some are readily broken along a scored line.
 it comprises a mixture of active substances and usually in
powder form, pressed or compacted from a powder into a
solid dose.
 Capsule – a drug enclosed in
a soluble case
 Caplet - a solid form, shaped like a capsule, easily
swallowed
 Pill – a finely ground drug or
drugs; oval, round or flattened
shape
 Lozenges – flat, round or oval preparation that dissolves
& releases a drug when held in the mouth
 Enteric coated – tablets that are coated w/ a
substance that enables them to pass through the
stomach and into the intestine unchanged

• Contains drug that are destroyed by the

acid contents of the stomach
• Should not be crushed before
administration
• Do not administer with antacids, milk or
other alkaline substances
 Time – released capsules / Sustained –release
Tablets or Capsules / Modified- release – encased
substance that is further enclosed with smaller casing
to deliver a drug dose on an extended period of time.
B. Liquid

 Syrup – an aqueous solution of sugar often

used to disguise unpleasant taste
 Suspension – finely divided,
undissolved drugs (e.g., powders for
suspension) dispersed in liquid
 Emulsion – fine droplets of one liquid are
dispersed in another liquid to disguise the taste of
oil.
 Most creams and lotions are emulsions.
 Elixir – a sweetened & aromatic solution of alcohol
used as a vehicle for medical agents
 Sublingual
 a drug that is placed under the tongue where it dissolves

Advantages:

• Same as oral, plus-

• Can be administered for local effect
• Rapidly absorbed into the bloodstream
• Ensures greater drug potency

Disadvantages:

• If swallowed, drug can be inactivated by gastric juice

• Must remain in the mouth against the mucus membrane until
it dissolved & absorbed
 Buccal
 medication is held in the mouth against the mucous
membrane of the cheek until the drug dissolves.

Advantages:

• Same as oral, plus-

• Can be administered for local effect
• Rapidly absorbed into the bloodstream
• Ensures greater drug potency

Disadvantages:

• If swallowed, drug can be inactivated by gastric juice

• Must remain in the mouth against the mucus membrane
until it dissolved & absorbed
 Topical
 application of medications to a circumscribed area of the body.
Includes dermatological medications, irrigations and instillations

Dermatologic
• Lotion
• Liniments
• Ointments
• Paste
• Transdermal patches
liniment lotion

ointment
Paste

Transdermal patch
 Dermatologic

Procedure:
1. Wash & pat dry area well before application to
facilitate absorption of the drug
2. Use surgical asepsis when open wound is present
3. If skin has lesion, wear gloves or use tongue
depressor to apply medication
4. Remove previous medication before the next
application of medication
5. Apply only a thin layer of medication
 Ophthalmic

• Instillation – to provide an eye medication

the client requires
• Irrigation – to clear the eye of noxious or
other foreign material or excessive secretions
 Ophthalmic

Procedure:
1. Position client either sitting or lying
2. For irrigations, tilt the client’s head toward the affected side
3. Use sterile technique
4. Clean the eyelid & eyelashes w/ sterile cotton balls moistened w/
sterile normal solutions; wipe from inner canthus to outer canthus
5. Instill the eye drops in the lower conjunctival sac
6. Instill eye ointment into the lower conjuntival sac from the inner
canthus to the outer canthus
7. Instruct patient to close eyes gently
8. For liquid eye medications, press firmly on the nasolacrimal duct
at least 1-2 minutes.
 Otic

Instillation:

• To soften earwax
• To reduce inflammation
• Treat infection; relieve pain

Irrigation:

• To remove cerumen or pus

• To apply heat
• To remove a foreign object
 Nasal
• Usually instilled for their astringent effect
• To loosen secretions & facilitate drainage
• To treat infections of nasal cavity or sinuses
 Inhalation
 use of nebulizers, metered dose inhalers

Procedure:
1. Semi or high fowler’s position
Nasogastric and Gastrostomy Tubes
 Vaginal suppository

Forms – tablet, cream, jelly, foam

Advantage – provides local therapeutic effect

Disadvantage – has limited use

Procedure:
1. Empty bladder before the procedure
2. Position & drape the client
3. Client to remain in bed 5-10 minutes following administration of
vaginal suppository, cream, jelly or irrigation
 Rectal

Advantage – cab be used when the drug has objectionable taste

or odor

Disadvantage – dose absorbed is unpredictable

Procedure :
1. Suppository tend to soften at room temperature;
need to be refrigerate
2. Use of gloves for insertion of suppositories
3. Patient to lie on left side and breathe through the
mouth to relax the anal sphincter
 Dos and Don’ts in Drug Administration:

Dos:
1. CHECK the patient’s record for allergies
2. CHECK the patient’s identity EVERY TIME a medication is
administered
3. Approach the patient in a firm but kind manner
4. Adjust the patient to the most appropriate position for the
route of administration
5. Remain with the patient to be sure that all medications have
been swallowed.
Don’ts
1. Prepare or administer a drug from a container
that is not properly labeled
2. Give any medication prepared by another
individual
3. Return an unused portion or dose of medication
to a stock supply bottle
4. Attempt to administer any drug orally to a
comatose patient
5. Leave medications at the patient’s bedside to be
taken “later”.
THANK YOU!