Chapter 36

Calculation of Medication Dosage

and Medication Administration

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Legal and Ethical Implications of

Medication Administration
Laws vary from state to state
Thorough knowledge of medications
administered to patient
Ethical considerations
Using drugs for personal benefit
Proper authorization

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Legal and Ethical Implications of

Medication Administration
The medication order
Given by provider

The prescription
Written legal document that gives directions for
compounding, dispensing, and administering
medication to patient
Eight parts

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Legal and Ethical Implications of

Medication Administration
The prescription
Two types of medicines
Prescription
Over-the-counter (OTC)

Prescriptions for controlled substances

Approved prescription abbreviations and symbols

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Calculation of Drug Dosages

Understanding ratio
Ratio expressed as a quotient
Ratio expressed as a fraction
Ratio expressed as a decimal

Understanding proportion
Means and extremes
Solving for X

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Calculation of Drug Dosages

Weights and measures
Metric system guidelines
The seven common metric prefixes

MicroMilliCentiDeciDekaHectoKilo-

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Calculation of Drug Dosages

Weights and measures
Fundamental units
Household measurements
Metric system conversion
Proportional method for converting metric equivalents
Moving the decimal in the correct direction

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Medications Measured in Units

How to calculate unit dosages
Proportional method
Formula method

Insulin
Individualized needs and treatment

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Medications Measured in Units

Types of diabetes

Type I insulin-dependent diabetes mellitus

Type II noninsulin-dependent diabetes mellitus
Type III gestational diabetes
Type IV other types of diabetes

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Medications Measured in Units

Importance of exact dosage
Precautions to observe when administering
insulin
Expressing the weight of medication
Expressing the volume of medication

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Calculating Adult Dosages

The proportional method
The formula method

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Calculating Childrens Dosages

Youngs, Clarks, and Frieds rules replaced
by more exact methods
By body surface area (BSA)
Nomogram
Used for infants and children up to 12 years of age

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Calculating Childrens Dosages

By kilogram of body weight
Mathematical process
Proportional method

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Administration of Medications
The Six Rights of proper drug
administration

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Administration of Medications
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Administration of Medications
Medication errors
When a medication error occurs
Standard procedure for reporting errors

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Administration of Medications
Patient assessment

Age
Physical condition
Body size
Gender
Muscular build
Skin texture

Injection sites to avoid

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Administration of Oral Medications

Equipment and supplies for oral medications

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Administration of
Parenteral Medications
Parenteral routes
Subcutaneous
Intramuscular
Intradermal

Multiple dose form

Unit dose forms

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Administration of
Parenteral Medications
Hazards associated with parenteral
medications
Reasons for parenteral route selection
Rapid response time to medication
Accuracy of dosage
Need to concentrate medication in specific body part or
area

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Administration of
Parenteral Medications
Reasons for parenteral route selection
Inability to administer orally because medication is
destroyed by gastric juices or patient is incapable of
taking medication orally
Liquid or powder form
Expressed in terms of volume
Ordered in terms of weight and volume

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Parenteral Equipment and Supplies

Syringes
Disposable syringes
Non-disposable syringes
Combination disposable and non-disposable cartridgeinjection syringes

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Parenteral Equipment and Supplies

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Parts of a Syringe

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Parts of a Needle

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Parenteral Equipment and Supplies

Safe disposal of needles and syringes
Sharps containers
Needlesticks

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Parenteral Equipment and Supplies

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Principles of Intravenous Therapy

Patient needs and
conditions
Patient safety
Types of solutions
Legal aspects
Basic IV
Administration
Set >>

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Site Selection for Injections

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Injection Angles

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Site Selection and Injection Angle

Marking the correct site for intramuscular
injection

Dorsogluteal site
Ventrogluteal site
Deltoid muscle
Vastus lateralis site

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Basic Guidelines for

Administration of Injections
Withdrawing medication
Withdrawing medication from a vial
Withdrawing medication from an ampule

Reconstituting a powder medication

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Basic Guidelines for

Administration of Injections
Administering subcutaneous, intramuscular,
and intradermal injections

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Basic Guidelines for

Administration of Injections
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Z-track Method of
Intramuscular Injection
Given to avoid irritation to subcutaneous
tissues
Imferon is an example of a medication given by this
route

Pull skin to side before inserting needle

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Z-track Method of
Intramuscular Injection
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Administration of Allergenic Extracts

MAs may administer allergenic extracts
Always follow guidelines
Have emergency supplies on hand

Allergic reactions
Observe the patient for 20-30 minutes after
administration

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Administration of
Inhaled Medications
Inhalation therapy
Inhaler may be used to administer medication to the
lungs

Implications for patient care

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Administration of
Inhaled Medications
Administration of
oxygen

Hypoxemia
Oxygen tanks
Dosage
Methods of oxygen delivery

Oxygen safety
precautions

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