MODULE NO.

1: ADMINISTRATION OF MEDICATION
FUNDAMENTAL RULE: bed board Q4 8 12 4 8
“Never administer an unfamiliar HS 9
medication.” Right Drug qOD Every other day
 Expiration date Right Route
(6) Right’s  Color Per Orem – mouth
1. Right Patient  Spelling Otic – ears
2. Right Drug  Label (3x) Optic – eyes
3. Right Dose - Before (and after) going to Parenteral – ID, SC, IM, and IV
4. Right Frequency dispensing unit
5. Right Route - Before opening/ pouring Right Documentation
6. Right Documentation a. After the procedure
- Before administering to b. No erasures
Medical Order Telephone the patient c. No superimpositions
Order d. No blank spaces
5R’s Signature of Right Dose e. Universal abbreviations
physician within a. Multiple dugs
24 hours b. Abrupt change of odor
Signature of Policy of c. Available medication dose
physician hospital
Acceptable Child Dose Computation
emergency Clark’ Weight
x adult
cases s Rule (lbs.)
dose
RN validation 150
(R: witness) Fried’ Age (mo.) x adult
Read back and s Rule 150 dose
spell it out Young Age (yr.)
x adult
’s Age (yr.) +
dose
Right Patient Rule 12
(2) Types of Client
Ask client to Right Frequency
Conscious
state name - Intervals or in between
Find ID bracelet OD 8
Unconscious Check MAR BID 8 6
Check name on TID 8 1 6
ROUTES
 MODULE NO. 1: ADMINISTRATION OF MEDICATION
Per Orem b. Solid
 Tablet
- Via mouth  Pills Nitroglycerin Therapy
 Capsules A. DOC: Angina Pectoris
S – safest  Lozenges
A – accessible most B. Class: Vasodilator – Dec. lactic
S – slowest absorption Nursing Consideration: acid
C- comfortable 1. Enteric coated: Don’t
crush or chew C. Side Effect: Headache
A. Position: Upright - 90 degrees (R: prevent GI upset or
(R: prevent aspiration) stomach ache) D. Adverse Effect: Hypotension
2. Sublingual: Place under Dangle the legs, stand slowly,
B. Types: the vessels walk slowly
a. Liquid (R: immediate absorption)
 Syrup 3. Dry mucosa: Moisten with
E. Tablet: 3
 Suspension 1cc of water
 Solution F. Intervals: 5 mins.
 Elixir
G. Health Teaching: No smoking
Nursing Considerations: (R: Nicotine promotes
1. Consider calibration vasoconstriction)
(R: get the exact amount)
2. Consider lower meniscus
3. Label against the palm
4. Smudge: return to
pharmacy

ROUTES
Otic A. Position: Side lying

- Via ears B. Age: 3 years old

 MODULE NO. 1: ADMINISTRATION OF MEDICATION
Above 3 years a. Miotic – constriction
Up and back b. Mydriatics – dilation
old
Below 3 years c. Antibiotics – bacterial infection
Down and back d. Lubricant – moisture
old
(R: straighten ear canal)
Forms:
C. Solution: Warm Liquid Solid
(R: prevent discomfort) Pinch down the Pull down the
**if cold: immerse in warm water conjunctival sac conjunctival sac
and form a
D. Direction: Side of ear canal canal
Administer 2-3 Administer at
E. Absorption: Press the tragus 3x drops on the least 2cm of
lower outer 3rd ointment
F. Timeline: 3 mins. before next ear of conjunctiva
Tip of canister Direction: inner
G. Technique: Clean technique will not touch to outer
the eye canthus
(R: prevent
cross
contamination)
Optic
- Via eyes **If systemic reaction occurs: press inner canthus 20 to
30 mins.
Categories:
ROUTES
Parenteral B. SC
1. Rotate the site of injection
- Most invasive (R: prevent lipodystrophy)
- Uses needles and gauges
C. IM
Universal Precaution 1. Aspirate before releasing the
1. Hand wash before and after medication
2. Never recap needles after use
3. Dispose to sharp containers
(puncture proof)

Needles and Gauges

ID SQ IM
Leng 3/8 - 5/8 – 1/2 – 1
th 5/8 1/2 1/2
C: 24 –
Gau 25
26 – 27 25 – 26
ge A: 23 –
24
Angl 15 45 90
e

Principles:
A. ID
1. Bevel up
2. No red ink
3. No massaging

PARENTERAL
Intradermal A. Purpose: check for
hypersensitivity
- Allergy test or skin test

B. Position: Palms up and inner
aspect of forearm
C. Components:
9cc of NSS + 1cc of
medication = 10cc
1cc to make a wheal
D. Evaluation: 30 mins.
E. Drugs: Antibiotic
**Penicillin
Toxic sign: Diarrhea
Antidote: Epinephrine
- If (+): give prophylaxis:
isoniazid
- Interpretation: 48 to 72 hrs.
**Purified protein derivative
**Definitive test for PTB: Sputum
examination
Induction
5mm Immunocompromised
10mm Expert individual
15mm General population

Mantoux Test
aka Tuberculin Test
- To check exposure to M.
Tuberculae

PARENTERAL
Subcutaneous
- Insulin therapy
Nursing Consideration:
1. SC: Rotate the site of
injection
2. IV: Regular insulin
Ex. Humulin-R (short-
clear)
**Clear before cloudy
Insulin Cocktails – 2 types of (R: prevent xx
cross contamination)
syringes
R NPH
 - Z track technique 90 degrees
C. Diet: Green leafy vegetable (R: prevent leakage of
medication)

Nursing Consideration: Sites: Large muscles (Deltoid,

1. At least 1inch D. Things to use: vastus lateralis, rectus femoris)
2. Avoid: 2inch radius in navel a. Brushing of teeth: soft bristle
3. Injection site shouldn’t be b. Shaving: electric razor
c. HT: No contact sports Principles:
reinjected at least 4wks.
1. Pull the skin laterally: 10 secs
before withdrawing the syringe
Regular Aspron 2. Airlock technique: add 2cc of air
Short R (R: prevent backflow)
Intermediate N
Long Ultra-Lentin
Very Long Glargine
Sliding Scale Depends on
blood glucose
level of patient

Anti-Coagulant
Heparin Aspirin
SQ, IV PO
AD: Protamine AD: Vitamin K
SO4
Dx: PTT Dx: PT
**NV:
PTT: 10 to 30 secs x 2 (40 to 60
secs)
PT: 12 to 15 secs x 2 (24 to 30
secs)

A. Complication: Bleeding
PARENTERAL
B. VS: PR, RR, BP
Intramuscular
Vial Ampule
Injected air = Tap the neck
amount of drug
withdrawn
Release air on File the neck
the airspace
If powder: Break it with
dilute with gauze pad
sterile water
Types: Mixing: V + A
 Single
dose:
single use
only
 Multidose:
use within
24 hrs.