Procedure Rationale

PREPARATION

Check the Doctor's order and know the reason why the
client is receiving the medication.

Checks the Medication Administration Record (MAR) such Orders for certain medications expire after a specified time
as the drug name, dosage, frequency, route of frame and they need to be recorded by the primary care
administration, and expiration date of the medication provider

Verifies the client’s ability to take medication orally.

Determines whether the client can swallow, is NPO, is
nauseated or vomiting, has gastric suction, or has
diminished or absent bowel sounds.

Performs hand hygiene. Reduce the risk of contamination

Arranges and organize medication tray and cups in To save time and reduce the risk of errors
preparation area including medication ticket

Gather all the medication or MARs for each client together Organization of supplies saves time and reduces the
so that medications can be prepared for one client at a chance of error.
time. Obtain the correct drug, compare name of
medication on label with medication ticket and exit ADS
after removing drug(s).

Checks or calculate drug dose as necessary, double-

check calculation, check expiration date on all medications
and return outdated medication to pharmacy, if there are
any. Check record for medication count and compare
current count with supply available especially if preparing
a controlled substance.

PERFORMANCE

Perform hand hygiene

Places packaged unit-dose capsules or tablets directly

into the medicine cup. Do not remove the medication from
the package until at the bedside.

If using a stock container, pour the required number into

the bottle cap, and then transfer the medication to the
disposable cup without touching the tablets.

Breaks only scored tablets if necessary to obtain the

correct dosage. Use a cutting or splitting device if needed.

If the client has difficulty swallowing, check if the

medication can be crushed. If it is acceptable, crush the
tablets to a fine powder with a pill crusher.

Place the prepared medication and MAR together on the

medication cart.

Recheck the label on the container before returning the

bottle, box, or envelope to its storage place.

Avoids leaving prepared medications unattended. Locks

the medication cart before entering the client’s room.

PATIENT ADMINISTRATION

Introduces self and verify the client’s identity using agency Build client rapport and ensure that the medication is
protocol. given to the right client

Provides for client privacy. Protect the client’s integrity

Educates the client and client's family of the medication to To facilitate cooperation and compliance with the therapy
be taken, its purpose, route of administration, intended
effect and possible side effects.

Assists the client to a sitting position or, if not possible, to To facilitate swallowing and prevent aspiration
a side-lying position.

If not previously assessed, take the required assessment

measures, such as PR, RR, BP.
Compares names of medication on labels with medication
tickets at client's bedside. If using the eMAR, scan the
client's barcode to verify the administration of medication.
Pick up the due medication and compare the labels with
barcode on the drug and eMAR.

Administer the medication at the correct time. Takes the

medication to the client within the guidelines of the
agency. Give the client sufficient water or preferred juice
to swallow the medication.

Stay with the client until all medications have been

swallowed.

Document each medication given. Records the

medication given, dosage, time, any complaints or
assessments of the client, and your signature.

If medication was refused or omitted, record this fact on

the appropriate record; document the reason, when
possible, and the nurse’s actions according to agency
policy.

Disposes of all supplies appropriately. Replenishes stock

and return the cart to the appropriate place and discard
used disposable supplies.

Calcium and Vitamin D: This combination medication is used to prevent or treat low
blood calcium levels in people who do not get enough calcium from their diets. Calcium
plays a very important role in the body. It is necessary for normal functioning of nerves,
cells, muscle, and bone. If there is not enough calcium in the blood, then the body will
take calcium from bones, thereby weakening bones. Vitamin D helps your body absorb
calcium and phosphorus. Having the right amounts of vitamin D, calcium, and
phosphorus is important for building and keeping strong bones. This medication us
taken orally. Since this is in solid form, it must not be crush and must be taken as a
whole to reduce the risk of drug release all at once. Since if too much calcium and
vitamin d3 are released in the body, you will have the tendency to feel nauseous or
weak, and your kidney will accumulate too many stones.
Check the Doctor's order
and Know the reason
why the client is
receiving the
medication.
Performs hand
hygiene.
Checks or calculate
drug dose as
necessary
If using a stock container,
pour the required number
into the bottle cap, and then
transfer the medication to
the disposable cup without
touching the tablets.
Place the prepared
medication and MAR
together on the
medication cart.
Introduces self and
verify the client’s
identity using agency
protocol.
If not previously
assessed, take the
required assessment
measures, such as PR,
RR, BP.
Give the client
sufficient water or
preferred juice to
swallow the
medication.
If medication was refused or
omitted, record this fact on
the appropriate record;
document the reason, when
possible, and the nurse’s
actions according to agency
policy.
Check the Medication Verify the client’s
Administration ability to take
Record (MAR) medication orally
Arranges and organize Gather all the
medication tray and medication or MARs for
cups in preparation each client together so
area including that medications can be
medication ticket prepared for one client
at a time.
Places packaged unit-dose
capsules or tablets directly
Perform hand into the medicine cup. Do not
hygiene remove the medication from
the package until at the
bedside.
If necessary, we can use If the client has difficulty
a cutting or spliting swallowing, check if the
medication can be crushed. If
device to obtain the it is acceptable, crush the
correct dosage of the tablets to a fine powder with
tablet a pill crusher.
Recheck the label on the Avoids leaving prepared
container before medications unattended.
returning the bottle, box, Locks the medication
or envelope to its cart before entering the
storage place. client’s room.
Educates the client and
client's family of the Assists the client to a
medication to be taken, its
purpose, route of
sitting position or, if not
administration, intended possible, to a side-lying
effect and possible side position.
effects.
Administer the medication
Compares names of
at the correct time. Takes
medication on labels
the medication to the
with medication tickets client within the
at client's bedside. guidelines of the agency
Stay with the client
Document each
until all medications
have been medication given.
Records
swallowed.
Disposes of all supplies
appropriately. Replenishes
stock and return the cart
to the appropriate place
and discard used
disposable supplies.