UNIT-10

Medication
 Objectives
◼ Define selected terms related to the administration of medications.
◼ Describe legal aspects of administrating medications.
◼ Identify factors affecting medication action.
◼ Discuss various routes of medication administration including its
advantages and disadvantages.
◼ Oral.
◼ Sublingual.
◼ Buccal.
◼ Parenteral.
◼ Topical.
◼ Identify essential parts of medication order.
◼ List examples of various types of medication orders.
◼ State the “rights” to accurate medication administration.
◼ Calculate drug dosage correctly.
 Medication
◼ A substance administered for the
diagnosis, cure, treatment, or relief of a
symptom, or for disease prevention.
◼ Medication = Drug

◼ Prescription: - The written direction

for the preparation and
administration of a drug.
Types of Drug Preparations

◼ Tablet ◼ Suppository
◼ Capsule ◼ Lozenge
◼ Syrup ◼ Spray
◼ Suspension ◼ Gel or jelly
◼ Cream ◼ Transdermal patch
◼ Lotion ◼ Ointment
Can you identify the type of
medication administered?
 Legal aspects of administering
medications
◼ Nurses need to know how nursing practice in their area of work
define & limit their functions.
◼ Be able to recognize the limits of their own knowledge and skill.
Under the law, nurses are responsible for their actions
regardless of whether there is a written order.
◼ Another aspect of nursing practice governed by law is the use
of controlled substances. In hospitals, controlled substances are
kept in a locked drawer, cupboard, medication cart, or
computer-controlled dispensing system. Agencies may have
special inventory forms for recording the use of controlled
substances
 Effects of Drugs

◼ Therapeutic/Desired Effect – the primary effect

intended, that is the reason the drug is prescribed.
◼ Side effect – secondary effect, is one that is unintended.
◼ Adverse effects-Severe side effect which needs
discontinuation of drug.
◼ Drug allergy – is an immunologic reaction to a drug.
◼ Drug interaction-occur when administration of one
drug alters the effect of one or both drugs.
◼ Drug toxicity-results from over dosage, ingestion of
drug intended for external use, buildup of drug in the
blood due to impaired metabolism.
Factors Affecting Medication
Action
◼ Developmental Factors
◼ Gender
◼ Diet
◼ Environment
◼ Psychological factors
◼ Illness & disease
◼ Time of administration
◼ Cultural, ethnic and genetic factors
Routes of Medication Administration

◼ Oral
◼ Sublingual
◼ Buccal – pertaining to the cheek
◼ Parenteral – by needle
◼ IM = intramuscular

◼ IV = intravenous

◼ ID = intradermal

◼ SC = subcutaneous

◼ Intrathecal (spine)
 Routes of Medication Administration

◼ Topical – applied to a circumscribed area of the

body:

◼ Instillations & irrigations – applied into body

cavities or orifices e.g. eye, ear, nose
◼ Inhalations – applied into the respiratory
tract
◼ Dermatologic preparations – applied to the
skin
 Oral Medications
◼ Disadvantages
◼ Advantages
◼ Inappropriate for clients
◼ Most convenient
with nausea or vomiting
◼ Usually least ◼ May have unpleasant taste
expensive ◼ Inappropriate for
◼ Safe, does not unconscious client
break skin barrier ◼ May irritate gastric
mucosa
◼ Does not cause
◼ May discolor the teeth
stress
 Sublingual & Buccal Medications

◼ Disadvantages
◼ Advantages
◼ If swallowed drug may
◼ Most convenient
be inactivated by
◼ Usually least expensive
gastric mucosa
◼ Safe, does not break skin
◼ Must remain under
barrier the tongue until
◼ Does not cause stress dissolved & absorbed
◼ Can be used for local effect ◼ Rapidly absorbed into

◼ More potent than oral the blood stream

because directly enters in to
the blood stream
Parenteral Medications
◼ Advantages ◼ Disadvantages
◼ Rapid absorption ◼ Must involve

◼ Fast drug action sterile technique

◼ Can be ◼ More expensive

administered to ◼ Cause anxiety

unconscious client ◼ Some cause pain

◼ Can administer

only small amount

◼ Breaks skin barrier
Topical Medications
◼ Advantages ◼ Disadvantages
◼ Provide local ◼ May be messy &

effect may soil clothes

◼ Slow steady ◼ Dose absorbed is

absorption unpredictable
◼ Appropriate for ◼ Limited use

unconscious client
◼ Few side effects
 Essential Parts of a Medication Order

 Full name of the client

 Date & time of the order is written
 Name of the drug
 Dosage of the drug
 Frequency of administration
 Route of administration.
 Signature of the person writing the order.
 Types of Medication Orders

1. stat order
Medication is to be given immediately and
only once.
E.g.: Tab. Lasix 40 mg stat
2. Single order
One time order – medication to be given
once at a specified time.
E.g.: Seconal 100mg at bedtime before surgery
Types of Medication Orders con’t
3. Standing order
May be carried out indefinitely (e.g.Multi
Vitamin daily) until an order is written to
cancel it, or it may be carried out for a specific
number of days (e.g. Ampicillin 500mg × 5
days)
May or may not have a termination date.
Types of Medication Orders
4. prn order (PRN)-As needed order
Permits the nurse to give the medication
when, in the nurse’s judgment, the client
requires it.
The nurse must use good judgment about
when the medication is needed and can be
safely administered.
E.g.: Tab. Panadol 500mg prn
 Ten “Rights” of Medication
Administration

 1. Right medication
 2. Right dose
 3. Right time
 4. Right route
 5. Right client
 6. Right documentation
 7. Right client education
 8. Right to refuse
 9. Right assessment
 10.Right evaluation
 Guidelines For Administering
Drug

 Use only medications which are clearly

labeled.
 Do not use medications which are
cloudy in appearance.
 Calculate accurately.
 Administer medications personally
prepared.
 Identify the client accurately.
 Continue …

 Do not leave medications at the bedside.

 After the medication if the client vomits inform
group leader/nurse in charge.
 Take special precautions when administering
anticoagulants, insulin.
 Check for any new order form for post surgery
care.
 If client refused to take the medications record the
reason.
 Medication error should be reported immediately.
Calculating Dosage

Amount to administer =
desired dose × quantity on hand
dose on hand

Dose = Want × amount

Have
Calculation (Example)
Cap.Amoxicillin is available on hand as
500 mg capsules. Dr. Nour advised to
give 1000 mg. bid. How many capsules
will you administer at once?
Want 1000
Dose= -------- x quantity = ------- x 1 = 2
Have 500
Answer = 2 capsules
Medication Exercise-1
◼ Tab. Adalat 8 mg q12h . Available tablet
is 2 mg.
◼ How many tablets will you administer at
one time ?
Medication Exercise-2

Cap. Klacid 1gm q8hx 5 days. Available

capsule is 250 mg.
1. How many capsules will you give at
once?
2. How many times per day will you
administer?
3. If the first dose is given at 6 am,

when will you give the next dose?

4. What type of medication order?
Medication Exercise-3
◼ Susp. Amoxycillin 600mg q6h. Available
susp is 200 mg in 5ml. How many ml
will you administer once?
◼ How many times will you administer in
a day?
◼ If the first dose is given at 6 am, when
will you give the next dose?
 Bibliography

Berman,A.,Snyder,S. " Kozier and Erb’s Fundamental of

nursing " 10th edition, P.P 750-769

N100 Jan 2020