NCM103 SKILLS LABORATORY

MEDICATIONS
A MEDICATION is a
substance administered for
the diagnosis, cure,
treatment, or relief of a
symptom or for prevention
of disease.
PHARMACOLOGY is the
study of the effect of drugs on
living organisms.
The written direction for the
preparation and administration
of a drug is called a
PRESCRIPTION.
PHARMACIST’S ROLE
a person licensed to prepare and
dispense drugs and to make up
prescriptions.
NURSE’S ROLE
Administers medications.
Patient and family
education on the
medication prescribed.
Purpose of Medication
Drugs can be administered for these purposes:
• Diagnostic purpose: to identify any disease
• Prophylaxis: to prevent the occurrence of disease.
• Therapeutic purpose : to cure the disease.
Uses of Drugs
Prevention- used as prophylaxis to prevent
diseases e.g. vaccines; fluoride-prevents tooth
decay. 
Diagnosis- establishing the patient’s disease
or problem e.g. radio contrast dye; tuberculosis
(Mantoux) testing. 
Suppression- suppresses the signs and
symptoms and prevents the disease process
from progressing e.g. anticancer, antiviral
drugs
Uses of Drugs
Treatment- alleviate the symptoms for
patients with chronic disease e.g. Anti_x0002_asthmatic
drugs. 
Cure- complete eradication of diseases e.g.
anti-biotics, anti-helmintics. 
Enhancement aspects of health- achieve
the best state of health e.g. vitamins,
minerals
12 RIGHTS
IN MEDICATION
ADMINISTATION
12 Rs for Drug Administration
• RIGHT PATIENT
• RIGHT DRUG
• RIGHT DOSE
• RIGHT ROUTE
• RIGHT TIME
• RIGHT PREPARATION
• RIGHT ASSESSMENT
• RIGH MOTIVATION/ APPROACH
• RIGHT OF THE CLIENT TO REFUSE
• RIGHT OF THE CLIENT TO KNOW THE REASON OF THE DRUG
• RIGHT EVALUATION
• RIGHT DOCUMENTATION
FACTORS AFFECTING
MEDICATION ACTION
PATIENT-RELATED FACTORS
a) Age
b) Gender
c) Body weight
d) Presence of food in the stomach
e) Drug allergies
f) Genetic variation
g) Environmental state
h) Pathological state
i) Psychological state
FACTORS AFFECTING
MEDICATION ACTION
MEDICATION-RELATED FACTORS
a) Physical state of the drug
b) Route of administration
c) Time of administration
d) Drug cumulation
e) Drug tolerance
f) Drug dependence
FACTORS IN MEDICATION
ADMINISTRATION
a) Convenience
b) State of the patient
c) Desired onset of action
d) Patient’s cooperation
e) Nature of the medication
f) Age of the patient
g) Effects on the GI tract
 TYPES OF
MEDICATION
ACTION
TYPES OF MEDICATION ACTION
TYPES OF MEDICATION ACTION
TYPES OF MEDICATION ACTION

THERAPEUTIC EFFECTS
the expected or predicted
physiological response caused
by a medication.
TYPES OF MEDICATION ACTION
ADVERSE EFFECTS
undesired, unintended and
often unpredictable responses
to medication that ranges from
mild to severe.
TYPES OF MEDICATION ACTION
SIDE EFFECTS
a predictable and often
unavoidable adverse effect
produced at a usual therapeutic
dose.
TYPES OF MEDICATION ACTION
TOXIC EFFECTS
excess amounts of a
medication within the
body sometimes have
lethal effects.
TYPES OF MEDICATION ACTION
IDIOSYNC RATIC
REACTIONS
a patient overreacts or
underreacts to a medication or
has a reaction different from
normal.
TYPES OF MEDICATION ACTION
ALLERGIC REACTIONS
unpredictable responses to a
medication.
COMMON DOSAGE
ADMINISTRATION
SCHEDULES
 FORMS OF MEDICATION

SOLID LIQUID SEMISOLID INHALATION

FORMS OF MEDICATION
 FORMS OF MEDICATION

SOLID LIQUID SEMISOLID INHALATION

SOLID
SOLID
 SOLID
POWDERS
a finely powdered drug, which are
used externally and internally.
SOLID
 SOLID
EFFERVESCENT
contains soda bicarbonate and citric
or tartaric acid which
is mixed with water
SOLID
 SOLID
TABLETS
powdered drug compressed
into a hard small disc; some
are readily broken along a scored
line; others are enteric
coated to prevent them from
dissolving in the stomach.
SOLID
 SOLID
PILLS
single dose units made by mixing the
powdered drug with a liquid and
rolled into round or oval shape.
SOLID
 SOLID
CAPSULES
A gelatinous container to hold a drug
in powder,
liquid or oil form.
SOLID
 SOLID
LOZENGES
combinations of drugs
having some sugar or
soothening material which
relieves the tickling sensation at the
back of the throat.
SOLID
 SOLID
SUPPOSITORIES
a solid dosage form of drug or
several drugs mixed with a firm
base.
SOLID LIQUID
 LIQUID

SOLID
 LIQUID
AQUEOUS SOLUTION
are intended for use in intravenous
administration.
 LIQUID

SOLID
 LIQUID
SUSPENSIONS
one or more drugs finely
divided in a liquid such as
water.
 LIQUID

SOLID
 LIQUID
ELIXIR
solution containing alcohol,
sugar and water. May or
may not have active medicines or
medicaments.
 LIQUID

SOLID
 LIQUID
DROPS
concentrated solution of
medicaments that are meant for oral,
eyes, nasal
or ears.
 LIQUID

SOLID
 LIQUID
LOTIONS
A medication in a liquid suspension
applied to the skin.
 LIQUID

SOLID
 LIQUID
LINIMENTS
a medication mixed
with alcohol, oil, or soapy emollient
and
applied to the skin.
 LIQUID

SOLID
 LIQUID
INJECTIONS
the sterile solution or
suspension in aqueous
or oily medium.
SOLID
 SEMI SOLID

SOLID
 SEMI SOLID
OINTMENT
a semisolid preparation of
one or more drugs used for
application to the skin and mucous
membrane.
 SEMI SOLID

SOLID
 SEMI SOLID
CREAMS
a non-greasy, semisolid preparation
used on the
skin.
 SEMI SOLID

SOLID
 SEMI SOLID
PASTES
a preparation like an ointment, but
thicker and stiff, that penetrates the
skin less than an ointment.
 SEMI SOLID

SOLID
 SEMI SOLID
GELS
a clear or translucent semisolid that
liquefies when applied to the skin.
SOLID INHALATIONS
 INHALATIONS

SOLID
 INHALATIONS
METER DOSE INHALERS Inhalers
are small, handheld devices that
allow you to breathe medicine in
through your mouth, directly to your
lungs. Types include metered-dose,
dry powder and soft mist inhalers.
 INHALATIONS

SOLID
 INHALATIONS
JET NEBULIZER
a mist of drugs
solution is generated
by pressurized air.
 INHALATIONS

SOLID
 INHALATIONS
SPINHALER / ROTAHALER
consist of a capsule which
is punctured and particles are
released once inhaled.
ROUTES OF
MEDICATION
ADMINISTRATION
METHODS OF MEDICATION
ADMINISTRATION

1. ENTERAL ROUTE
• drugs are administered
orally (mouth or tube)
METHODS OF MEDICATION
ADMINISTRATION

A. ORAL ROUTE
- most common, least
expensive, and most
convenient route.
- tablets, capsules,
suspensions, lozenges and
chewable.
METHODS OF MEDICATION
ADMINISTRATION

B. SUBLINGUAL /
BUCCAL ROUTE
- placed under the tongue
(sublingual) or between the
gums and teeth(buccal).
- these medications are not
swallowed.
EQUIPMENT:
• Disposable cup or disposable oral syringe
• Liquid with straw if not contraindicated
• Medication cart or tray
• Medication administration record
ASSESSMENT
1. Verify the patients name, name of drug, route, time, frequency,
appropriateness of the drug
2. Review medical history, allergy, laboratory data that may influence
drug administration
3. Ability to swallow medication, is in NPO, experiencing nausea or
vomiting
4. If medication will affect the vital signs, assess them before
administration
5. If the medication is for pain relief, assess the patient's pain level
before and after administration
6. Knowledge of the patient about the medication
NURSING DIAGNOSES
Determine related factors for the nursing diagnoses based on the
patient's current status.
⦁ Impaired Swallowing
⦁ Risk for Aspiration
⦁ Anxiety
⦁ Deficient Knowledge
⦁ Noncompliance
OUTCOME IDENTIFICATION
• patientwill swallow the medication
• patient will experience the desired effect from the
medication
• the patient will not aspirate
• the patient experience decrease anxiety
• the patient does not experience adverse effects
• the patient understands and complies with the
medication regimen
IMPLEMENTATION
1. Gather the needed equipment.
⦁ check each medication order against the original
physician's order according to the agency policy
⦁ clarify any inconsistencies
⦁ check the patient's chart for allergies
IMPLEMENTATION
2. Know the actions, special nursing considerations, safe
dose ranges, purpose of administration, and adverse
effects of the medications to be administered
⦁ consider the appropriateness of the medication for the
patient

3. Perform hand hygiene

IMPLEMENTATION
4. Move the medication cart to the outside of the
patient's room or prepare for administration in the
medication area

5. Prepare medication for one patient at a time

IMPLEMENTATION
6. Read the Medication Administration Record (MAR)
and select the proper medication from the patient's
medication drawer or unit stock.

7. Compare the label with the MAR. Check expiration

dates and
perform calculations, if necessary
IMPLEMENTATION
8. Prepare the required medications
• Unit dose packages: place unit -dose packaged
medications in a disposable
cup. Do not open wrapper until at the bedside. Keep
narcotics and medications that require special nursing
assessments in a separate container.

• Multidose containers:
IMPLEMENTATION
• Multidose containers:
- when removing tablets or capsules from a multidose
bottle, pour the necessary
number into the bottle cap and then place the tablets in a
medication cup.

- break only scored tablets, if necessary, to obtain the

proper dosage. do not touch
tablet with hands
IMPLEMENTATION
Liquid medication in multidose bottle; when pouring
liquid medication in a multidose bottle, hold the bottle
so the label is against the palm.

Use the appropriate measuring device when pouring

liquids, and read the amount of
medication at the bottom of the meniscus at eye level.

wipe the lip of the bottle with a paper towel

IMPLEMENTATION
IMPLEMENTATION
Remember:
• When all medications for one patient have been
prepared,
recheck the label with the MAR before taking them to
the
patient.
IMPLEMENTATION
Remember:
• Replace any multidose containers in the patient's
drawer or unit
stock. Lock the medication cart before leaving it.

• Transport medication to the patient's bedside carefully,

and keep
the medication in sight at all times
IMPLEMENTATION
9. Ensure that the patient receives the medication at the
correct time
IMPLEMENTATION
10. Identify the patient usually, the patient should be
identified using these
methods.
• check the name and identification number on the patient's
identification band
• ask the patient to state his/her name
• if the patient cannot identify himself or herself, verify the
patient's identification with a staff member who knows the
patient for the second
source
IMPLEMENTATION
11. Complete necessary assessments before
administering medications.
• Make sure to separate drug that might be withheld
based on preassessment data

12. Check allergy bracelets or ask patient about

allergies.
IMPLEMENTATION
13. Explain the purpose and action of each medication to
the patient

14. Assist the patient to an upright or lateral position

IMPLEMENTATION
ADMINISTERING TABLET/PILL/CAPSULE AND
LIQUID MEDICATION

15. Open unit-dose packages and place one drug in the

patient’s hand or pour in medication cup and give to the
patient; provide
assistance if needed
IMPLEMENTATION
ADMINISTERING TABLET/PILL/CAPSULE AND
LIQUID MEDICATION

• offer water or other permitted fluids with pills,

capsules, tablets, and some liquid medications

• administer liquid medication after pills, instructing

client to drink all of the solution
IMPLEMENTATION
16. Remain with the patient until each medication is
swallowed. never leave the medication at the patient's
bedside

17. Perform hand hygiene. Leave the patient in a

comfortable position

18. Check on the patient within 30 minutes, or time

appropriate for drugs, to verify response to the
medication
IMPLEMENTATION
ADMINISTERING BUCCAL AND SUBLINGUAL
MEDICATION
15.Don gloves
16.Place tablet:
• Under tongue for sublingual medication
• Between cheek and gum for buccal administration
• If mucous membranes are dry, offer a sip of water
before giving medication
IMPLEMENTATION
17.Instruct patient not to swallow drug but to let drug
dissolve

18.Discard gloves and perform hand hygiene

IMPLEMENTATION
19.Document administration on medication record

20.Check on the patient within 30 minutes, or time

appropriate for drugs, to verify response to the
medication
EVALUATION
• The expected outcomes are met when the patient
swallows the medication.
• Does not aspirate.
• Verbalizes an understanding of the medication.
• Experiences the desired effect from the medication.
• Does not experience adverse effects.
DOCUMENTATION
Record each medication given on the MAR or record
using the required format immediately
after it is administered, including date time of
administration.

• PRN medications require documentation of the reason

for administration
DOCUMENTATION
Prompt recording avoids the possibility of accidentally
repeating the administration of the drug

• if the drug was refused or omitted, record this in the

appropriate area on the medication
record and notify the physician

• this verify the reason why the medication was omitted

and ensures that the physician is aware of the patient's
condition
DOCUMENTATION
Recording of administration of a narcotic may require
additional documentation on a narcotic
record, stating drug count and other specific
information.

• Record fluid intake if intake and output measurement

is required
METHODS OF MEDICATION
ADMINISTRATION

2. TOPICAL ROUTE
• a medication that is applied
to a particular place on or
in the body
METHODS OF MEDICATION
ADMINISTRATION
a. TRANSDERMAL ROUTE
-referred to as the “patch”

-the medication can be

delivered slowly and
continuously for many
hours or days or even
longer
METHODS OF MEDICATION
ADMINISTRATION
b. OPTHALMIC ROUTE
- the administration of a drug
through the eyes,
most typically as an eye
drop formulation.
METHODS OF MEDICATION
ADMINISTRATION
c. OTIC ADMINISTRATION
- applied directly to the affected
ears. Ear drops containing
solutions or suspensions are
typically
applied only to the outer ear
canal.
METHODS OF MEDICATION
ADMINISTRATION
d. NASAL ADMINISTRATION
- route of administration in
which medications are insufflated
through the nose.
METHODS OF MEDICATION
ADMINISTRATION
e. VAGINAL ROUTE
-slowly absorbed through
the vaginal wall.
-often used to give estrogen to
women during menopause to
relieve vaginal symptoms such as
dryness, soreness, and redness.
METHODS OF MEDICATION
ADMINISTRATION
f. RECTAL ROUTE
- a medication is mixed with a
waxy substance that
dissolves or liquefies after it
is inserted into the rectum.
METHODS OF MEDICATION
ADMINISTRATION

3. PARENTERAL ROUTE
- invasive method of administering medications.
EQUIPMENT
NEEDLES
-are made of stainless steel, and most are disposable.
- Reusable needles need to be sharpened periodically
before sterilization
because the points become dull with use and are
occasionally damaged or acquire burns on the tips.

**A dull or damaged needle should NEVER be used

EQUIPMENT
• Hub- fits into the syringe

• Shaft/Cannula- attached to
the hub

• Bevel- slanted part at the

tip of the needle
EQUIPMENT
3 VARIABLE CHARACTERISTICS
1. Slant or Length of the bevel

-longer bevel provide the sharpest

needles & cause less discomfort.
(IM & SC)

-short bevel are used for ID & IV

injections
EQUIPMENT

2. Length of the Shaft

-commonly used needles varies
from ½- 2 inches.

3. Gauge (or diameter)

-gauge varies from #18 to #30
EQUIPMENT
**The larger the number, the smaller the diameter of the
shaft
EQUIPMENT
SYRINGES
• Tip- connects with the needle
• Barrel- or outside part on which the scales are printed.
• Plunger- fits inside the barrel.
TYPES OF SYRINGES
1. STANDARD/ HYPODERMIC
SYRINGE
-comes in 3ml, 5ml & 10ml sizes
-larger size syringes (10,20
&50ml) are not used to administer
drugs directly but can be useful for
adding medications to IV solutions
or for irrigating wounds
TYPES OF SYRINGES
2. INSULIN SYRINGE
-similar to hypodermic syringe but
the scale is specially designed for
an insulin.

-insulin pen is an insulin injector

device that looks like an insulin
cartridge.
TYPES OF SYRINGES
3. TUBERCULIN SYRINGE
-it is a narrow syringe, calibrated in
the tenths and hundredths of a
milliliter (up
to 1ml).

-useful in administering drugs,

particularly when small or precise
measurement is indicated.
• NON-LUER LOCK SYRINGE
-has smooth graduated syringe &
needles are slip into it.
-the larger non- luer lok syringe is
used for irrigation of wounds and
tubing
• LUER LOK SYRINGE
-has a tip that requires a needle to
be twisted onto it to avoid
accidental removal of the needle.
• PREFILLED UNIT-DOSE
SYSTEM
-are available and disposable
prefilled syringes ready for use.
AMPULES & VIALS
▪ Ampules
-is a glass container usually
designed to hold a single dose of a
drug.
-it is made of a clear glass & has a
distinctive shape with a constricted
neck.
-most ampule necks have colored
marks around them, indicating where
they are prescored for easy opening.
AMPULES & VIALS
▪ Vials
-is a small glass bottle with a sealed
rubber cap.
-comes in different sizes: single use
vials & multiple-dose vials
-usually have a metal or plastic cap that
protects the rubber seal and must be
removed to access the medication.
A. INTRADERMAL ROUTE
-administration of drug into the
dermal layer of the skin just beneath
the epidermis.

-this method is used in allergy

testing & tuberculosis (TB)
screening.

-usually small amount of liquid is

used.
B. SUBCUTANEOUS ROUTE
-administered subcutaneously or
just
beneath the skin like vaccines,
insulin, heparin.

-common sites: outer aspect of the

arms & anterior aspect of the thighs.

-3ml syringe & #25 gauge needle

orsmalle
C. INTRAMUSCULAR ROUTE
-are absorbed more quickly that
subcutaneous injections.

-usually a 3-5ml syringe is needed.\

-standard prepackaged
intramuscular needle is 1 ½ inches
and #21
or #22 gauge.
FACTORS INDICATING THE SIZE & LENGTH OF THE
NEEDLE TO BE USED:
1. Muscle
2. Type of solution
3. Amount of adipose tissue covering the muscle
4. The age of the client
D. INTRAVENOUS ROUTE
-medications enters into the client’s
bloodstream directly by way of a
vein, they are appropriate when a
rapid effect is required.

-is also appropriate when

medications are too irritating to
tissues to be given by other routes.
E. INTRA-ARTERIAL ROUTE
-administration into an artery.
F. INTRATHECAL ROUTE
- targeted delivery of the medication
directly into the cerebral spinal
fluid.
G. INTRAPERITONEAL ROUTE
-administration into the
peritoneum.
H. INTRAVITREAL ROUTE
- administered by an
Ophthalmologist.
4. INHALATION ROUTE
- medications administered by
inhalation through the mouth must
be atomized into smaller
droplets than those
administered by the nasal
route, so that the drugs can pass
through the windpipe (trachea) and
into the lungs.
TYPES OF
MEDICATION
ORDERS
1. STANDING ORDER
- carried out until the physician
cancels it by
another order or a prescribed
number of days elapse.

Ex: KCL tab twice daily x 2 doses

*In some agencies, standing orders are automatically canceled after a specified
number of days and must be recorded.
2. PRN ORDER “Pro Re Nata”
- “as needed order”
-an order of a
medication prescribed by
the physician to be given
when a patient requires it.

Ex: HNBB 1amp every 8 hours

for colicky pain
3. SINGLE ORDER
- “one time order”
-medication order to be given once
at a specified time.

Ex: Ativan 1 mg IV on
call to MRI
4. STAT ORDER
- signifies that a single dose of a
medication is to be given
immediately and only once.

Ex: Lasix 40 mg IM STAT

5.NOW ORDER
- used when a patient
needs a medication quickly but not
right away, as in a STAT order.

Ex: Clonidine 75 mcg SL now

MEDICATION
CARDS
MEDICATION CARDS
Medication cards or tickets serve as a tool for nurses to
effectively carry out doctor’s written order. It guides them in
administering medications to clients.

Depending on the hospital/healthcare facility’s protocol,

medication cards may contain the name of the ordered
medication and client’s personal data to safelyand efficiently
administer prescribed medications to them.
And depending on themedication type and the route or it to be
given, medication cards may vary in
different shape and color.
FORMS OF MEDICATION CARDS
ACCORDING TO SHAPE:

ORAL

INHALATION

PARENTERAL
***may vary depending on each hospital protocol***
FORMS OF MEDICATION CARDS
ACCORDING TO COLOR:

***may vary depending on each hospital protocol***

FORMS OF MEDICATION CARDS
1. NAME OF PATIENT
2. AGE
3. SEX
4. NAME OF MEDICATION
5. DOSAGE
6. ROUTE
7. FREQUENCY
8. DATE ORDERED
9. ROOM NUMBER/WARD/BED NUMBER
10.SIGNATURE OVER PRINTED NAME OF NURSE ON DUTY (OR INITIALS OF
NOD)
FORMAT
FORMAT
KEY POINTS:
1. NEVER TRANSCRIBE DOCTORS’ ORDER IN A
MEDICATION CARD WITH ERASURES OR
TAMPERED.

2. ALWAYS WRITE LEGIBLY, NEATLY, AND

CORRECTLY.

3. DO NOT RE-USE THE USED MEDICINE

TICKET.
KEY POINTS:
4. A NEW DOCTORS’ ORDER SHOULD BE
WRITTEN IN A NEW MEDICATION CARD.

5. ENDORSE MEDICATIONS THAT HAVE BEEN

REVISED/CHANGED (INCREASED/DECREASED
DOSAGE, CHANGED ROUTE, ETC.)
KEY POINTS:
6. DO NOT REVISE/REPHRASE WHAT HAS
BEEN WRITTEN IN THE DOCTORS’ ORDER
SHEET. REWRITE COMPLETELY WHAT HAS
BEEN WRITTEN IN THERE.

7. IF IN DOUBT, CHECK THE MEDICATION

CARD FROM THE DOCTORS’ ORDER SHEET
KEY POINTS:
8. ARRANGE THE MEDICATIONS ACCORDING
TO COLOR CODING IF FOR ONE (1) PATIENT
WITH LOTS OF DRUGS IN DIFFERENT
FREQUENCIES/TIMING.

9. MAKE AN INDICATION/MARK ON THE

MEDICINE TICKET FOR STAT ORDERS, TO
PREVENT FROM ADMINISTERING TWICE.
KEY POINTS:
10.SIGN THE MEDICATION SHEET AS PROMPT
AS POSSIBLE AFTER ADMINISTERING/GIVING
A DUE MEDICINE.

11.DO NOT SIGN THE MEDICATION SHEET IN

ADVANCE WITHOUT ADMINISTERING
THEMEDICATION/S, ESPECIALLY
INTRAVENOUS (IV) MEDICATIONS.
KEY POINTS:
12.ALWAYS COORDINATE WITH THE CHARGE
NURSE/SENIOR NURSE/FELLOW NURSE ON
DUTY WITH REGARDS TO NEW ORDERS, NEW
MEDICATIONS, AND OTHER DOCTOR’S
ORDERED.

13.BE MINDFUL, ALWAYS

SYSTEMS OF MEDICATION MEASUREMENT
1. METRIC SYSTEM
- WHEN WRITING
MEDICATION DOSES IN
METRIC UNITS,
HEALTHCARE PROVIDERS
AND NURSES USE
FRACTIONS OR MULTIPLES
OF A UNIT.
SYSTEMS OF MEDICATION MEASUREMENT
2. HOUSEHOLD SYSTEM
- INCLUDED UNITS ARE
DROPS,
TEASPOONS, TABLESPOONS,
CUPS,
PINT AND GLASSES.
SYSTEMS OF MEDICATION MEASUREMENT
3. APOTHECARY SYSTEM -
THE BASIC UNITS USED IN
THIS SYSTEM ARE THE
GRAIN (GR) FOR WEIGHT,
MINIM FOR VOLUME,
OUNCE, AND POUND.
SYSTEMS OF MEDICATION MEASUREMENT
4. OTHER SYSTEM
- MEQ, UNITS
MEDICATION DOSAGE CALCULATIO N
•D = DESIRED DOSE OR DOSE ORDERED BY
THE PRIMARY CARE PROVIDER.

•S = DOSE ON HAND OR DOSE ON THE LABEL

OF BOTTLE, VIAL, AMPULE.

•Q = VEHICLE OR THE FORM IN WHICH THE

DRUG COMES
(I.E., TABLET OR LIQUID).
STANDARD FORMULA
AMOUNT TO
ADMINISTER = DESIRED DOSE X QUANTITY
STOCK DOSE
MEDICATION ERRORS
MEDICATION ERRORS
A MEDICATION ERROR IS ANY
PREVENTABLE EVENT THAT MAY CAUSE
OR LEAD TO INAPPROPRIATE
MEDICATION USE OR PATIENT HARM
WHILE THE MEDICATION IS IN THE
CONTROL OF THE HEALTHCARE
PROFESSIONAL, PATIENT, OR CONSUMER.
MEDICATION ERRORS
SUCH EVENTS MAY BE RELATED TO
PROFESSIONAL PRACTICE, HEALTH CARE
PRODUCTS, PROCEDURES, AND
SYSTEMS, INCLUDING PRESCRIBING;
ORDER COMMUNICATION; PRODUCT
LABELING, PACKAGING, AND
NOMENCLATURE; COMPOUNDING;
DISPENSING; DISTRIBUTION;
EDUCATION; MONITORING, AND USE.
MEDICATION ERRORS
NEAR MISS (MEDICATION ERROR): A
MEDICATION ERROR THAT OCCURRED
BUT WAS CAPTURED BEFORE REACHING
THE PATIENT.
FACTORS CONTRIBUTING TO MEDICATION ERRORS
1.HUMAN RELATED
PROVIDERS :
• OVERWORKED
• UNDERTRAINED
• COMPETENCE
• DISTRACTED
• ILLNESS
• STRESSED
FACTORS CONTRIBUTING TO MEDICATION ERRORS
1.HUMAN RELATED
PATIENTS:
• IN A HURRY
• HEALTH LITERACY LEVEL
• DO NOT UNDERSTAND THE MEDICATION
• TRUST PROVIDERS TO NOT MAKE MISTAKES
FACTORS CONTRIBUTING TO MEDICATION ERRORS
2.SYSTEM RELATED
• LACK OF COMMUNICATION
• POOR WORKFLOW
• DISORGANIZED WORKSPACE
• INADEQUATE TOOLS TO COMPLETE WORK
• LACK OF SUPERVISION
FACTORS CONTRIBUTING TO MEDICATION ERRORS
3.MEDICATION RELATED
• LOOKALIKE/ SOUND A LIKE MEDICATIONS
• MULTIPLE DOSAGE FORMS AND STRENGTHS
TYPES OF MEDICATION ERRORS
A. PRESCRIBING ERRORS
• INCORRECT PRESCRIPTION
• ILLEGIBLE HANDWRITING
• DRUG ALLERGY NOT IDENTIFIED.
• IRRATIONAL COMBINATIONS
• OUT-OF-LIST ABBREVIATIONS
B. DISPENSING IS A DISCREPANCY
C. DOCUMENTATION
D. ADMINISTRATION
MEDICATION CALCULATION
PEDIATRIC FORMULA

DOSAGES FOR MEDICATION ADMINISTRATION

TO PEDIATRIC PATIENTS ARE ALMOST ALWAYS
DETERMINED BY THE PATIENT'S SIZE (HEIGHT
AND WEIGHT).
PEDIATRIC FORMULA

THE METHODS THAT WILL BE DISCUSSED IN

THIS MODULE ARE:

NOMOGRAM METHOD
FRIED'S RULE
YOUNG'S RULE
CLARK'S RULE
PEDIATRIC FORMULA

IT IS VERY IMPORTANT TO MAINTAIN

PRECISION WHEN USING THESE RULES TO
DETERMINE THE CORRECT DOSE OF
MEDICATION FOR THE PEDIATRIC PATIENT.
THEREFORE, IT IS SUGGESTED TO USE THE
FOLLOWING ROUNDING RULES:
PEDIATRIC FORMULA
WEIGHT DOSES (MG)

• When calculating doses in weights, medications that are less

than 1 mg should be rounded two decimal places
(hundredths place).

• Doses that are 1mg - 10 mg should be rounded to one

decimal place (tenths place).

• Doses greater than 10 mg should be rounded to the whole

number.
PEDIATRIC FORMULA
VOLUME DOSES (ML)

• Doses that are less than 1 milliliter should be rounded to two

decimal places (hundredths place).

• Doses greater than 1 milliliter should be rounded to one

decimal place (tenths place).
PEDIATRIC FORMULA
A. FRIED’S RULE
APPLIES TO A CHILD YOUNGER THAN 1 YEAR
OF AGE.

THE RULE ASSUMES THAT AN ADULT DOSE

WOULD BE APPROPRIATE FOR A CHILD WHO IS
12.5 YEARS (150 MONTHS) OLD.
PEDIATRIC FORMULA
A. FRIED’S RULE

Pedia Dose = Infants age (mos) x Adult Dose

150 mos
PEDIATRIC FORMULA
B. YOUNG’S RULE
APPLIED TO CHILDREN 1 TO 12 YEARS OF AGE.

Pedia Dose= Child Age (Years) x Adult Dose

Child Age (Years)+12
PEDIATRIC FORMULA
B. YOUNG’S RULE
PEDIATRIC FORMULA
C. CLARK’S RULE
USES THE CHILD WEIGHT TO CALCULATE THE
APPROPRIATE DOSE AND ASSUMES THAT THE
ADULT DOSE IS BASED ON A 150 LB PERSON

Pedia Dose= Wt of Child (LB) x Adult Dose

150 pounds
PEDIATRIC FORMULA
C. CLARK’S RULE
PEDIATRIC FORMULA
D. SURFACE AREA CALCULATION
TO DETERMINE THE APPROX DOSAGE THAT
SHOULD BE USED, THE CHILD’SURFACE AREA
IS DETERMINED WITH THE USE OF
NOMOGRAM. THE HEIGHT AND WEIGHT OF
THE CHILD ARE TAKEN INTO CONSIDERATION
IN CHART.

Pedia Dose= Surface Area (M2) x Adult Dose

1.73
PEDIATRIC
FORMULA
D. SURFACE AREA
CALCULATION
PEDIATRIC FORMULA
D. SURFACE AREA CALCULATION
ADULT FORMULA

DOSAGE= DOSE PRESCRIBED X QUANTITY

STOCK DOSE

DOSAGE= D X Q
S
THANK YOU FOR LISTENING! :)