ADMINISTERING MEDICATION 8.

RIGHT TO REFUSE – sign a consent/

waiver.
MEDICATION – is a substance administered for the
9. RIGHT ASSESSMENT – as a nurse you
diagnosis, cure, treatment or relief of symptom or for
must have a good judgement.
prevention of disease (prophylaxis). Forms of
10. RIGHT EVALUATION
medication, caplet, tablet, capsule, suppository.
Antibiotics- to cure infection. TYPES OF MEDICATION ORDERS
USES OF MEDICATION: 1. STANDING ORDERS
- Is carried out until the doctor cancels it by
1. PREVENTION (to prevent disease) used as
another order or a prescribed number of
a prophylaxis (antibiotics, antibacterial
days elapse.
(newborns – erythromycin)
- Example: Cefuroxime (antibiotics
2. DIAGNOSIS (to establish patient’s disease
generic) (Zinacef) (brand) 500 mg/tab /
or problem.) the trial and error
tab p.o.(per orem) bid (twice a day) for 7
3. SUPRESSION (to prevent the disease
days
process from progressing) to control the
2. PRN ORDERS
symptoms or disease
- Is an order wherein the medication is to
4. TREATMENT (to alleviate the symptom) to
be given only when a patient requires it.
control the symptoms
- This requires the nurses’ assessment
5. CURE (to completely eradicate diseases)
and judgement in determining whether or
6. ENHANCEMENT OF HEALTH (to achieve
not the patient needs the medication
the best state of health)
(judgment, critical thinking)
PURPOSE OF MEDICATION: - Example: Paracetamol (Tempra Forte)
500 mg/tab / tab p.o. every 4 hours prn
1. THERAPEUTIC PURPOSE (to cure the for fever (T>38.0-degree celsius).
disease) 3. SINGLE ORDERS
2. PROPHYLAXIS (to prevent he occurrence of - A medication to be given once at a
disease) specified time.
3. DIAGNOSTIC PURPOSE (to identify any - Example: Ranitidine (to control gastric
disease) acidity) (Zantac) 150 mg IVTT
TEN RIGHT OF DRUG ADMINISTRATION: (intravenous through tubing) on call to
OR (operating room)
1. RIGHT PATIENT – give it to the right patient, 4. STAT ORDERS
a lot of medication error happened because - A single dose of a medication is to be
of giving it to the wrong patient (room given immediately and only once
number and name of the patient should - Example: Captopril (Capoten) 25 mg/tab
be written in the medication ticket.) wrong / tab SL (sublingual) STAT
medications will cause side effects & the right 5. NOW ORDERS
patient will not be treated. How to make sure: - Is more specific than a one-time order
ask the name of the patient, and is used when a patient needs a
2. RIGHT DRUG – different drug has different medication quickly but not right away.
effect. It could harm or kill. - Example: Furosemide (Lasix) 40 mg
3. RIGHT DOSAGE IVTT (intravenous through tubing) now
4. RIGHT ROUTE – PO -per orem (oral) IM -
(intramuscular) COMPONENTS OF A MEDICATION ORDER
5. RIGHT TIME TICKET:
6. RIGHT DOCUMENTATION – everything ✓ PATIENT’S FULL NAME – a patient’s full
that a nurse is going to do should be name distinguishes the patient from other
documented. people with the same last name.
7. RIGHT CLIENT EDUCATION – explain to ✓ DATE THE ORDER WAS WRITTEN – the
the patient why the medication is given. day, month, and year need to be included to
 clarify when certain orders are to start and
stop.
✓ MEDICATION NAME – the doctor orders a
medication by its generic or brand name.
✓ DOSAGE
✓ ROUTE ADMINISTRATION
✓ TIME AND FREQUENCY OF
ADMINISTRATION
✓ NAME OF HEALTH CARE PROVIDER

ANST- after negative skin test

IM – intramuscular
MEDICATION TIMING (IMCH)
od – 8 AM
bid – 8 AM & 6 PM
tid - 8 AM, 1PM, & 6PM
qid – 8 AM, 12 Noon, 4PM, & 8PM (IF THE
DOCTOR DID NOT STATE THE TIME TO GIVE
THE MEDICATION)
RTC – round the clock (e.g Paracetamol (tempra
forte) 500mg/tab 1 tab p.o every 4 hrs RTC (in 24
hrs, every 4 hrs = 24 hrs/4hrs= 6x))

CORRESPONDING MEDICINE TICKET COLOR

CODING:

MEDICINE TICKET COLOR

RED Once a day (od)
ORANGE Twice a day (bid)
PINK Three times a day (tid)
YELLOW Four times a day (qid)
WHITE Round the clock (e.g.
everynight hours) parenteral
medications (rtc) now, stat,
single.
BLUE PRN (as needed) medications
GREEN Treatment (e.g. nebulization,
topical administration) topical
 PARTS OF A SYRINGE

AMPULE – contain single doses of medication in a

liquid. It is made of glass with a constricted neck that
must be snapped off to allow access to the
PARENTERAL ROUTES medication.

It involves injecting a medication into body tissues.

• The following are the four major sites of

injection:
1. INTRADERMAL – involves injecting into the
dermis just under the epidermis (bevel facing
up)
2. SUBCUTANEOUS – involves injecting into
the dermis just under the epidermis (dart
position of hand)
3. INTRAMUSCULAR – involves injecting into
a muscle
4. INTRAVENOUS – involves injecting into a
vein
VIAL – is a single-dose or multi-dose container with
TYPES OF PARENTERAL ROUTES OF a rubber seal at the top; a metal cap protects the seal
ADMINISTRATION until it is ready for use. It contains liquid or dry forms
of medications. Unlike the ampule, the vial is close
system, and air needs to be injected into it to permit
easy withdrawal of the solution.

SYRINGES consists of a cylindrical barrel with a tip

designed to fit the hub of hypodermic needle and a
close-fitting plunger.
 What to prepare? (oral medication)
▪ Medicine cups #3
▪ Medication tray #1
▪ Glass with juice or water #1
▪ Paper towel
▪ Liquid medicine in a bottle #1
▪ Single-packed tablet or capsule #1
▪ Tablets or capsules in a stock container #1
What to prepare?
▪ Tuberculin syringe 1cc #1
▪ Syringe (3 ml) #1
▪ Needle (gauge 23) #1
▪ Alcohol-soaked cotton balls or alcohol swabs
▪ Dry cotton balls
▪ Medicine in an ampule #1
▪ Medicine in a vial #1
▪ Distilled water in a vial #1
▪ Tray with towel lining
RETDEM NOTES

• Wear mask
• AM- blue pen
• PM- black pen

ADMINISTERING ORAL MEDICATIONS ORAL MEDICATION

h. Prepare liquid • Read the doctors order

• Transcribe the medication into the
1) gently shake container medication sheet and medication ticket
2) Remove bottle cap from container and place • Prepare the medication
cap upside down. Hold multidose bottle with • Go to the patient (perform hand hygiene and
label against palm of hand while pouring. ask for the clients name)
3) Place medication cup at eye level on hard • Give the medication (give it one by one, start
surface. Fill to desired level on scale. Make from the solid one, and let the patient drink
sure that scale is even with fluid level at its water alternately)
surface or base of meniscus, not edges. • Chart the medication
4) Discard any excess liquid into sink
5) Wipe the mouth of the medication bottle with PARENTERAL MEDICATION
a paper towel or tissue before covering with
• Read doctors order
the bottle cap.
5. Return stock containers to shelf or drawer and • Transcribe to the medication sheet and ticket
read label again • Prepare the medication (perform hand
6. Do not leave medications unattended hygiene)
7. Before going to patient’s room, compare ▪ Tap the top of the ampule until no fluid in the
patient’s name and name of medication on label neck
of prepared drugs with the medicine ticket. ▪ Disinfect the neck
8. Take medications to patient at correct time ▪ Get your gauze pad
▪ Snap the neck
▪ Discard the top part of the ampule
▪ Change the needle (gauge 23)
 SKIN TESTING PREP
• Use 1cc syringe
• 0.9 mL from the vial (aspirate air first 0.9
air and then introduce to the vial and
aspirate 0.9 mL from the vial)
• Aspirate 0.1 mL from the ampule
(medication)
• Change the needle back to its original
• Go to the patient (ask the name and
perform hand hygiene)
• Assess clients skin for any lesions, hair or
spots
• Remove the cap
• Taunt the skin, the bevel should be facing
up
• Introduce the test until it will form a wheal
• Draw a circle around the wheal.
IM (TUBERCULIN SYRINGE)

• Change the needle into gauge 23

• Disinfect the vial first
• Remove the cap
• Aspirate air equal to the prescribed
dosage
• Aspirate medication according to its
ordered dosage
• Discard excess medication
• Change the needle back to its original
• Read the medication again
• Cover the vial
• Administer the medication (perform hand
hygiene)
• Ask clients name
• Select appropriate site for IM
o Disinfect the site with alcohol swabs
or alcohol soaked cottons in a
circular motion from inner to outer
• Introduce the medication to the patient
• Apply pressure to the site with cotton ball
and discard the cotton