administration of medication in patient care.pptx

• 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.

Purpose of medication
these
any
Drugs can be administered for
purposes:
• Diagnostic purpose: to identify
disease
• Prophylaxis: to prevent the
of disease.
heparin to prevent
thrombosis
occurrence
eg:-
or
antibiotics to prevent infection.
• 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.

⚫Treatment- alleviate the symptoms for
patients with chronic disease e.g. Anti-
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

Storage of Medications
• Medications are dispensed by the pharmacy
to nursing units. Once delivered, proper
storage becomes the responsibility of the
nurse. All medications must be stored in a
cool dry place (usually in cabinets, medicine
carts or fridges)

All medications must be stored in a cool dry place
(usually in cabinets, medicine carts or fridges)

Storage of Medications
• In less advanced countries, 3 cupboards are
usually used for drug storage.
• Cupboard I-used for drugs for external use only;
e.g. calamine lotion, detol, methylated spirit etc.
These drugs are contained in distinctive bottles,
usually ridged with deep colours (dark green,
blue, brown) with red label marked POISON and
FOR EXTERNAL USE ONLY.

• Cupboard II-contains drugs for internal use
only e.g. tablets, suspension, mixtures etc. All
drugs must be labelled.
• Cupboard III-contains the dangerous drug;
drugs of addiction. E.g. Morphine, pethedine
etc.
All drugs should be kept away from direct
sunlight and at a temperature suggested by
the manufacturer.

• Another cupboard called the Emergency
Cupboard may be stationed at or near the
nurses bay for easy access. This cupboard
contains drugs for emergency situations e.g.
aminophylline (for asthma), hydralazine (for
severe hypertension), oxytocin (for maternal
bleeding), intravenous infusions (for
rehydration) etc.

Principles of medication
administration
• Principles include 3 checks and
10 Rights:
• 3 checks are
1. Check when obtaining the
container of medicine.
2. Check when removing the
medicine from the container.
3. Check when replacing the
container.

Rights of Medication Administration
Medication errors can be detrimental to patients.
To prevent these errors, these guidelines are - the
rights- are used in drug administration.
1. Right Patient: correct identification of the client
cannot be over emphasized. This can be done by
asking the client to mention his/her full name
which should be compared with that on the
identification bracelet or the patient’s folder
and medication/treatment chart for
confirmation.

2. Right Medication:
⚫Beware of same and similar first and surnames to
prevent the error of administering one person’s
medication to another and vice versa.
⚫Right Medication: before administering any
medicine, compare name on medication
chart/medication order with that on the medication at
least 3 times-checking medication label when
removing it from storage unit, compare medication
label with that on treatment chart and medication
label and name on treatment chart with patient’s
name tag.

3. Right Time
Right Time: drug timing is very especially with
some drugs like antibiotics, antimalaria drugs etc.
to achieve cure and prevents resistance. Some
drugs must be given on empty stomach
e.g. antituberculosis drugs; and some after meals
e.g. NSAIDS-these must be noted and adhered to.
• The interval of administration of drugs should also
be adhered to because it is important for many
drugs that the blood concentration is not allowed
to fall below a given level and for others two
successive doses closer than prescribed might
increase blood concentration to a dangerous level
that can harm the patient.

4. Right Dose
This becomes very important when
medications at hand are in a larger volume or
strength than the prescribed order given or
when the unit of measurement in the order is
different from that supplied from the
pharmacy. Careful and correct calculation is
important to prevent over or under dosage of
the medication.

5. Right Route
An acceptable medication order must specify
the route of medication. If this is unclear, the
prescriber should be contacted to clarify or
specify it. The nurse should never decide on a
route without consulting the prescriber.

6. Right to information on drug/client
education
• The patient has the right to know the drug
he/she is taking, desired and adverse effects
and all there is to know about the medication.
The charter on patient’s right made this clear.

7. Right to Refuse Medication
The patient has the right to refuse any
medication. However, the nurse is obliged to
explain to patients why the drug is prescribed
and the consequences refusing medication.

8. Right Assessment
Some medications require specific assessment
before their administration e.g. checking of vital
signs. Before a medication like Digoxin is
administered the pulse must be checked. Some
medication orders may contain specific
assessments to be done prior to medication

9. Right Documentation
after
Documentation should be done
medication and not before.

10. Right Evaluation
Conduct assessment to ascertain drug action,
both desired an side effect.

Medication order
The drug order, written by the physician, should
has 7 essential parts for administration of
drugs safely.
1. Patients full name.
2. Date and time.
3. Drug name.
4. Dosage.
5. Route of administration.
6. Time and frequency of administration.
7. Signature of physician.

Types of Medication Orders
• Four types of medication orders are commonly used:
1. Stat order: A stat order indicates that the
medication is to be given immediately and only
once. e.g: morphine sulfate 10 milligrams IV stat.
2. Single order: The single order or one-time order
indicates that the medication is to be given once at
a specified time. e.g: Seconal 100 milligrams at
bedtime.

3. Standing order: Standing order is written in
advance carried out under specific
circumstances. (e.g: amox twice daily × 2 days)
4. PRN order: “PRN” is a Latin term that stands
for “pro re nata,” which means “as the thing is
needed.” A PRN order or as-needed order,
permits the nurse to give a medication when
the client requires it. (e.g., Amphojel 15 mL
prn)

Terminologies and abbreviations
used in prescriptions of
medications

Abbreviations Meaning
STAT order
 refers to any medication that is needed immediately and is to
be given only once
 often associated with emergency medications that are
needed for life-threatening situations
 comes from the latin word "statim" meaning
immediately
 should be administered within 5 minues or less of
recieving
the written order
ASAP order
 not as urgent as STAT
 as soon as possible
 should be avaliable for administration to the patient with 30 minutes
of the written order
Single order  for a drug that is to be given only once, and at a specific time, such as a
preoperative order
PRN order
 latin "pro re nata"
 administered as required by the patient's condition


Routine orders
 orders not written as STAT
, ASAP, NOW or PRN
 these are usually carried out within 2 hours of the time the order is
written by the physician
Standing order
 written in advance of a situation that is to be carried out under specific
circumstances. example: set of postoperative PRN prescriptions
that are written for all patients who have undergone a specific
surgical procedure "Tylenol elixir 325mg PO every 6 hours PRN
sore throat"
 standing orders are no longer permitted in some facilites because of
the legal implications of putting all patients into a single
treatment category
ac
 before meals
AM
 morning
bid  twice per day

gtt  drops
h or hr  hours
IM  intramuscular
IV  intravenous
no  number
pc  after meals, after eating
PO  by mouth
PM  afternoon
PRN  when needed/necessary

qid  four times per day
q2h, q4h, q6h,
q8h, q12h
 every hours
Rx  take
STAT  immediately, at once
tid  three times per day
ad lib  as desired, as directed
tab  tablet

Drug forms
• Medications are available in variety of
forms. The form of the medication
determines its route of administration.

• Drug forms can be of three types;
– Solid eg: tablet, capsule
– Liquid eg: syrup, eye drops
– Semi solid eg: ointment, lotion

• Tablet: It is the powdered
medication compressed into
hard disk or cylinder.
• Capsule: Medication covered in
gelatin shell.
• Gel or jelly: A clear or
translucent semisolid that
liquefies when applied to the
skin.

• Lozenge: A flat, round, or oval
preparation that dissolves and
releases a drug when held in the
mouth.
• Lotion: Drug particles in a solution
for topical use.
• Ointment: Semisolid preparation
containing a drug to be applied
externally.

• Powder: Single or mixture of
finely ground drugs.
• Solution: A drug dissolved in
another substance.
• Suspension: Finely divided,
undissolved particles in a liquid
medium; should be shaken
before use.

• Syrup: Medication
combined in a water and
sugar solution.
• Suppository: An easily
melted medication
preparation in a firm base
such as gelatin that is
inserted into the body
(rectum, vagina, urethra)

• Transdermal patch: Unit dose of
medication applied directly to skin for
diffusion through skin and absorption
into the bloodstream.

administration of medication in patient care.pptx

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