Guidelines for Preparation & Administration of Medication
1. Work in a quiet, well-lit atmosphere that is free of distractions.
2. Always ask if you have a question about the medication order.
3. Know the drug to be given.
4. Select the proper drug.
***Check the label of the medication 3x
(when taken from its storage; before preparing the
medication; after preparing the medication.)
***DO NOT use a drug IF label is missing OR is difficult to read!
5. DO NOT use a drug if the color has changed, if a precipitate has formed, OR if it has an ususual odor
6. Check the expiration date before preparing the drug for administration.
7. Prepare the proper dose of the drug.
***Dose refers to, the quantities of a drug to be administered at one time.
***It is important to adminster the exact dose of the drug.
***A dose that is too small would not produce a therapeutic effect.
***A dose that is too large cold be harmful or even fatal to the patient.
8. Correctly identify the patient so that the drug is administered to the intended patient.
***When adminstering medication, the patient should be identified by his/herfull name & DOB.
9. Before administering the medication, check the patient's records or question the patient to enssure that he/she is NOT allergic to the medicaton.
10. If you are giving an injection, determine the appropriate route and site at which to administer the injection being given.
***Allergy injection is given thru SC route.
***Antibiotic injection is given thru IM route.
***This site MUST BEfree from abrasions, lesions, bruises, and edema.
11. Use the proper technique to administer the medication.
12. Stay with the patient after administering the medication.
13. Document information properly in the patient's chart immediately after the administering the drug.
***Make sure the recording is clear and legible to avoid confusion by others who read it.
***Document: date, time, name of medication, lot # (if required), dose given, route of adminstration, site of administration, and any unusual observations or partient reactions.
***Sign the recording w/ your name and credentials.
14. Always follow the seven "rights" of preparing and administering medication in the medical office.
***Rightdrug, dose, time, patient, route, technique, documentation.
The term dose refers to
The quantity of a drug to be administered at one time.
An allergy injection should be give where?
An antibiotic injection should be given where?
Do NOT use a drug if the label is
missing or is difficult to read.
The seven "rights" of preparing and administering medication in medical office is?
Oral adminstration means
that the drug is given bymouth in either a solid form (a tablet or capsule) or a liquid form (a suspension or a syrup).
Absorption of most oral medication occurs in?
small intestine, although some may be absorbed in the mouth and stomach.
Water should NOT be offered after the patient has received a cough syrup because?
the water would dilute the medication's beneficial effects.
Procedure 11-1:Administering Oral Medication
1. Sanitize your hands.
2. Assemble the equipment.
3. Work in a quiet, well-lit atmosphere.
***Good lighting aids the MA in readin the medication label.
4. Select the correct medication from the shelf.
***Compare the medication w/ the physician's instructions.
***Check the drug label 3x (When remove from storage, B4 and after preparing the medication).
***Check the expiration date.
***If the medication is outdated, consult the physician b/c it may produce undesirable effects for which the MA could be held responsible.
***To prevent a drug error, the medication should be carefully compared w/ the physician's instructions.
5. Calculate the correct dose to be given, if necessary.
6. Remove the bottle cap, touchin the outside of the lid only.
***Touching the inside of the lid contaminates it.
7. Check the drug label again, and pour the medication.
--Pour the correct number of capsules or tablets into the bottle cap.
--Transfer the medication to a medicine cup, being careful not to touch the inside of the cup.
***Pouring the medication into the lid prevents contamination of the medication and lid.
--Place the lid of the bottle on a flat surface with the open end facing up.
--Palm the surface of the label.
--With the opposite hand, place the thumbnail at the proper calibration on the medicine cup, and hold the cup at eye level.
--Pour the medication, and read the dose at the lowest level of the meniscus.
***Placing the bottle cap with the open end up prevents contamination of the inside of the cap.
***Palming the medication label prevents the medication from dripping on the label and obscuring it.
8. Replace the bottle cap, and check the drug label a third time to ensure it is the correct medication. Return the medication to its storage location.
9. Greet the patient and introduce yourself. Identify the patient by full name, dob, and explain the prodecure. Explain the purpose of administering the medication.
***It is crucial that no error be made in patient identity.
10. Hand the medicine cup containing the medication tot he patient, along with a glass of water. (If the medication is a cough syrup, do NOT offer water.)
***Water helps the patient swallow the medication.
11. Remain with the patient until the medication is swallowed. If the patient experiences any ususual reaction, notify the physician.
12. Sanitize your hands.
13. Chart the procedure.
---date & time, name of medication, dosage given, route of administration, and any significant observations or patient reactions
---In Latin po means "by mouth" can be used to indicate the route of administration.
What are the route of parenteral route of drug administration?
*Medications given subcutaneously, intramuscularly, and intravenously.
What are the advantages of parenteral route of drug administration?
Medications given subcutaneously, intramuscularly, and intravenously are absorbed more rapidly and completely than medications given orally.
If state laws permit, the MA is usually responsible for?
administering SC, IM, and intradermal injections.
What is the disadvantages of parenteral route injection?
pain & possibility of infection as a result of breaking the skin.
How can MA minimize the pain when giving parenteral injection?
by inserting and withdrawing the needle quickly & smoothly & by withdrawing the needle at the same angle as for insertion.
A needle is consists of several parts of?
*hub, the part that fits onto the top of the syringe.
*shaft, is inserted intot he body tissue.
*lumen, the opening in the shaft of the needle (is continue with the needle shaft).
---medication flows from the syringe and thru the lumen of the needle.
*point, tip of the needle is located at the end of the needle shaft.
---the point is sharp so that it can penetrate body tissues easily.
*bevel, is the top of the needle is slanted.
---the bevel is designed to make a narrow, slitlike opening in the skin.
---this narrow opening closes quickly when the needle is removed to prevent leakage of medication, and it heals quickly.
*gauge, for administering medication range between 18G & 27G.
---the gauge of a needle is determined by the diameter of the lumen: As the size of the guage incrases, the diameter of the lumen decrease.
The length of the needle ranges between?
3/8 and 3"
**the length used is based on the type of injection being given & the size of the patient.
IM injection to a thin patient requires?
a shorter needle to avoid inserting a needle too deeply and possibly penetrating the bone.
IM injection on an obese adult requires a?
longer needle to reach the muscle tissue than would be required for a normal-size adult.
IM injection needle is longer than an SC injection needle so that?
it penetrates deeply enough to reach the muscle tissue.
*is used for inserting fluids into the body.
*It is made of plastic and must be disposed of after one use.
Syringe is consists of?
*barrel, holds the medication & contains calibrated (cc unit) markings to measure the proper amount of medication.
*flange, a rim at the end of the barrel, which helps in injecting the medication.
---the flange also prevents the syringe from rolling when placed on a flat surface.
*plunger, a removable cylinder that slides back and forth in the barrel.
---it is used to draw medication into the syringe when preparing an injection and to push medication out of the syringe when administering an injection.
What are the types of syringes used in medical office?
1. Hypodermic syringes, are avilable in 2-, 2.5-, 3-, and 5-cc sizes & are calibrated in cubic centimeters.
---commonly used to administer IM injections.
2. Insulin syringe, for the administration of an insulin injection, and the barrel is calibrated in units.
---most common type is the U-100 syringe, which is calibrated into 100 units in increments of 2.
3. Tuberculin syringes, to administer a small dose of medication, such as when administering a tuberculin test.
---The tuberculin syringe has a capacity of 1 cc & hundredths (0.01) of a cubic centimeter.
---Syringes also available with capacities of 10, 20, 30, 50, and 60 cc; however, they are NOT used for administering medication, but rather for medical tx, such as irrigating wounds, & draining fluid from cysts.
Safety engineered syringes
a built-in safety feature to reduce the risk of a needlestick injury.
-is a closed glass container with a rubber stopper
-a soft metal or plastic cap protects the rubber stopper and must be removed the first time the medication is used.
-available in: single-dose vial, multiple-dose vial, or both.
Vials require mixing should be rolled between the hands rather than shaken because?
shaking would cause the medication to foam, creating air bubbles that may enter the syringe when the medication is withdrawn.
When remove medication from a vial, you must make sure that?
the amount of airexactly = the amount of liquid to be removed is injected into the vial.
is a small, sealed glass container that holds a single dose of medication.
prefilled disposable syringes
ex. Tubex Injector
the process of adding a liquid to a powedered drug.
the liquid used to reconstitute a powedered drug.
is made into the subcutaneous tissue, which consists of adipose (fat) tissue and is located just under the skin.
What are the subcutaneous injection sites?
1) Upper lateral part of the arms
2) Anterior thigh
3) Upper back
Absorption of medication from a SC injection occurs mainly through?
capillaries, resulting in a slower absorption rate than with IM injections.
Drugs given subcutaneouslymust be
isotonic, nonirritating, nonviscous, and water-soluble.
are made into the muscular layer of the body, which lies below the skin and subcutaneous layers.
ex., immunizations, antibiotics, injectable contraceptives, vitamin B12, and corticosteroids.
Z-Track Intramuscular injection method
*precedure where the skin and subcutaneous tissue at the injection site are pulled to the sidebefore the needle is inserted.
*this causes a zigzag path through the tissue when the skin is released, which seals off the needle track.