Procedure of Administering Oral Medication ~ Nursing

Procedure of Administering Oral Medication

Equipment
■ MAR.
■ Medication drawer or portable cart with keys to the medication drawer, as needed.
■ Procedure gloves, as needed.
■ Other supplies and equipment needed for the specific procedure (e.g., water, alcohol wipes).

Assessment
■ Assess for factors that interfere with drug absorption (e.g., diarrhea, inadequate circulation, foods, other drugs).
■ Assess for factors that affect absorption and/or metabolism of the drug (e.g., impaired liver function, edema, inflammation, or agerelated changes).
■ Before the first administration, assess the patient’s knowledge about the medications being given.
■ Be Smart! Assess your knowledge of the medication (e.g., drug action, recommended dosage, time of onset and peak action, common side effects, and so on); and verify the prescribed dosage is appropriate for the patient’s age and weight.
■ Be Safe! Before giving the medication, assess VS and check lab studies to determine whether the drug can be safely administered.
■ Be Smart! Assess for situations in which administering the medication would not be reasonable (e.g., oral medications prescribed for a patient who is vomiting, who is sedated, or who has difficulty swallowing).
■ Be Safe! Check for history of allergies. Post-Procedure Reassessment
■ Evaluate the therapeutic effects of the medication. For example, check BP after administering an antihypertensive medication, or check pain level after an analgesic.
■ Be Safe! Be alert for side effects, allergic reactions, or other adverse reactions. If present, notify the primary care provider.

Key Points
■ Observe the “three checks” and the “rights of medication”: right patient, drug, dose, time, route, and documentation.
■ Tablets and capsules: Count the correct number aloud.
■ Liquids: Hold the medication cup at eye level to measure the dose.
■ Assist the patient to a high-Fowler’s position, if possible.
■ Administer the medication:
■ Powder: Mix with liquid, and give it to the patient to drink.
■ Lozenge: Instruct the patient not to chew or swallow it before it dissolves in her mouth.
■ Tablet or capsule: Place the tablet in her mouth or hand, or in a medication cup; instruct the patient to swallow with sips of liquid.
■ Sublingual: Instruct the patient to place the tablet under the tongue and hold it there until it is completely dissolved.
■ Buccal: Instruct the patient to place the tablet between the cheek and teeth and hold it there until it is completely dissolved.

Documentation
■ Scheduled medications are documented on the MAR.
■ Document:
■ Medication, time, dose, and route given, and assessments.
■ Therapeutic and adverse drug effects.
■ Nursing interventions.
■ Teaching.
■ Record PRN medications in the nursing notes; include reason given and response.
■ For parenteral medications, note the site of injection.