Procedure of Administering Oral Medication

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.

Hold the bottle with the label in your palm

Sublingual Place and hold the tablet under the tongue until it is completely dissolved

Buccal Place the tablet between the cheek and teeth or tongue