Medication Administration

Medication Administration
Medication Rights	Triple Check
■ Right Patient ■ Right Medication ■ Right Dose ■ Right Time ■ Right Route	■ When obtaining medication from where it is stored. ■ Side-by-side comparison of medication and the written order and the medical administration record (MAR). ■ One last time after preparation, just prior to administration.
Approximate Onset	Assessment and Documentation
IV 3–5 minutes	■ Assessment needs vary and depend on route and medication. ■ Always assess patient after giving drugs that may adversely affect RR, HR, BP, LOC, and blood glucose. ■ Assess meds for their efficacy and adverse drug reaction (ADR). ■ Document: drug, dose, route, time given, and time d/c’d if applicable. Include patient response and any ADR.
IM 3–20 minutes
SC 3–20 minutes
PO 30–45 minutes
These onset times are only approximate, but will help guide you in your assessment.

Aspirate (IM and SC Injections)

■ The reason for aspirating prior to actually injecting a medication is to ensure that the needle is not in a blood vessel.

■ If blood appears in the syringe, withdraw the needle, discard the syringe, and prepare a new injection.

When Not to Aspirate

■ When administering SC anticoagulants (e.g., heparin) or insulin, it is recommended that you do not aspirate.

■ Entering a blood vessel is unlikely with SC injection and manipulating the syringe is more likely to cause bruising.

■ Aspiration while administering anticoagulants increases the risk of bleeding and bruising.

Points to Remember

■ Confirm MAR is up to date. Question unclear medication orders.

■ Always confirm compatibility.

■ Always check for allergies and assess for reactions to new drugs not previously taken by the patient.

■ Do not crush sustained-release or enteric-coated capsules or pills.

■ Take VS before and 5 minutes after applying NTG paste and the administration of IV vasoactive meds.

■ Always use a filter needle when withdrawing medication from a glass ampule (discard and replace filter needle before injection).

■ Use a straw for PO iron to prevent the staining of patient’s teeth.