Download Nonparenteral Medication Administration

Nonparenteral Medication Administration
Administering Oral Medications
Procedure Guidelines
1. Before administering an oral medication, review the physician's order. Also observe the
first five rights of medication administration, and later address the sixth right of
documentation as shown in the Video Skill, “Ensuring the Six Rights of Medication
Administration.”
2. Prepare drugs for one person at a time.
3. Now obtain the correct drug from the automated dispensing system (or unit-dose drawer),
and compare the drug label with the medication administration record (MAR).
4. If the dose printed on the container differs from the ordered one, verify the correct
amount to give and put the correct number of tablets or capsules into the medication cup.
5. For unit-dose tablets or capsules, put the packaged medication directly in the medication
cup without removing the wrapper.
6. If tablets and capsules will be given at the same time, use the same medication cup
(except for drugs that require preadministration assessments).
7. For a patient with difficulty swallowing, crush a pill with a pill crusher or by placing it
between two medication cups and grinding with a blunt instrument. Then mix the crushed
tablet in a small amount of soft food, such as applesauce.
8. For a patient who needs half of a prescored tablet, break it at the center line with a pill
cutter or your gloved fingers. Based on facility policy, discard the unused portion or
return it to the original container.
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc
Procedure Guidelines
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9. For any medication, check the expiration date.
10. To prepare a liquid, gently shake the container.
11. If the medication is in a multi-dose bottle, remove the cap. With a medication cup at eye
level, pour the liquid to the prescribed level. If it appears discolored or cloudy, discard it.
12. Be sure to measure at the liquid's meniscus, not its edges.
13. Then wipe the lip and neck of the bottle with a paper towel, and recap the bottle.
14. If the prescribed dose is less than 5 ml, draw the liquid into a calibrated oral syringe.
15. When you must prepare a controlled substance, such as an opioid, ensure that the drug
dispensing system automatically tracks its removal.
16. Now compare the MAR with the prepared drug, reading the label once again. Do not
leave the drugs unattended.
17. To administer oral medications:
A. Take them to the patient at the correct time, and identify the patient according to
facility policy.
B. After explaining each medication's purpose and action, allow the patient to ask
questions about the drugs.
C. If needed, perform preadministration assessments, such as taking the patient’s pulse
or blood pressure.
D. With the patient in a seated or side-lying position, administer tablets or capsules with
his or her preferred fluid. If desired, let the patient hold solid medications in his or her
hand or a cup before placing them in his or her mouth.
E. If the patient can't hold the drugs, place the medication cup or a spoon to his or her
lips and gently place each drug in his or her mouth, one at a time. Do not rush or force
the medications.
(1) For a sublingual drug, have the patient place it under the tongue.
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Procedure Guidelines
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(2) For a buccal drug, have the patient place it against the mucous membranes of the
cheek.
(3) With either type of drug, instruct the patient to let it dissolve, and warn against
swallowing it.
(4) Similarly caution against chewing or swallowing a lozenge.
18. To administer a powdered medication:
A. Mix it with liquid at the bedside and give it to the patient to drink.
B. Administer an effervescent powder or tablet immediately after it dissolves.
19. Stay until the patient has completely swallowed each medication. Ask the patient to open
his or her mouth if you are not sure whether the drug has been swallowed.
20. For a medication that may upset the patient's stomach, offer a snack, such as crackers, if
not contraindicated.
21. As part of your follow-up care, verify the patient's understanding of each medication's
use.
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.