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Practical Nursing Diploma Program Semester 2 Administering Oral Medication General Principles………. Know the drug you are giving - what it is? - what it’s for? - why the patient is getting it? - proper dose - side effects - contraindications Giving Oral Medication • • • • • Can the client swallow? Do they have a gag reflex? Do they have gastric motility? Do you need to check vital signs If you need to assess the effect of the med, you need to assess prior to administration as well Oral Routes • • • • • Swallow Bucal Sublingual Local (Swish and Swallow) Enteral Feeding Tube More Principles • Meds kept in different places • Unit dose, stock meds, narcotic drawer, fridge • Know what assessments are necessary prior to giving certain meds • Know agency policy re “holding” meds • Know how to safely dispose of unused meds More Principles • • • • • Position the client Give water (100 mL) “Swish and swallow” meds Use appropriate measuring tools Health teaching in the home Computing Drug Dosages……. • Always use the appropriate formula • Drugs are not always packaged in dose ordered • dose on hand = dose desired quantity on hand quantity desired • Know when to double check with someone else (independent double check) • Calculation errors can kill patients Sample Calculation • Digoxin 0.125 mg is ordered • Digoxin 0.25 mg/tablet is available • 0.25mg = 0.125 mg 1 x • 0.25x = 0.125 • x = 0.125 = 0.5 tablets or 1/2 tablet 0.25 Safety Measures • • • • • • Right Client Right Medication Right Dosage Right Route Right Time Right Documentation * If the client questions, listen and double check Cutting and Crushing • Can you crush? • Can you cut? Oral Medications.. Refer to pharm notes • • • • • • • Where are they absorbed? Why do we use this route most often? What is the disadvantage of oral meds? When can we not use them? What forms do they come in? What’s the purpose of EC meds? Can you crush EC meds? Sublingual, Bucal & Local Administration • • • • Where do you place them? Why are they used? Risks? What meds are given this way? Via Enteral Feeding Tube…... • Liquid or meds that can be crushed and combined with liquid • Room temperature • Ensure proper tube placement prior to administering medication • Flush tube with 15-30 mL of water before and after giving med to check patency and prevent plugging tube Via Enteral Feeding Tube • Give each med separately and flush after each (count “flush” in I&O) • Many meds can’t be given together due to interactions • If tube connected to suction, disconnect and allow 20-30 mins for absorption of med before reconnecting • Disconnect continuous feed prior to giving meds and leave off according to agency policy Dosage Calculation Exercise Ordered Available Digoxin 0.0625 mg Digoxin 0.25 mg Erythromycin 250 mg Erythromycin 500 mg/2 ml Lasix 120 mg Lasix 40 mg/ml KCL 20 mEq KCL 60mEq/15ml Coumadin 1.25 mg Coumadin 5 mg What would you give??? Ordered Available Digoxin 0.0625 mg Digoxin 0.25 mg Erythromycin Erythromycin 500 mg/2 ml 250 mg What would you give??? ¼ tab 1.0 ml Lasix 120 mg Lasix 40 mg/ml 3.0 mls KCL 20 mEq KCL 60mEq/15ml 5.0 ml Coumadin 1.25 mg Coumadin 5 mg ¼ tab In the Home • • • • • Vision problems Memory problems Dexterity problems Changes related to aging Adapt for children
