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BAKERSFIELD COLLEGE LICENSED VOCATIONAL NURSING PROGRAM 1ST SEMESTER FUNDAMENTALS SCIENTIFIC BASIS FOR NURSING PRACTICE CHAPTER 35 - MEDICATION ADMINISTRATION - ORAL MEDICATION INTRODUCTION The goal of this unit is to provide you with the knowledge and skills necessary to safely administer oral medications to clients. OBJECTIVES Upon completion of this unit, the student will be able to: A. Theory 1. Recall the nurse’s legal responsibilities in drug prescription and administration. 2. Recall the nature of drug actions. 3. Recall the factors influencing drug actions. 4. Recall the oral routes of administration. 5. State the guidelines for administering drugs through a Nasogastric tube. 6. Successfully complete a math test. B. Laboratory 1. Correctly calculate a prescribed drug dose. 2. Verbalize an understanding of correct procedures for administering oral medications. 3. Demonstrate in the laboratory correct preparation of oral medications. ASSIGNMENT A. Read Chapter 35- Potter & Perry, pgs. 686 – 734. B. Review skills – Administration or oral medications, Adm. Nasal Instillation, Adm. Ophthalmic Meds, Adm. Vaginal Meds, Adm. Rectal Supp., Using Metered Dose or Dry Powder Inhaler. C. Study Guide for Chapter 35 Critical Thinking Exercise # 3,5 and Review Questions. D. View video on Medication Administration Chapter 35 Medication Administration Scientific Knowledge Base To safely and accurately administer medications you need knowledge related to: Pharmacology Pharmacokinetics Life sciences Human anatomy Mathematics Medication Legislation and Standards Federal regulations State and local regulation of medication Health care institutions and medication laws Medication regulations and nursing practice Pharmacological Concepts Drug names: Chemical, generic, trade Classification Medication forms: Solid, liquid, other oral forms, topical, parenteral, instillation into body cavities Pharmacokinetics The study of how medications: Enter the body Are absorbed and distributed into cells, tissues, or organs Alter physiological functions Absorption The passage of medication molecules into the blood from the site of administration Factors that influence absorption: Route of administration Ability to dissolve Blood flow to site of administration Body surface area Lipid solubility of medication Excretion Medications are excreted through: Kidney Liver Bowel Lungs Exocrine glands Types of Medication Action Medication Interactions Occur when one medication modifies the action of another A synergistic effect occurs when the combined effect of two medications is greater than the effect of the medications given separately. Medication Dose Responses Routes of Administration Nursing Knowledge Base Safe administration is imperative. Nursing process provides a framework for medication administration. Clinical calculations must be handled without error. Conversions in and between systems Dose calculations Pediatric and elderly calculations Prescriber’s Role Prescriber can be physician, nurse practitioner, or physician’s assistant. Prescribers must document the diagnosis, condition, or need for each medication. Orders can be written, verbal, or by telephone. Types of Orders in Acute Care Agencies Medication Administration Pharmacist’s role Distribution system Nurse’s role Medication error Critical Thinking and Medication Administration Knowledge Experience Attitudes Standards Medication Administration Oral Topical Inhalation Irrigation Parenteral Injections A. GUIDELINES FOR GIVING DRUGS THROUGH A NASOGASTRIC TUBE 1. administer meds as a liquid 2. read med labels carefully before crushing a tablet or opening a capsule 3. DO NOT crush buccal or sublingual tablets 4. DO NOT crush enteric-coated or sustained-action meds 5. Dissolve crushed tabs, powders and soft, gelatin capsules in warm water 6. ALWAYS check tube placement before giving any medication 7. Avoid giving syrups of meds with a PH of less than 4 8. Do not use pigtail vent for irrigation or instillation of fluid 9. Do not attempt to give whole or undissolved medications 10. IRRIGATE the tube before and after all medications is given with 50-150 ml of water GUIDELINES FOR ORAL MEDICATION ADMINISTRATION IN the A.M. 1. Check the Dr. orders with the medication sheets WHEN IT’S TIME TO GIVE MEDICATIONS First be prepared: 1. Have any calculations already figured out. 2. Have any recent apical pulse and/or blood pressure measurements 3. Be prepared to answer questions re: side effects, drug actions, special considerations. Then ----- get your instructor: 1. Set up the medications you are to give. Remember to check 3 times ( upon removal – before opening the medication – before putting away the medication). * Keep the packages intact – have supplies ready (syringes, alcohol pads, etc.) * Do not open any meds or pour any liquid medications until instructed to do so 2. Check for your 6 rights 3. Administer the medications only under the supervision of your instructor.