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Medication Administration. Automated Medication Administration Equipment. Pyxis SureMed MedServe. Essential Components of a Medication Order. Client’s Name Medical Record Number, Room/Bed # Date & time of order Name of Medication Dosage of Medication Route Frequency of administration

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essential components of a medication order
Essential Components of a Medication Order
  • Client’s Name
  • Medical Record Number, Room/Bed #
  • Date & time of order
  • Name of Medication
  • Dosage of Medication
  • Route
  • Frequency of administration
  • MD’s signature
six rights of medication administration
Six “Rights” of Medication Administration
  • Right Patient (check name band, ask client their name)
  • Right Medication
  • Right Dose
  • Right Route
  • Right Time (frequency)
  • Right Documentation

* Client’s also have the right to refuse (say no) to medication

the nurse s responsibility for medication administration
The Nurse’s Responsibility for Medication Administration
  • Assess whether the client can tolerate the meds
  • Administer meds accurately & timely
  • Monitor for side-effects
  • Know contraindications
  • Client teaching
  • Practice the “Six Rights”(stressed in clinical)
  • Evaluation (effectiveness & client response)
types of oral medications
Types of Oral Medications
  • Tablets
  • Capsules
  • Sublingual
  • Buccal
  • Elixirs
  • Enteric Coated
rectal medications
Rectal Medications
  • Provide for privacy
  • Explain procedure to client
  • Place client in Sim’s position
  • Apply clean gloves
  • Lubricate tip, round end inserted first
  • Encourage client to relax , deep breathe
  • Insert past sphincter, towards umbilicus
  • Have client remain on side at least five mins. (hold buttocks together etc.)
ophthalmic medications
Ophthalmic Medications
  • Place HOB down or low Fowler’s
  • Provide Kleenex for client
  • Have client look towards ceiling
  • Instill meds in conjunctiva (if gtts)
  • If ointment, apply ribbon from inner to outer canthus
  • Know od, os, ou routes
topical inhalation medications
Topical & Inhalation Medications
  • Ointments (absorbed via mucous membranes, skin)
  • Inserted (vaginal)
  • Instilled (ear/nose gtts)
  • Lotions
  • Sprays (nasal)
  • Pastes (absorbed through skin)
  • Inhalation (nebulized treatments, MDI)
medications via ngt eft
Medications via NGT/EFT
  • Determine whether med comes in elixir form
  • Crush all except for EC meds and mix with water or other liquid medications
  • Stop feedings, clamp tube, apply syringe, unclamp tube, flush tube with approx. 30cc water
  • Clamp tube, remove syringe, pull plunger from barrel, reattach barrel, pour meds through barrel
  • Add water as necessary to keep things flowing smoothly
  • After all meds have been given, flush with 30cc water, clamp tube, remove syringe, start feedings

Always record:

  • Date, time & your initials or signature, title (R. Otten, SN,CSUF )
  • Medication, route (site) and actual time given
  • Reason why med was omitted (ie. refused)
  • Client’s response to the medication
nursing considerations for injection sites
Nursing Considerations for Injection Sites
  • Assess for adequate tissue & muscle availability/client body wt.
  • Assess where previous injections have been administered
  • Assess client restrictions
  • Assess for quantity & quality of medication to be administered
parts of a needle syringe
Parts of a Needle & Syringe


  • Barrel
  • Plunger
  • Tip


  • Bevel
  • Shaft
  • Hub
tips of syringes
Tips of Syringes


Non Luer-Lok


Three Types of Injections

  • Intradermal

- Injected into dermal skin layers (Allergy tests, PPDs, etc.)

  • Subcutaneous

- Injected into subcutaneous tissues (Heparin, Insulin)

  • Intramuscular

- Injected into deep muscles

(narcotic analgesics, iron)


Intradermal Injections

  • Given in small doses (i.e.. 0.1cc)
  • Common sites include: RFA, LFA
  • Use 1cc syringe with 26-27 gauge needle, 1/4 - 5/8 inch long
  • Administer with needle at 5-15 degree angle with bevel of needle up
  • Check for “bleb” or “wheal”
  • Document site in medication book/nurses’ notes
subcutaneous injections
Subcutaneous Injections
  • Given in doses of 0.5cc - 1.5 cc
  • Common sites include: deltoid, abdomen
  • Deltoid landmarks: Find Acromium Process and go 4 to 6 finger-lengths below
  • Rotate sites to minimize tissue damage
  • Use Insulin/TB syringe for these meds
  • For other SQ meds use 1-3 cc syringe,

25-27 gauge needle, 3/8-5/8 inch length

  • Insert needle 45-90 degrees

Vastus Lateralis Injections

  • Site well-developed in both adults & children, lacks major blood vessels/nerves
  • Landmark: Find Greater Trochanter & Knee, divide thigh up into three equal quadrants with hand, middle 1/3 is the site for injection (lateral aspect).
  • Good for clients with position restrictions
dorsogluteal injections
Dorsogluteal Injections
  • Rarely used due to Sciatic nerve risk
  • Less accessible than other sites (i.e. requires side-lying or turned further)
  • Landmark: Find Greater Trochanter & Iliac Crest, draw quadrants and administer in upper two quadrants
  • Good for deep injections
  • Away from blood vessels and nerves
  • Z-track
  • Thick, viscous meds
  • Antibiotics
  • Large volume
  • Irritating
what if
What if……

when giving an IM injection, the aspirate comes back with blood.

  • What is the correct procedure and why?
preparing nph regular insulin
Preparing NPH & Regular Insulin
  • Swab tops of both vials
  • Inject desired units of air into NPH vial, remove needle and then inject desired units of air into Regular vial
  • Invert Regular vial and withdraw desired units of insulin (no bubbles)
  • Insert needle into NPH vial, invert and withdraw desired units of insulin
mixing insulins
Mixing Insulins



Regular Insulin

Remember !!!

If an IM injection requires the administration of > 3cc of medication, divide the medication up into two equal doses and administer in different sites.

Remember !!!

Always double-check Insulin & Heparin amounts/doses with another licensed person