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 mg is ordered Digoxin 0.25 mg/tablet is available 0.25mg = mg 1 x 0.25x = x = = 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 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 mins for absorption of med before reconnecting Disconnect continuous feed prior to giving meds and leave off according to agency policy

Dosage Calculation Exercise OrderedAvailableWhat would you give??? Digoxin mg Digoxin 0.25 mg Erythromycin 250 mg Erythromycin 500 mg/2 ml Lasix 120 mgLasix 40 mg/ml KCL 20 mEqKCL 60mEq/15ml Coumadin 1.25 mg Coumadin 5 mg

OrderedAvailableWhat would you give??? Digoxin mgDigoxin 0.25 mg ¼ tab Erythromycin 250 mg Erythromycin 500 mg/2 ml 1.0 ml Lasix 120 mgLasix 40 mg/ml3.0 mls KCL 20 mEqKCL 60mEq/15ml 5.0 ml Coumadin 1.25 mgCoumadin 5 mg¼ tab

In the Home Vision problems Memory problems Dexterity problems Changes related to aging Adapt for children