University of Northern Philippines

COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

Nursing Care Management 109 (Skills)

MEDICATION

M.Z.C.A.- R.N. - M.A.N.

– a substance administered for the diagnosis, cure, treatment, or relief of symptom or
prevention of disease
The Therapeutic Actions of
Drugs
Drug Type Description Examples
Palliative * supporting people with life- * analgesics
limiting and terminal (to treat
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illnesses pain)
Curative *Antibiotic
* refers to health care practices s for
that treat patients with the intent bacterial

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of curing them, not just reducing infections
Supportive their pain or stress

* to prevent or treat as early as *Allopurino

possible the symptoms of a l (Zyloprim)
Substitutive disease, side effects caused prevents
by treatment of a disease, and the buildup
psychological, social, and of uric acid
spiritual problems related to a in the body
disease or its treatment.
Chemotherapeutic
* type of cancer treatment that *Altretamin
uses one or more anti-cancer e

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drugs as part of a standardized
Restorative chemotherapy regimen.

* drug or agent that restores or * Vitamins

revives by improving health or
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strength, or increasing energy. 

Process of Administering Medications

*when administering any drug, regardless of the route of administration, the nurse
must do the following:

1. Identify the client – use at least two identifiers (give at least 2) -* name & date of
birth
2. Inform the client – explain the intended action as well as any side effect or adverse
effects that might occur *

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 University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

3. Administer the drug – read the MAR carefully and perform the three checks
a. _______________________________________________
b. _______________________________________________

M.Z.C.A.- R.N. - M.A.N.

c. _______________________________________________
4. Provide adjunctive interventions as needed – give physical assistance or guidance*
5. Document the administered drug – record the facts in the chart *
6. Evaluate the client’s response to the drug – behaviors that reflect the action or lack
of action of a drug and its untoward effects *

10 RIGHTS OF MEDICATION ADMINISTRATION

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1. The right medication -

2. The right dose - 3. The right patient - 4. The
right route -

M.Z.C.A.- R.N. - M.A.N.

5. The right time and frequency -
6. The right documentation - 7.
The right reason - 8. The right to
refuse - 9. The right patient
education -
10. The right evaluation –

M.Z.C.A.- R.N. - M.A.N.

Mild Allergic Reactions:

a. Urticaria –
b. Eczema –
c. Pruritus –
d. Rhinitis –

zeagal.agam.x@gmail.com
 University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

Identify the parts medication label

A.
B.
A B C C.
D.
E.
F.
G.
H.

D E F G H
efinition of the parts:

A.
B.
C.
D.
E.
F.
G.
H.
PREPARING PARENTERAL MEDICATIONS
- Injectable medications can be prepared by withdrawing the medication from
an ampule or vial into a sterile syringe.

There are four routes for parenteral administration:

• Subcutaneous injection: * type of injection, a short needle is used to inject a
drug into the tissue layer between the skin and the muscle.
• Intramuscular (IM): * used to deliver a medication deep into the muscles
• Intradermal (ID) injection: * shallow or superficial injection of a substance
into the dermis, which is located between the epidermis and the hypodermis
• Intravenous (IV) injection or infusion: * therapy that delivers fluids directly
into a vein.

zeagal.agam.x@gmail.com
 University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

AMPULE – is a glass container usually designed to

M.Z.C.A. - R.N. - M.A.N.

hold a single dose of a drug.

M.Z.C.A.- R.N. - M.A.N.

Types of ampules and its description:

a. *

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b. *

c. *

NOTE: Preparing medications from ampules and vials involves knowledge and use of
sterile technique. These techniques are not delegated to UAP.

Equipment:
• Medication administration record (MAR) or computer printout

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• Ampule or sterile medication
• File (if ampule is not scored), small sterile gauze
• Alcohol swab
• Syringe, filter needle
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• Needle for administering the medication

• Sharps with engineered sharps injury protection (SESIP) safety needle for
injection
• Puncture-proof container for disposal of syringes, needles, and glass

Assessment: RATIONALE
1. Check accuracy and completeness of each MAR or computer printout with
prescriber’s written medication order.
Question: What to check before medication administration?
patient identification, medication, dosage, time, and route

2. Assess patient’s medical and medication history.

zeagal.agam.x@gmail.com
 University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

3. Assess patient’s history of allergies * prevent the prescription and

administration of drugs inducing allergic reactions and will
improve patient safety

M.Z.C.A.- R.N. - M.A.N.

4. Review medication reference information for:
a.
b.
c.
d.
5. Assess patient’s body build, muscle size, and weight if giving subcutaneous or
intramuscular (IM) medication. * Allows you to administer drug properly and
monitor patient's response
M.Z.C.A.- R.N. - M.A.N.

Planning: RATIONALE
Question: why do you need to prepare the medication with

M.Z.C.A.- R.N. - M.A.N.

proper dosage and without air bubbles in the syringe barrel?
- Preparing the proper dosage for a medication means you’re
giving the right amount of medication to treat the said
illness or condition of the patient avoiding from overdosing
the patient or giving insufficient amount of it will not take
effect or even cause side effect depending on what
medication or drug effect it is. And preparing it without air
bubbles will prevent from giving the patient embolism if it
is given through IV and also air bubbles takes up the space
from the syringe that might cause inaccurate dosage of the
medication that is being administered.

Performance: RATIONALE

M.Z.C.A.- R.N. - M.A.N.

1. Perform hand hygiene * Good hand hygiene will reduce the risk of things like
flu, food poisoning and healthcare associated infections being passed from
person to person.
2. Prepare the medication ampule for drug withdrawal
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a. Flick the upper stem of the ampule several times with fingernail * to
unseat any fluid lodged at top.
b. Use an ampule opener or place a piece of sterile gauze or alcohol wipe
between your thumb and the ampule neck or around the ampule neck, and
break off the top by bending it toward you to ensure that the ampule is
broken away from yourself and away from others *
c. Or place the antiseptic wipe packet over the top of the ampule before
breaking off the top * to prevent from getting injured

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 University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

3. Withdraw the medication

a. Place the ampule on a flat surface
b. Attach the filter needle to the syringe *
c. Remove the cap from the filter needle and insert the needle into the center
of the ampule. Do not touch the rim of the ampule with the needle shaft *
d. With a single dose ampule, hold the ampule slightly on its side, if
necessary, to obtain more than the ordered amount of medication
e. If giving an injection, replace the filter needle with a regular needle,
tighten the cap at the hub of the needle, and push solution into the needle,
tot the prescribed amount

VIALS - is a single- or multi-dose plastic or glass container with a rubber seal at the
top.

Note: A multi-dose vial contains several doses of a medication and

thus can be used several times, although only for a single patient. When using
a multi-dose vial, write the date that the vial is opened on the vial label.

Question: how long does a multi-vial be used? the vial should be dated and discarded
within 28 days

Reconstitution – * The process of adding a diluent to a dry ingredient to make it a

liquid.

Two preparations of powdered drugs:

A. Single dose vial – * A single-dose or single-use vial is a vial of liquid
medication intended for parenteral administration (injection or infusion) that is
meant for use in a single patient for a single case, procedure, injection

B. Multi Dose Vial – * a vial of liquid medication intended for parenteral

administration (injection or infusion) that contains more than one dose of
medication.

Equipment:
zeagal.agam.x@gmail.com
 University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:

- MAR
- Vial or sterile medication
- Antiseptic swabs

M.Z.C.A.- R.N. - M.A.N.

- Safety needle and syringe
- Sterile water or normal saline, if drug is powdered form

Preparation: (Same with preparing medication from ampules)

RATIONALE
Performance:
1. Perform hand hygiene and observe other appropriate infection control
procedures
M.Z.C.A.- R.N. - M.A.N.

2. 2. Prepare the medication vial for drug withdrawal

a. Mix the solution, if necessary, by rotating the vial between the palms of
the hands, not by shaking. *

M.Z.C.A.- R.N. - M.A.N.

b. Remove the protective cap, or clean the rubber cap of a previously opened
vial with an antiseptic wipe by rubbing in a circular motion. *
3. Withdraw the medication
a. Attach a filter needle, as agency practice dictates, to draw up premixed
liquid medications from multidose vials *
b. Ensure that the needle is firmly attached to the syringe
c. Remove the cap from the needle, then draw up into the syringe the
amount of air equal to the volume of the medication to be withdrawn
d. Carefully insert the needle into the upright vial through the center of the
rubber cap, maintaining the sterility of the needle.
e. Inject the air into the vial, keeping the bevel of the needle above the
surface of the medication. *

M.Z.C.A.- R.N. - M.A.N.

f. Withdraw the prescribed amount of medication by holding the vial down,
move the needle tip so that it is below the fluid level and withdraw the
medication. Avoid drawing up the last drops of the vial. *
g. Or; invert the vial, ensure the needle tip is below the fluid level; gradually
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withdraw the medication. *

h. Hold the syringe and vial at eye level to determine that the correct dosage
of the drug is drawn into the syringe. Eject air remaining at the top of the
syringe into the vial

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M.Z.C.A. - R.N. - M.A.N. University of Northern Philippines
COLLEGE OF NURSING
MARC ZEAGAL C. AGAM, MAN
Instructor

NOTES:
i.
When correct volume of medication plus a little more is obtained,
withdraw the needle from the vial, and replace the cap over the needle
using the scope method, thus maintaining its sterility.
j. If necessary, tap the syringe barrel to dislodge any air bubbles present into
the syringe *
k. In giving an injection, replace the filter needle, if used, with a regular or a
safety needle of the correct gauge and length. Eject air from the new
needle and verify correct medication volume before injecting the client

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