provide a medication that has systemic effects or local effects on the gastrointestinal tract or both.

Allergies to medication Clients ability to swallow the medication Presence of vomiting or diarrhea that would interfere with ability to absorb the medication Specific drug action, side effects, interactions and adverse reactions. Clients knowledge of and learning needs about the medication perform appropriate assessments (e.g. vital signs, laboratory results) specific to medication

Medication cart/tray Disposable medication cups: 1. small paper or plastic cups for tablets and capsules or 2. plastic calibrated medication cups for liquids Pill crusher

Preparation 1. Know the reason why the client is receiving the medication, the drug classification, contraindication, usual dosage range, side effects and nursing considerations.

2. Check the doctors order against medication sheet for the drug name, dosage, frequency, route of administration and expiration date 3. Assemble the medication tray and medication ticket for each client together so that medication can be prepared for one client at a time

Procedure 1. Wash hands and observe other appropriate infection control procedures. 2. Unlock the medication drawer 3. Obtain appropriate medication. a. read the medication ticket and take the appropriate medication from the shelf, drawer, or refrigerator.

RATIONALE Prevents the transfer of microorganisms

b. compare the label of the medication This is safety check to container against the order on the Medication ensure that the right ticket. medication is given. 4. Check the expiration date of the medication. Return expired medications to the pharmacy.

Procedure 5. Use only medications that have clear, legible labels to ensure accuracy.

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6. Calculate medication dosage accurately 7. Prepare the correct amount of medication for the required dose, without contaminating the medication. Aseptic technique maintains drug cleanliness.

Procedure TABLETS OR CAPSULES:

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A. Place packaged unit-dose capsules or tablets directly into the medicine cup. Do not remove the medication from the wrapper until at the bedside

The wrapper keeps the medication clean. Not removing the medication from the wrapper facilitates identification of the medication in the event the client refuses the drug
This reminds the nurse to complete the needed assessments in order to decide whether to give the medication or withhold the medication if indicated

B. Keep narcotics and medication that require specific assessments, such as pulse measurements, respiratory rate or depth, or blood pressure, separate from the others.

Procedures C. Break only scored tablets if necessary. Use a file or cutting device if needed.

RATIONALE to obtain the correct dosage

D. If the client has difficulty in swallowing, crush the tablets to a fine powder with a pill crusher. Then mix the powder with a small amount of soft if indicated. Some medications should not be crushed.

Procedures LIQUID MEDICATION A. Thoroughly mix the medication before pouring. Discard any medication that has changed color or turned cloudy.

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B. remove the cap and place it upside down on the counter top

To avoid contaminating the inside of the cap This prevents the label from becoming soiled and illegible as a result of spilled liquids

C. Hold the bottle so the label is next to your palm and pour the medication away from the label

Procedures

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D. Hold the medication cup at eye level and fill it to the desired level, using the bottom of the meniscus (upper surface column of a liquid) to align with container scale

This method ensures accuracy of measurements

E. before capping the bottle, wipe the lip with a paper towel.

This prevents the cap from sticking

Procedures

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ALL MEDICATIONS:
8. Place the prepared medication and Medication ticket together on the medication cart/tray. 9. Recheck the label on the container before returning the bottle This check further reduces the risk of error

10. Avoid leaving prepared medications This precaution unattended prevents potential mishandling errors)
11. take medication to the client 12. Identify the client properly by This ensures that the checking the clients identification band right client receives the or asking the patient to state his name right medication)

Procedures 13. Assist the client to a sitting position or, if not possible, to a side-lying position

RATIONALE This position facilitates swallowing and prevents aspiration Information facilitates acceptance of and compliance with the therapy

14. Explain the purpose of the medication and how it will help, using language that the client can understand. Include relevant information about the effects

15. Administer the medication at the correct time. (30 minutes before or after the scheduled time.)

Procedures

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16. Give the client sufficient water or preferred juice to swallow the medication.

Fluids ease swallowing and facilitate absorption from the gastrointestinal tract putting the cup in the clients mouth maintains the cleanliness of the nurses hands
Most clients are familiar with appearance of medications taken previously. Unfamiliar medications may signal a possible error

17. If the client is unable to hold the pill cup, use the pill cup to introduce the medication into the clients mouth and give only one tablet or capsule at a time
18. If the client says that the medication you are about to give is different from what the client has been receiving, do not give the medication without first checking the original order.

Procedures

RATIONALE

19. Stay with client until all medication has been swallowed.

The nurse must see the client swallow the medication before the drug administration can be recorded)

20. Document the medication given, dosage, time, any complaints or assessments of the client and your signature. 21. If the medication was refused or omitted, record this fact on the appropriate record; document the reason.

Procedures 22. dispose all of supplies appropriately.

RATIONALE To prevent nosocomial infection

23. Return to the client when the medication is expected to take effect (usually 30 minutes)

evaluate the effects of the medication.

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