Module 9

Medication

https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQnQgU7lXUoK2OhUq4shMsq0bJ0WnXVYpZBAA&usqp=CAU

Melanie I. Contreras, MAN, RN

Instructor

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 In the preparation of distance-learning modules and online-accessible
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TABLE OF CONTENTS

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 Module 9: Medication 1

Disclaimer 2

Table of Contents 3

Learning Outcome 4

Learning Activities 4

Post Test 22

SAQ 22

ASAQ 22

References 22

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 Learning Outcome
At the end of this concept, the learners will
be able to:
1. Define terms related to the administration
of medications
2. Identify factors affecting medication
actions
3. Describe various routes of medication
administrations
4. State the rights to accurate medication
administration
5. Compute drug dosages.

Warm Up Activity
Before you will start your learning activity, we will have our synchronous
session as a class. .

LEARNING ACTIVITIES

Drug
 Any substance that alters physiologic function, with the potential of
affecting health.
Medication
 A substance used in the diagnosis, treatment, cure, relief, or
prevention of health lteration

Pharmacology
 Study of the effects of drugs on living organism.
Indications
Drugs can be administered for these purposes:
 Diagnostic purposes
 Prophylaxis
 Therapeutic purposes.

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Effects of Drugs
 Therapeutic effects
 Referred to as the desired effect, the primary effect intended
 Side Effect
 Or the secondary effect, unintended effect
 Usually predictable and may be either harmless or harmful.
 Adverse Effect - more severe side effects
 Drug toxicity
 Harmful effect of a drug which results from overdosage, ingestion
of a drug intended for external use, or build up of drug in the blood
because of impaired metabolism or excretion
 Drug Allergy
 Immunologic reaction to drug
 Anaphylactic shock - severe allergic reaction; can be fatal if
symptoms are not noticed immediately

Maybe

 Drug Tolerance
 person exhibits usually low physiologic response to a drug who
requires increase in dosage to maintain desired effect
 Cumulative Effect - is the increasing response to repeated doses
of a drug that occurs when the rate of administration exceeds the
rate of metabolism or excretion.
 Idiosyncratic effect - unexpected effect that may occur

 Drug Interaction
 administration of one drug before or the same time, or after
another drug, alters the effects of one or both drug
 May be beneficial, harmful
 Potentiating effect - effect of one or both drug may be increased
 Inhibiting effect- effect of one or both drug may be decreased
 Synergistic effect - two different drugs increase the action of each
other.

 Iatrogenic effect
 Disease caused unintentionally by medical therapy.

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Factors Affecting Medication Action
1. Developmental Factors
 In infants, body systems are not fully developed, they may
have trouble breaking down or excreting drugs. Smaller
doses or different drugs may be required when treating the
very old or the very young
2. Gender
 Females have a higher percent body fat than males which can
affect the distribution of certain drugs. Renal clearance of
unchanged drug is decreased in females due to a lower
glomerular filtration.
3. Culture, Ethnic and Genetic Factors
 The study of genetic differences in the response to drugs is
called pharmacogenetics. ... Because of their genetic makeup,
some people process (metabolize) drugs slowly.
 Ethnopharmacology - is the study of the effect of racial and
ethnic differences to prescribed medication.
4. Diet
 Nutrients can affect the action of a medication
5. Environment
 extremes of weather or temperature can affect the action of
drugs because heat and cold influence body functions. Heat
relaxes the blood vessels and speeds up circulation so drugs
act faster. Cold slows their action by constricting the blood
vessels and slowing circulation. High altitude makes some
drugs ineffective because of the lower levels of oxygen.
6. Psychological Factors
 A client’s expectations about what drug can do can affect the
response to medication.
7. Illness and Diseases
 Drugs action is altered in clients with circulatory, liver and
kidney dysfunctions.
8. Time of Administration
 Some oral medications are absorbed more quickly when the
stomach is empty and some have more rapid absorption when
taken with food

ROUTE OF ADMINISTRATION

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Oral
- the drug is
swallowed
https://www.arrowedge.co.uk/wp-content/uploads/2018/07/Oral-Drug-delivery-system-
challenges.jpg

Sublingual
- drug is placed unde
the tongue, largely
absorbed into the blood
vessels on the https://nursingcrib.com/wp-content/uploads/2009/07/routes-of-drug-administration.jpg
underside of the tongue

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Buccal
- “pertaining to the
cheek”, medication is
held into the mouth
against the mucous
membrane of the cheek https://ratchedpsychology.files.wordpress.com/2019/01/cheeking-pills.jpg
until it is dissolved
Parenteral
- other than through
the alimentary tract or
respiratory tract; that is
by needle
 Subcutaneous
(hypodermic) - in the
subcutaneous tissue
just below the skin
 Intramuscular (IM) -
into a muscles
 Intradermal (ID) -
under the epidermis
(into the dermis)
 Intravenous (IV) -
into a vein
 Intraarterial - into an
artery
 Intracardiac- into the https://encrypted-tbn0.gstatic.com/images?
heart q=tbn:ANd9GcSuVr3gNnbjf7LGh1lpln7A_Yt6nXUflFoRX0MiozAVyHJ_NGOazSMy_IGbnZ86OfzVMFc&usqp=CAU

 Inraosseous - into
the bone
 Intrathecal/
intraspinal - into the
spinal canal
 Intrapleural - into the
pleural space
 Epidural- into the
epidural space
 Intraarticular - into a
jpint
Topical
- applied into a
circumscribed surface
area of the body
-Medications applied
to the skin and mucous
membranes generally
have local effects.
 Dermatologic
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 preparation -
applied to the skin

 Instillation or
irrigation - applied
into a body cavities-
urinary bladder,
eyes, ears, vagina,
rectum, nose

 Inhalation - into the

respiratory tract

Types of Medication Orders

1. stat order - medication is to be given immediately and only once
2. Single order /one time order - medication be given once at a specified
time
3. Standing order - may be carried out indefinitely; may or may not have
a termination date
4. prn order or as needed order - permits the nurse to give the order
when, in the nurse judgment, the client requires it.

Parts of a Medication Order

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 1. Full name of the patient
2. Date and time of the
order written
3. Name of the drug to be
administered
4. Dosage of the drug
5. Frequency of
Administration
6. Route of administration
7. Signature of the person
writing the order

MEDICATION RIGHTS

BASIC GUIDELINES OF DRUG ADMINISTRATION

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 1. Assess the patient's history for allergies, drug- drug or drug-food
interactions, and drug contraindications, and notify the physician if any
exists.
2. Patients must be correctly identified by using 2 identifiers; complete
name and file number checked against the ID band. Do not identify
patient using room or bed number.
3. Gather or review assessment data that may influence drug
administration. This may include vital signs, lab data, drug serum
levels, or patient's behavior.
4. administer medications you have personally prepared, unless
the medication has been supplied in a unit of use package.
5. Do not administer medications from containers that are unmarked or
illegible. Do not give medications that have changed color,
appearance, or from which the container is broken or crusted.
6. Always check medication expiration dates.
7. Tablets and capsules should be maintained in their wrappers and
opened at the bedside immediately prior to use.
8. With each drug, inform the patient of the drugs name, purpose,
action, and potential side effects
9. The medication order shall be written in the physician order sheet
and transcribe in the Medication Sheet.
10. Medications shall be double checked by a witness during
preparation and administration
11. The nurse and the witness sign the medication sheet after
administration.
12. Any order that is incomplete, illegible, or of any concern should be
clarified prior to administration
13. In situations such as
Not given-
Not tolerated-
Refused-
Notify the physician and justify the reason in the
Interdisciplinary Progress Notes.
14. Do not leave medications unattended and accessible to patients,
family or visitors
15. Remain with the patient while they take medications.
16. Always Check for:
 The indication of the drug before administering
 The medication sheet is up to date.
 For allergies and assess for reactions to drugs not previously
taken by the pt.
17. TRIPLE CHECKING
 Check label when obtaining medication from storage.
 do side-by-side comparison of the medication with the written
order and the medication sheet.
 Recheck one last time after preparation with a witness, just
before administration.

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MEDICATION ADMINISTRATION

Opthalmic Medication  Allow the pt to sit with head tilted backward or to

lie in a supine position.
 Clean the eyelid and eyelashes.
- Don gloves
- Wipe the eyes from the inner canthus to outer
canthus with moist cotton balls
 Pull the lower lid down to expose the
conjunctival sac. have the pt look up and
away, then squeeze the prescribed numbers of
drops into the sac. Release the patient's
eyelid, and have him/ her to blink to distribute
the medication.
 If drops land on outer lid margins, repeat
procedure
 Gently lay a thin strip of the medication along
the conjunctival sac from the inner canthus to
the outer canthus. avoid touching the tip of the
tube to the patient's eye. then release the eye
lid and have the patient roll his eye behind
closed lids to distribute the medication.

Otic Instilation  Before instilling eardrops, have the client lie on

his or her side. Then straighten the ear canal
to help the medication reach the eardrum. For
adult, gently pull the auricle up and back.
For young child and infant, gently pull down
and back

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Oral administration  Calculate correct drug dose. Take time. Double
check calculation.
 If the client has difficulty in swallowing, grind
tablets in a pill crusher until smooth. Mix it with
drinks or soft food.
 Measure liquid medication by holding the
medication cup at eye level. Pour away from
the label and wipe the neck.
 Measure liquid medication by holding the
medication cup at eye level. Pour away from
the label and wipe the neck.
 Re-check each medication with the medication
card and physician order.
 Don’t use liquid medication that are cloudy or
have changed in color.
 Record medication administration.
 Sign after giving the medication
 Counter sign with another nurse for high risk
medication.
 If client refuses the medication, record
according to the hospital policy.
 check the client after 30 minutes

INTRAVENOUS (IV) MEDICATION

AMPULE

VIALS

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SYRINGES

NEEDLES

DRAWING UP MEDICATIONS

from Ampules  Wash hands and gather equipment.

 Grasp the stem with an alcohol swab

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  Snap off the ampoule’s neck away from
the hands and face

 Uncap the needle and insert the needle

into the ampule. Avoid touching the rim
with the needle.

 Invert the ampule, insert the needle into

the solution and aspirate.

 Remove the needle cap and draw an

amount of air into the syringe that is
equal to the amount of medication that will
be withdrawn from the vial

From a Vial  Insert the needle keeping it above the

solution

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  Invert the vial at eye level

 Hold the needle upright and re-check the

syringe’s contents for presence of air

BODY SITES FOR INJECTIONS

Intradermal Injections (ID)

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Subcutaneous Injections

Intramuscular Injections

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DELTOID MUSCLE

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DRUG COMPUTATIONS

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Example:
Administer 250 mgs of Erythromycin every 8 hours . The Stock dose is 250mgs in 5 ml,

D = 250 mgs
H/ S = 250mgs in 5 ml
V = 5 ml

250mgs X 5 ml = 5 ml
250 mgs

PEDIATRIC DOSAGE CALCULATIONS

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 Post test assessment will be administered via Google
Forms. Wait for the announcement of your lecturer.

References:

Kozier. 2016. Fundamentlas of Nursing, Concepts, Process and Practice. 10 th

edition. Pearson Education Limited. Edinburg Gate, Harlow, England.

Taylor. 2005. Fundamentals of Nursing. The Art and Science of Nursing

Care. 5ht edition. Lippincot Williams and Company.

httsps://www.prnfunding.com/the-evolution-of-nursing

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