Giving of Medication 12 Rights

Giving of
Medication
(all routes)
12 Rights
Presented by
Leslie L. Paguio
BSN 3-C
#1
Right
Patient
Always check patient's identification bracelet.
Ask patient to state their name.
Compare the medication order to identification bracelet and patients
stated name and birth of date.
Verify patients allergies with chart and with patients.
#2
Right
Drug
Check the drug label 3 times before administering the medication.
1. When retrieving the medication.
2. When preparing the medication.
3. Before administering the medication to client.
For hospitalized clients, the drug orders are
written on the “doctor’s order sheet” and signed by
the duly authorized person.
Never administer medication prepared by other person.
Never administer medication that is not labeled.
COMPONENTS OF DRUG ORDERS:
Date and time the order is written

Drug name
Drug dosage
Route of administration
Frequency of administration
Physician/ provider’s signature
Categories of Drug Orders:
Standing order- protocols derived from guidelines created by healthcare providers for
use in specific settings, for treating certain diseases or sets of symptoms.
Standard order- may be an ongoing order,may be given for a specific number of doses
or days. May include prn orders.
One time or single order- given once and usually at a specific time.
PRN orders- given at the client’s request and nurse’s judgment concerning need and
safety.
Stat orders- given once immediately.
#3
Right
Preparation
After you verify that what you have is the “Right Drug”, you then need to check if you have the
right preparation. There are many different forms of medication preparations that are
available for almost any given drug.
The different drug preparations are as follows:Pills, tablets, capsules, spansules, syrups,
drops, solution for injection in a vial or ampule, powder for injection, ointments, gels,
patches, aerosolized spray, lozenge, paste, suppository.
We nurses must adhere exactly to the type of drug preparation indicated by the doctor
because different types of preparation could produce potent or less potent or delayed or
unwanted expedited results when a “Right Drug” is given to the patient in a different
preparation.
#4
Right Dose
Refers to the dose prescribed for a particular client.
NURSING IMPLICATION:
Be familiar with the various measurement system and the conversion from one system to
another.
Measuring devices:
Medication cups
Dropper
Syringe
– Tuberculin
– Insulin
– General purpose (For use in administering .50-50ml of medication.
Step - Medication administration orally
Liquid medications and pills
Takes the medication to the children 30 minutes before
or after the prescribed times (according to the norm of the institution);
Correct administration route;
Correct administration record;
Checks the right child;
Checks the medication with the prescription;
Check the right dosage;
Guides child/responsible;
Administers immediate prescription medication at the right time;.
Medication preparation for oral administration
Step- Reading of medical prescription:

Reads the prescription;
Actions- Understands the writings of the medical prescription.
Checks the name of the child in the prescription.
Step - Hands sanitization:
Actions- Before the preparation of the medication;
Before the administration of the medication.
Step - Materials and Medication preparation.
Actions Performs countertop cleanup and organization;
Checks the name on the medication label with the medical prescription.
Liquid medications-*Uses syringe or dosing cup for a proper milliliter measurement;
*the liquid medication by shaking the bottle before
administration (only when the medication is not in a proper volume unit dose);.
Actions- *If the medication is in multiple-dose vial, removes the lid and
places it upside down on the work surface, avoiding flask contamination;.
*Wipes the medication bottle mouth with a paper towel and covers the bottle
again;
*If there is more than one medication, puts them separately in the disposable cup.
Pills
Actions- * When using blister-type packing, removes the medication by "bursting" the
blade or the coating paper and places it in a disposable cup, without
touching the pill;
*Parts only pills that are grooved by the manufactures beforehand;
*When necessary to part the pill, uses clean or gloved hand, or pill cutter;
*In case of difficulty to swallow, grinds the pills separately.
Allows the child to hold the drugs on hand or put them in the cup before inserting them
on the mouth;
Does not rush to administer the medications;
Remains next to the child until the it ingests the
medications;
Asks the child to open the mouth, if unsure that the medicine was
swallowed.
Pills
Action- Provides water to help the child swallow the pills;
When preparing to administer an injectable medication:
• Determine the exact volume of drug to be administered.
• Select the right type and size of syringe and needle.
• When removing a drug from a multiple dose vial, wipe the
topper on the vial with an alcohol sponge.
• Inject an amount of air into the vial equal to the volume of fluid
to be removed and withdraw the required amount of liquid.
• If there are air bubbles in the syringe, these must be removed
by holding the syringe with the needle toward the ceiling and
tapping the syringe with your finger to move the air bubbles
toward the hub.They should be expelled by gently pushing on
the plunger.
• When medication is in a glass ampule, flick the top of the ampule to be sure
all medication is in the larger bottom portion. Wrap the neck of the
ampule with dry gauze pad and snap off the top.
Nursing Implication:
Always use the appropriate measuring device and read it correctly.
Always measure the volume of a liquid medication at the lowest point of the meniscus.
Shake all suspensions and emulsions.
When measuring drops of medication with a dropper, always hold the dropper vertically
and close to the medication cup.
Do not attempt to divide unscored tablets and do not administer tablets which have
been broken unevenly along the scoring.
#5
Right
Route
Is necessary for adequate or appropriate absorption.
Includes the correct route of administration,
and administration in such a way that the client is able to take the entire dose of the
drug and receive maximal benefit from it.
Enteral Drug Administration Route – This medication route puts the drug directly through
the intestine.
Orally – By Mouth – Per Orem – P.O.

Sublingually – Under the Tongue – SL
Rectally – In the Rectum – Per Rectum – PR
Parenteral Drug Administration Route – This means “Not Enteral” or Not through the intestines
however, the parenteral route has come to be known as the route that uses needles. In this sense it
is the invasive medication route that uses injections or infusions to introduce the medication into
the body.
Intravenously – In the Vein – IV
Intramuscularly – In the Muscle – IM
Subcutaneously – Under the Skin – SC or SQ or SubQ
Intrathecally – Into the Spinal Canal – Into the
Subarachnoid Cavity
Transmucosally – This drug delivery method lets the mucosal lining of the body absorb the
medication.
Inhalation or Inhaled Drug Administration Route – This pulmonary route utilizes the respiratory
system of the body through active respiration to administer the drug.
Inhalers – The patient actively inhales dry powder or liquid medication that is contained by an
inhaler with a mouth piece for delivery.
Pressurized Metered Dose Inhalers – The drug is aerosolized by a pressurized canister as it is
pressed down by the patient for a “puff”.
Nebulizers – The liquid preparation drug is aerosolized into an easily breathable mist with the use
of an air compressor or an oxygen tank.
Nursing implications
Be sure to know the prescribed route by which a medication is to be administered.
If no route is specified in the order, the prescribing physician should be questioned
about the intended route.
Always gain the client’s cooperation, before attempting to administer a dose of
medication.
Consider the client’s developmental level during administration of medication.
Assess the client’s ability to swallow prior to administering oral medications.
Use aseptic technique when administering drugs especially parenteral ones.
#5
Right
Time
Verify schedule of medication order.
1. Date
2. Time
3. Specific period of time.
Check the last dose of medication given to client.
Administer medication within 30 minutes of schedule.
Here are the standard timing abbreviations

Once a Day – od or qd
BID - Twice a Day – Two Times a Day
TID -Thrice a Day – Three Times a Day
QID – Four Times a Day
PRN – As Needed
Nursing Implication
• To achieve maximum effectiveness, medications are scheduled to
be administered at a specific time.
• Administer drugs that are affected by foods,such as tetracycline
and penicillin before meals.
• Administer drugs such as potassium and aspirin after meals or
with food
• It is the nurse’s responsibility to check whether the client is
scheduled for diagnostic purposes such as endoscopy,fasting
blood sugar etc.
• Check the expiration date. Discard the medication or return to
pharmacy if the date is passed.
• Antibiotics should be administered at even intervals throughout a 24-hour
period to maintain therapeutic blood level.
#6
Right
Assessment
Check your patient actually needs the medication.
Check for contraindications.
Baseline observations if required.
Properly assess patient and tests to determine if medication is safe and
appropriate.
If deemed unsafe or inappropriate,notify ordering physician and document
notification.
Document that medication was not administered and the reason that dose was
skipped.
#7
Right
Education
This right is a principle of informed consent which is based on the individual’s having
the knowledge to make a decision.
Check if the patient understands what the medication is for.
Make them aware they should contact a healthcare professional if they experience side-
effects or reactions.
Inform patient of medication being administered.
Inform patient of desired side effects of medication.
Patient teaching topics:
• Name of medication
• Purpose of medication
• How and when to take medication
• How to monitor drug’s effectiveness
• Drugs/foods that may cause interactions
• Possible adverse effects
• Signs and symptoms to bring to the doctor’s
attention
• Storing and handling
#8
Right to
Refuse
Clients can and do refuse medications.
The legally responsible(patient,parent,family member,guardian,etc.)for patient's care
has the right to refuse any medication.
Inform responsible for the consequences of refusing medication.
Verify that responsible understands all of these consequences.
Notify physician that ordered medication and document notification.
NURSING IMPLICATIONS:
• Be sure to assess client’s reason for refusing
medication
• If knowledge deficit underlies client’s reason for refusal. Provide appropriate explanation
for why medication is ordered
• Document if client refuses medication and client reason
• Secure consent and report or inform the physician
#9
Right Reason
Confirm the rationale for the ordered medication.
What is the patient’s history? Why is he/she taking this
medication?Revisit the reasons for long-term medication use.
# 10
Right to
Response
Make sure that the drug led to the desired effect.
If an antihypertensive was given, has his/her blood pressure improved? Does
the patient verbalize improvement in depression while on an antidepressant?
Be sure to document your monitoring of the patient and any other nursing
interventions that are applicable.
After Medication has been administered
# 11
Right Evaluation
Assess patient for any adverse side effects.
Assess patient for effectiveness of medication.
Compare patient's prior status with post medication status.
Document patient's response to medication.
# 12
Right
Documentation
Requires that the nurse immediately record the
appropriate information about the drug administered.
Right documentation includes the
1. drug,
2. dosage,
3. route,
4. time,
5. client’s response
6. signiture and credentials

Giving of Medication 12 Rights

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Giving of Medication 12 Rights

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Giving of

Date and time the order is written

Step- Reading of medical prescription:

Orally – By Mouth – Per Orem – P.O.

Here are the standard timing abbreviations

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