Transcript Oral Medications

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
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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
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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
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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 0.125 mg is ordered
• Digoxin 0.25 mg/tablet is available
• 0.25mg = 0.125 mg
1
x
• 0.25x = 0.125
• x = 0.125 = 0.5 tablets or 1/2 tablet
0.25
Safety Measures
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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
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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
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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 15-30 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 20-30 mins for absorption of med
before reconnecting
• Disconnect continuous feed prior to giving
meds and leave off according to agency
policy
Dosage Calculation Exercise
Ordered
Available
Digoxin 0.0625
mg
Digoxin 0.25
mg
Erythromycin
250 mg
Erythromycin
500 mg/2 ml
Lasix 120 mg
Lasix 40 mg/ml
KCL 20 mEq
KCL
60mEq/15ml
Coumadin 1.25
mg
Coumadin 5 mg
What would
you give???
Ordered
Available
Digoxin 0.0625 mg Digoxin 0.25
mg
Erythromycin
Erythromycin
500 mg/2 ml
250 mg
What would
you give???
¼ tab
1.0 ml
Lasix 120 mg
Lasix 40 mg/ml 3.0 mls
KCL 20 mEq
KCL
60mEq/15ml
5.0 ml
Coumadin 1.25 mg Coumadin 5 mg ¼ tab
In the Home
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Vision problems
Memory problems
Dexterity problems
Changes related to aging
Adapt for children