Medical assisting Administrative and clinical procedures (5e) Chapter 53 Medication administration

After completing this unit, you should be able to: Describe rules and responsibilities regarding drug administration and the initial preparation for the drug administration, list the rights of drug administration, recognize the correct equipment to use for administering medications,...

53Medication Administration

53.1 Describe rules and responsibilities regarding

drug administration and the initial preparation for the drug administration.

53.2 List the rights of drug administration.

53.3 Recognize the correct equipment to use for

administering medications.

Learning Outcomes

53.4 Carry out the procedures for administering

oral medications.

53.5 Carry out procedures for administering

parenteral medications.

53.6 Carry out procedures for administering

parenteral medications by other routes.

Learning Outcomes

53.7 Relate special considerations required for

medication administration to pediatric, geriatric, and pregnant patients.

53.8 Outline patient education information related

to medications

53.9 Implement accurate and complete

documentation of medications.

Learning Outcomes

• Drug administration

• Medical assistant must

of drug administration

practice

Preparing to Administer a Drug

• For common drugs know

– Uses

• Be alert to any change in patient’s condition that could

affect drug therapy

Preparing to Administer a Drug (cont.)

• Drug and drug allergies

patient record

at every appointment

Preparing to Administer a Drug (cont.)

• Administration site

using the site

Preparing to Administer a Drug (cont.)

• Patient condition

• Patient consent form

General Rules for Drug Administration

• Give only drugs the doctor orders

• Wash your hands

well-lit area

General Rules for Drug Administration

• Triple check medication

When taken from storage container and matched to MAR

When prepared Before administration

General Rules for Drug

Administration (cont.)

• Calculate the dose carefully

• Do not leave a prepared drug unattended

• Do not administer a drug you did not prepare

• Verify patient identity

General Rules for Drug

Administration (cont.)

• The physician must be in the office

• Have patient remain in office

• Instruct patient

General Rules for Drug

Administration (cont.)

• If patient refuses the medication

• Report medication errors

• Document after administering medication

Apply Your Knowledge

What does “triple check” include?

ANSWER: The medication needs to be checked 3 times:

1 st check – when you remove it from the storage area

and match it to the MAR

2 nd check – when you prepare it

3 rd check – before you close the storage container or

just before you administer the medication to the patient

Rights of Medication Administration

Rights of Medication Administration (cont.)

• Right Patient

• Right Drug

Rights of Medication Administration (cont.)

• Right dose

• Right route

Rights of Medication Administration (cont.)

• Right time

• Right documentation

Rights of Medication Administration (cont.)

Apply Your Knowledge

How do you properly identify the patient before

administering a drug?

ANSWER: To ensure that you have the right patient,

you should check the name and date of birth on the

patient record and ask the patient to state his/her name

and date of birth.

• You must be able to give drugs safely by any route

• In the medical office

Drug Routes and Equipment

Medications by Mouth

• Oral administration

lozenges, and liquids

• Nausea

• Comatose

• Unable to swallow

Medications by Mouth

• Buccal or sublingual administration

gum

Gold star Answer!

Gold star Answer!

Apply Your Knowledge

1 Why is it important to be able to administer

medications by a variety of methods?

ANSWER: You may be asked to administer drugs

by any of an number of different routes.

2 Why is absorption faster when drugs are

administered sublingually or buccally?

ANSWER: The drug is absorbed directly into the bloodstream bypassing the GI tract.

Medications by Injection

• Parenteral administration

• Rapid administration

• Exposure to blood-borne pathogens

Medications by Injection (cont.)

Medications by Injection (cont.)

• Syringes

Needle

Syringe hub Barrel

Plunger

Leading ring

Forms of Packaging for Parenteral Drugs

• Cartridge

• Ampule

• Vial

Medications by Injection (cont.)

• Intradermal ( ID )

and longer duration of action

Epidermis and dermis

Subcutaneous tissue Muscle

Medications by Injection (cont.)

• IM injections – choose sites carefully

Ventrogluteal

Iliac Crest

Deltoid muscle

Clavicle Vastus lateralis

(mid-portion)

Medications by Injection (cont.)

Medications by Injection (cont.)

• Intravenous ( IV )

• Drug is dissolved into a solution

• Slow drip into a vein

Apply Your Knowledge

_ prevents drug from leaking into subcutaneous tissue _ used to administer skin tests _ small bottle with rubber

diaphragm _ can administer a larger amount

of medication _ provides a slow, sustained release

inside diameter of needle

Other Medication Routes

Other Medication Routes

• Urethral administration – local effect

• Vaginal

• Rectal – suppositories or enemas

Apply Your Knowledge

List parenteral routes other than an injection.

ANSWER: Other parenteral routes include:

Special Considerations

• Pediatric patients

measurements of doses

Special Considerations (cont.)

• Pediatric patients

adverse effects and interactions

Special Considerations (cont.)

Special Considerations (cont.)

• Pregnant patients – check drug references for safety

during pregnancy

• Patients who are breast-feeding

lactation

Apply Your Knowledge

Why are drug effects less predictable in

children?

ANSWER: Drugs are absorbed, distributed, metabolized, and excreted differently in children than adults.

Fantastic!

Patient Education about Medications

• Over-the-counter drugs

other substances

symptoms

one active ingredient

Patient Education about Medications (cont.)

• Prescription drugs

• Special instruction

• Warnings

Patient Education about Medications (cont.)

• Drug-drug interactions

• Effects may be increased

• Effects may be decreased

• One drug may be increased by another

• Lead to adverse reactions

Patient Education about Medications (cont.)

• Food-drug interactions

• Be specific about foods to avoid and when

• Explain what to expect if interaction occurs

• Describe what to do

Patient Education about Medications (cont.)

• Adverse effects

disease ~ more susceptible

• Take as instructed

• Recognition of significant adverse effects

• Report to physician

Patient Education about Medications (cont.)

• Complete medication list

and alcohol

• Tell all of their doctors about their medications

Patient Education about Medications (cont.)

• Patient compliance – patient education

Patient Education about

Medications (cont.)

• Patient compliance – patient education

Apply Your Knowledge

What should you instruct the patient about

regarding drug administration?

ANSWER: The patient should be taught how

to read the prescription label, drug-drug and

drug-food interactions, adverse effects, and

how to take the drug correctly.

Bravo!

Charting Medications (cont.)

• Tips (cont.)

Apply Your Knowledge

When charting that you gave the patient a

subcutaneous injection, you wrote intravenously by

mistake What should you do?

ANSWER: If you make an error, do not erase

it Draw a line through intravenously The

mistake should still be visible, so do not

black it out Initial it and then chart “subcut”.

In Summary

53.1 Before administering a medication, you should

check the patient for allergies and also evaluate any

53.2 The rights of drug administration include the right

patient, right drug, right dose, right route, right time,

In Summary (cont.)

53.3 Drugs may be administered for either local or

systemic effects Table 53-2 outlines the many drug

administration routes.

53.4 Oral medications typically are swallowed and

absorbed through the digestive tract Sublingual

medications go under the tongue, and buccal medications

go between the cheek and gum.

53.5 The three most common injection routes are ID,

subcut, and IM IV is less frequently used in a

In Summary (cont.)

53.6 Other medication routes include inhalants

(respiratory), topical (including transdermal), urethral,

vaginal, and rectal.

53.7 Certain special considerations must be made when

caring for pediatric, pregnant, and breastfeeding patients

Pediatric patients require extreme care when calculating doses

Checking medications given to pregnant and breastfeeding patients for possible adverse effects is

In Summary (cont.)

53.8 Patients should be educated about why, when, and

how they should take medications

This includes instruction to ensure patient compliance.

Patients should also be instructed about the dangers

of medication combinations, the importance of reporting an

medication list.

53.9 Documentation of medication administered should

occur immediately after the given and should include the

End of Chapter 53

Words are the most powerful drug used

by mankind.