ADMINISTRATION OF ORAL MEDICATION

INTRODUCTION: Medicine defined as a chemical substance used to promote health ,to prevent illness, to diagnose, to alleviate or cure

diseases.

Some medication has two names Chemical names (medication’s composition& molecular structure),e.g Ibuprofen- iso-butyl phenyl.

Trade name: is the registered name assigned by the manufacturer. One drug may be manufactured by several companies and known by several different trade names. E.g paracetamol---crocin , calpol, ifimo metacin

ABBREVIATION USED REGARDING TIME OF ADMINISTRATION

• A.C :Before meals.• P.C: After meals.• O.D: once a day.• O.N : Each night.• H.S: At bed time.• C.M : Tomorrow morning.• P.R.N:When required.• S.O.S: If necessary in emergency. • BD / BID: Twice a day.• T.DS/TID: Thrice a day.• QDS/QID: Four times a day.• STAT: At once/ Immediately.

CLASIFFICATION OF DRUG ACCORDING TO THEIR ACTION

• Analgesic: To relieve pain..• Antipyretic: To reduce fever.• Antidotes: Substances used to counteract the effects of

poison.• Anti inflammatory: To reduce the inflammation.• Anti-coagulants: Substances which inhibit or decrease

the blood clotting process.• Anti-histamine: To prevent or relieve allergies.• Anti-convulsants: To prevent or treat convulsions.

• Antibiotics: To destroy or inhibit the growth of micro organism.

• Anti emetics: Drugs preventing or relieving nausea & vomiting.

• Bronchodilator: Medicines which relax muscles of the bronchioles by reducing the smooth muscle spasm or mucosal edema.

• Diuretics: Which increase the flow of urine.• Anti- Hypertensive To lowering the blood pressure.

• Ionotropes: That drugs that strengthen cardiac contraction. E.g. injection Dobutamin.

• Thrombolytic agent: Act by breaking down the fibrin frame work of fresh blood clot.

ABBREVIATIONS USED REGARDING PREPERATION OF THE DRUG

• Dil: Dilute.• Liq: Liquid• Lot: Lotion• Mist: Mixture• Ol : Oil Pulv: Powder• Syr: Syrup• Tr: Tincture• Ung: Ointment.• Inj: Injection.

REGARDING AMOUNT• Gr: Grain.• Gtt: a drop• M: Minim• Kg: Kilogram• O : A pint.• Oz : Ounce• Ib : Pound• Cap :Capsule• Tab : Tablet• Tsp :Tea Spoon Full (5 ml)• Tbsp: Table spoon • Sol : Solution.• Gal : Gallon• L : Litre.

WEIGHT & MEASURES

• 1 Dram : 4 grams / 1 Tsf• 1 Ounce: 30 ml• 1 Liter: 1000ml / 2 pint .• 1cc : 1 ml.• 1 minim: 1 drop.• 1 pint : 500 ml• 1 pound: 16 ounces.• 1 kg : 2.2 Ibs.• 1 tsf : 5 ml.• 1 Tbs : 3 tsf / 15 ml.• 1 glass full : 8 ounce.

TYPES OF ORDERS

• Standing orders: It should be carried out for a specific number of days Or until another order cancels it .

• PRN Orders : When needed ( good judgment needed) e.g Pain killer / Laxatives.

• One time order / single order : Only one time eg Preoperative medication.

• Stat order : Administered immediately & only one time . Eg Inj .Lasix 1 amp (20 mg) IV stat.

• Telephone orders / Verbal order.

CALCULATION OF PAEDIATRIC DOSAGE

A) Young’s Rule :(for children over 1 yr of age up to 12 yrs )• Child f dose= Age of the child (in yrs) X Adult dose Age of the child (In yrs) + 12

• Clark’s Rule (use for children in all age)

Child’s dose = Weight of the child in pounds X Adult dose

150• Fried’s Rule (Children under 1yr of age) Child Dose=Age of the child( in months) x Adult Dose

150

SAFETY MEASURES• The ‘’six Rights’’ ensures safety in giving drugs:

• Right Client : Read the clients name on the client’s chart & on the medicine card.

• Call the client by name & ask him to repeat his name.

• Right Drugs : To study the correct name of the drug and compare with the consultants order & medicine card.

• The name of the drugs should be checked three times before

giving----

• Taking the drugs from the locker. • Before pouring or open it. • When returning the strip or bottle.

• Right Dose :The correct dose of medicine should compare with medicine card.then read the strength of medicine on the strip& should observe date of expiry.

• Right Time : Should know the time e.g B.D ,T.D.S etc & know the hospital routines for the intervals.

• Right Method: To determine the route of administration e.g orally, parenterally, rectally etc.

• Right Documentation : Documentation should be done immediate after giving medication.

NURSES RESPONSIBILITY IN THE ADMINISTRATION OF ORAL

MEDICATION• Assessment: • Check the diagnosis & age of the patient.

• Check the medication order.

• Check the diet & fluid order : To avoid medication If the patient is kept nil orally in preparation for surgery &diagnostic tests .But in case of anticonvulsants, Antidiabetics, Antihypertensive drugs ,Digoxin etc better to talked to concerned physicians

• Laboratory values: To be monitor serum drug levels , medication effects & side effects. Before giving Anticoagulants -check the P Time& before chemotherapy blood count is monitored , as these drugs can cause severe leucopenia/ thrombocytopenia ect.

• Physical assessment Check the abilities & limitations swallowing the

medications. check the vital signs –heart rate before giving Digoxin &

BP – before giving Antihypertensive& Respiratory rate before giving opium.

• Check the articles available in the patient’s unit.

ARTICLES REQUIRED FOR ORAL MEDICATION

• A tray containing : • Ounce glass teaspoon,dropper small container

etc. • Drinking water in a glass or Feeding cup.• Pestle.• Duster or towel to wipe the out side of the bottle

after pouring the medication.• Kidney tray .• Medicine card.

STEPS OF PROCEDURE

• Explain the procedure to the patient.• Keep the patient in suitable position according to the

condition of the patient.• Give the mouth wash if necessary.• Protect the bed clothes & garments with a towel placed

under the chin across the chest.• Wash hands.• Read the doctor’s order& compare with medicine cards.• After reading the medicine cards take the appropriate

medicine from the locker.Check three times before giving the medication & follow the’ Five Right’.

• Give the water to the patient to moisten the mouth.

• Give medications one at a time. Stay with the patient until he has taken the medication.

• Check the patient’s mouth when indicated to verify that medications are swallowed.

• Provide water to drink after the medicines are administered.

AFTER CARE OF THE PATIENT &

ARTICLES • Remove the towel & wipe the face with it.• Position the patient & tidy up the bed.• Take articles in the utility room and wash, dry ,

&kept in proper place.• Record medications given & signature on the

medicine card.• Return to the patient side & observe any

reactions.• Return the medication cards to the nurses

station.

Formulas

• Drop calculation:

Total volume x drop factor

Hours x 60

Formulas

• BSA:Height in cm x weight in KG

3600

Formulas

• BMI

Weight in Kg

Height in Meter square

• IBW:

For Male: 50 Kg+2.3 kg (Height in Cm/2.54- 60)

For Female: 45 Kg+2.3 kg (Height in Cm/2.54- 60)