Prepare, administer and evaluate the effectiveness of prescribed medications.
Objectives:
– Administer prescribed medication to the patient safely. – Educate the patient and family on the therapeutic regimen.
Equipment:
Equipment necessary for the preparation and administration of medication according to the route of administration.
Material:
– Prescribed medication. – Medical treatment sheet with prescription. – Material necessary to prepare and administer the medication according to the type of route to be used. – Nursing records.
Procedure:
– Perform hand washing. – Verify the medical order before administering the drug. – Check that the written medical prescription contains: patient’s name, date of prescription, name and dosage of the drug to be administered, route of administration, frequency, signature of the prescribing physician. The medical prescription should be clear; if in doubt, consult the physician. – Schedule the administration schedules according to a joint protocol with the pharmacy service. – Check for allergies, interactions and contraindications with respect to the medications. – Prepare each patient’s medication separately. – Prepare the medications using the appropriate material and techniques for the medication administration modality. – Verify the good condition of the medication, expiration date and drug identification. – Reject open medication and broken tablets. – In the case of parenteral medication, use different needles for preparation and administration. Multipurpose vials (insulins, etc.) should be disinfected before use with antiseptic on the cap. Parenteral medication can be presented for direct administration or previously mixed with a solvent. The steps to obtain the mixture are: 1. Load the solvent in the syringe. 2. Introduce the indicated amount of solvent into the container containing the drug. 3. Homogenize the solution (do not shake the mixture, rotate the container between the hands). 4. Load the solution back into the syringe. – Make sure again that the drug, dose, route, frequency and time of administration are correct. – Check that the patient who is to receive the medication is the correct patient. In children verify with the parents the identity, in disoriented or unconscious patients with the bracelet.
– Prepare the medication. – Preserve the patient’s privacy. – Inform the patient. – Request the collaboration of the patient and family. – Proceed to alcoholic hand disinfection. – Put on gloves. – Administer the medication with the appropriate technique and route. – Stay with the patient while taking the medication. – Instruct the patient and family on how to handle the medication: doses, schedules, form of administration, if applicable (oral, topical, rectal and inhalers). – Instruct the patient and family about the action and expected adverse effects of the medication. – If the patient refuses the medication, note it in the nursing documentation and communicate it to the physician. – Collect the material and dispose of it in the specific containers according to waste segregation criteria. – Record: medication administered, dose, route, date and time, incidents and patient response. The signature on the medication administration sheet must clearly identify the nursing professional.
Observations:
– If the patient is a child: better to use sweet-tasting syrups than tablets. Avoid mixing medications with food and if the medication has a strange taste tell them so. – If the patient is elderly, there may be problems related to physiological changes of age: 1. impaired memory. 2. Decreased visual acuity and hearing impairment. 3. Decreased renal function: resulting in slower elimination of drugs and increased concentrations in the blood. 4. Incomplete absorption. 5. Increase in the proportion of fat in the body mass, facilitating the retention of fat-soluble drugs, which increases toxicity. 6. Lower response to the same drug concentration compared to younger persons. – In special situations, verbal orders should be signed by the physician before 24 hours, recorded by the nurse on the care sheet with the name of the prescribing physician and the name of the nurse. – Verify that the drug dosage does not exceed safety limits.
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