Steps for medicine administration1. Check the order given
against the MAR2. Sign the order Verify by on the top and on the
bottom initials and signature3. Go and ask Hanna for Lab values,
Ask Dr. Hanna for PTT in case of Heparin. PT and INR in case on
Warfarin?4. Pick up the medicines that you are going to
administer5. Do all the calculations. Pay close attention to the
strength of the medicine specially heparin 10,000 u/1ml. ASK Hanna
to verify calculations. 6. Meet the client. Check the patients ID
and DOB against the physicians Order and the MAR7. Ask the patient
for any allergies.8. Wash your hands to prepare the medicines.9.
Check the indications of every medicine. What is for? Safe amount?
Nursing assessment? Sites for parenteral
medicationsRouteSitesGaugeNeedle length
SC Max- 1mL Use a tuberculin syringe or an insulin if it is
insulin Needle 45 to 90 degrees Bevel up Do not aspirate
Outer aspect of the arms. Abdomen Anterior aspect of the thigh
Dorsogluteal Scapula
25 - 275/8
IM Always change the needle after drawing the medicine Always
aspirate if there is blood the needle is not in the muscle Use a 3
cc syringe Bevel up
Deltoid (Max 1 mL) Ventrogluteal Vastus lateralis
21 - 231 to 1
ID
Arm 25 - 275/8
ENTERAL MEDICATIONSMedication Classification Therapeutic
effectAssessment Lab considerations
Warfarin / Coumadin Anticoagulant Help to thinner the blood
Prevention of thrombus formationAssess for signs of bleedingPT and
INRPT is 10 to 13sec. the norm is 1.3 to 1.5. range
is:10*1.3=1313*1.5=19.5Less than or in the range give the
medicineMore than the range do not give the medicineINR
Digoxin AntiarrhythmicSuppression of cardiac arrhythmias
Increase cardiac output and slows the heart rateAssess the heart
rate.Assess the apical pulseElectrolyte levels Potassium 3.5 5.2
mEqMagnesium 1.6 2.4 mEqCalcium 8.8 10.3 mg/dL
Colace / DocusateStool softener Softening and passage of
stoolsAbdominal dictation, bowl sounds, movements. Color,
consistency and amount of stool
Furosemide / Lasix Diuretic Acts in the Loop of Henle
To eliminate excess of fluids. Decrease of BP.
Assess for BP orthostatic hypotension
Electrolytes levels Magnesium 1.6 2.6 mEqPotassium 3.5 5.1
mEqCalcium 8.6 10 mg/dLSodium 135 145 mEq
Nitroglycerin Antianginals Prevent attack of the anginaPrevent
angina attacks Increase cardiac output Decrease BPAssess BP and
hear rate for hypotension, bradycardia
Potassium Electrolytes replacement Replacement or prevention of
deficit of electrolytes Monitor pulse and blood pressure Potassium
3.5 5.2 mEq
Famotidine AntiulcerPrevention of formation of ulcers Healing
and prevention of ulcers ( stress create ulcers)Assess for
epigastric, abdominal pain, blood in stoolCBC with differential
(complete blood count)
Toradol / Ketorolac Nonsteroidal analgesics, anti-inflammatory
Decrease of pain Assess BP for hypotension Liver function
Tylenol / acetanomiphen Nonopiod analgesic Analgesia Assess BP
for hypotension
PARENTERAL MEDICATIONSDrug Classification Therapeutic
effectAssessmentLab results
Heparin Anticoagulant Prevention of thrombus formation.Assess
for signs of bleeding and hemorrhageaPTT: 25-35 sec
Insulin Lower glucose levels Control of hyperglycemia in
diabetic patients.
Accu Chek before administering the medication
Assess patient periodically for symptoms of hypoglycemia
(anxiety; tingling in hands, feet, lips, or tongue; chills; cold
sweats; confusion) and hyperglycemia (confusion, drowsiness;
flushed, dry skin; fruit-like breath odor; rapid, deep breathing,
polyuria; loss of appetite; unusual thirst) during therapy.Child:
60-100 mg/dlAdult: less than 100 mg/dl
Ampicillin Antibiotic Bactericidal action; spectrum is broader
than penicillin.Obtain a history before initiating therapy to
determine previous use and reactions to penicillins. Observe
patient for signs and symptoms of anaphylaxis
