Many drugs have similar spellings and variable concentrations. Before the administration of the medication, it is imperative to compare the exact spelling and concentration of the prescribed drug with the medication card or drug profile and the medication container. Regardless of the drug distribution system used, the drug label should be read at least three times:
1. Before removing the drug from the shelf or unit dose cart. 2. Before preparing or measuring the actual prescribed dose 3. Before replacing the drug on the shelf or before opening a unit dose container (just prior to administering the drug to the patient)
When scheduling the administration time of a medication, factors such as timing abbreviations, standardized times, consistency of blood levels, absorption, diagnostic testing, and the use of p.r.n. medications must be considered.
1. Standard Abbreviations—The drug order specifies the frequency of drug administration. Standard abbreviations used as part of the drug order specify the times of administrati0n. The nurse should also check institutional policy concerning administration of medications. Hospitals often have standardized interpretations for abbreviations. The nurse must memorize and utilize standard abbreviations in interpreting, transcribing, and administering medications accurately. 2. Standardized Administration Times—For patient safety, certain medications are administered at specific times. This allows laboratory work or ECGs to be completed first, in order to determine the size of the next dose to be administered. 3. Maintenance of Consistent Blood Levels—The schedule for the administration of a drug should be planned to maintain consistent blood levels of the drug in order to maximize the therapeutic effectiveness. 4. Maximum Drug Absorption—The schedule for oral administration of drugs must be planned to prevent incompatibilities and maximize absorption. Certain drugs require administration on an empty stomach. Thus, they are given 1hour before or 2 hours after meals. Other medications should be given with foods to enhance absorption or reduce irritations. Still other drugs are not given with diary products or antacids. It is important to maintain the recommended schedule of administration for maximum therapeutic effectiveness.
5. Diagnostic Testing—Determine whether any diagnostic tests have been ordered for completion prior to initiating or continuing therapy. Before beginning antimicrobial therapy, assure that all culture specimens (such as blood, urine, or wound) have been collected. If a physician has ordered serum levels of the drug, coordinate the administration time of the medication with the time the phlebotomist is going to draw the blood sample. When completing the requisition for a serum level of a medication, always make a notation of the date and time that the drug was at last administered. Timing is important; if tests are not conducted at the same time intervals in the same patient, the data gained are of little value. 6. P.R.N. Medications—Before the administration of any p.r.n. medication, the patient’s chart should be checked to ensure that the drug has not been administered by someone else, or that the specified time interval has passed since the medication was last administered. When a p.rn. medication is given, it should be charted immediately. Record the response to the medication.
Check the drug dosage ordered against the range specified in the reference books available at the nurses’ station.
1. Abnormal Hepatic or Renal Function—Always consider the hepatic and renal function of the specific patient who will receive the drug. Depending on the rate of drug metabolism and route of excretion from the body, certain drugs require a reduction in dosage to prevent toxicity. Conversely, patients being dialyzed may require higher...