Chapter 3

Medication Administration and the Nursing

Process of Drug Therapy

Rights of Medication Administration

Right
Right
Right
Right
Right
Right
Right

Dose
Drug
Patient
Route
Time
Reason
Documentation

Accurate Drug
Administration
Rights
Know your drugs
Interpret prescribers orders accurately
Verbal or Telephone order
Read labels
Use approved abbreviations
Calculate and measure doses correctly
Correct technique
Patient ID

NCLEX Question
A physician writes an order using the

abbreviation MS. The order states MS 10 mg IV

push every 6 hours as needed for pain.
According to the Joint Commissions Do Not Use
list, what is the potential problem in this order?
A. The order does not include a dosage.
B. The drug could be magnesium sulfate or

morphine sulfate.
C. The potential problem is minimal, and the order
is clear.
D. The order does not include a route.

NCLEX Question
A prescriber has written an order for an oral

medication to a patient following a

cerebrovascular accident (stroke). Prior to
administering the medication, which of the
following nursing interventions is most
important?
A. allowing the patient to take the medication

with thickened liquids

B. placing the patient in the sitting position
C. assessing the patients blood pressure and
pulse
D. assessing the patients ability to swallow

Legal Responsibilities
Legally empowered by state nurse practice

acts
Legally responsible for safe and accurate
administration
Sufficient drug knowledge

Medication errors and their

prevention
44,000-98,000 deaths occur each year in the

US due to medical errors

Adverse patient outcomes: serious illness,
conditions that prolong hospitalization or
require additional treatment, and death
Errors include: giving an incorrect dose, not
giving an ordered drug, and giving an
unordered drug

Changes to prevent medication

errors
Computer provider order entry
Bar coding
Point-of-care
Limiting use of abbreviations
Medication reconciliation

NCLEX Question
A prescriber has written an order for

levothyroxine sodium (Synthroid) 50 mg per

day by mouth. The nurse knows that the
standard dose is 50 mcg. What action should
the nurse take?
A. Call the prescriber and question the order.
B. Administer 50 mcg instead.
C. Consult the pharmacist about the order.
D. Ask the patient what he or she usually takes.

NCLEX Question
Which of the following nursing actions will

prevent adverse drug events?

A. Use only the trade name when documenting

medications.
B. Crush long-acting medications if the patient
has dysphagia.
C. After receiving a verbal order, administer the
medication and then write down the order.
D. Use bar code technology according to
institutional policy.

Medication Orders
Should include:
Patient full name
Name of the drug
Dose
Route
Frequency of administration
Date
Time
Signature of prescriber

Drug Preparations and Dosage

Forms
Dosage forms: include liquids, tablets,

capsules, suppositories, and transdermal and

pump delivery systems.
Enteric-coated
Controlled-release
Transdermal

Medication
Administration
Oral
Nasogastric or Gastrostomy Tube
Subcutaneous
Intramuscular
Intravenous
Skin
Eye
Nose
Ear
Rectum
Vagina