NUR 155 Exam 4 Medication Administration
& Pain Management Guide galen college of
nursing
Chapter 35:
Medication Administration
• Drug Classification
o Prescription and OTC
o Generic name or Trade/Brand name
• Legal
o Nurses must have physician orders
o Controlled substances = CASPER system tracking in KY
o US legislation – keeps drugs on or off the market
o State laws – restrictions on certain OTC drugs
• Drug Effects
o Side effects – (secondary effect) Expected and treated; may be harmless or
potentially harmful
o Adverse reactions – (adverse effects) aren’t expected, deadly; may justify the
discontinuation of the drug
o Drug toxicity – (harmful effects of a drug on an organism or tissue) too
much/overdose; ingention of a drug intended for external use or buildup of the
drug in the blood because of impaired metabolism or excretion; elderly/kids at
risk, kidney/liver
o Allergy = anaphylactic reaction (occurs immediately after the drug is
administered), doesn’t mean you had side effects of a drug
o Drug interactions – occurs when the administration of one drug before, at the
same time as, or after another drug alters the effect of one or both drugs;
contraindications, drug compatibility
• Actions
o Half-life – amount of time for half the med to get out of the body
o Onset – the time it takes for the med to start work
o Peak plasma level – highest level of med. PO (30-60) IV (med is done)
o Trough – Right before dose (lowest amount)
• Pharmacokinetics
o Absorption – the process by which a drug passed into the bloodstream; first step
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, in the movement of the drug through the body
o Distribution – the transportation of a drug from its site of absorption to its site of
action
o Biotransformation (metabolism) – process by which a drug is converted to a less
active form, mostly takes place in the liver- products called metabolites
o Excretion – process by which metabolites and drugs are eliminated from the
body
• Factors affecting med action
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, o Developmental – pregnancy, kids (immune body systems), older adults
(decreased renal function *start low go slow* - safety tops on pill bottles)
o Sex – Males = more protein & metabolize faster; females = more adipose tissue
o Genetic – genetic testing
o Diet – effects absorption (Coumidin – Vit K)
o Psychological – think it won’t work, won’t take certain meds, generic vs brand
names
o Disease- Cancer, circulatory issues, gut, renal, liver
o Time of administration – some drugs have to be taken with food or without food,
or am/pm
• Oral
o SAFEST ROUTE/MOST CONVIENENT – does not break skin barrier
o Tablets – can be scored/crushed as long as not enteric coated
o Capsules, liquid
o Sublingual (under tongue - NITROGLYCERIN)
o Buccal (Cheek)
o Enteral – tube feed, crushed or liquid
▪ If a person is on suction, stop suction before giving meds – wait 30 mins
to start suction again
o How to measure and administer liquid medication?
▪ Thoroughly mis the medication before pouring. Discard any medication
that has changed color or turned cloudy.
▪ Remove cap and place upside down on the countertop (avoids
contamination)
▪ Place medicine cup on a flat surface at eye level and fill it to the desired
level, using the bottom of the meniscus to align with the container scale
(ensures accurate measurement)
▪ Wipe the lip of bottle off with paper towel before capping bottle
• Transdermal
o Applied to skin, local and maybe systemic effects
o Lotion, creams, ointments, patches
o Soap/water, gloves, pat dry and apply
o Wrap in glove and put in sharps container
o Rotate sites
• Parenteral
o Injected VIA
▪ Intradermal – under the epidermis (into the dermis)
▪ Subcutaneous – into the subcutaneous tissue, just below the skin
▪ Intramuscular – into a muscle
▪ Intravenous – into a vein
• ANY TIME YOU SUSPECT AN ALLERGIC REACTION – GIVE BENADRYL
o Do not need to stop and ask – emergency protocol
• Topical
messages.downloaded_by
& Pain Management Guide galen college of
nursing
Chapter 35:
Medication Administration
• Drug Classification
o Prescription and OTC
o Generic name or Trade/Brand name
• Legal
o Nurses must have physician orders
o Controlled substances = CASPER system tracking in KY
o US legislation – keeps drugs on or off the market
o State laws – restrictions on certain OTC drugs
• Drug Effects
o Side effects – (secondary effect) Expected and treated; may be harmless or
potentially harmful
o Adverse reactions – (adverse effects) aren’t expected, deadly; may justify the
discontinuation of the drug
o Drug toxicity – (harmful effects of a drug on an organism or tissue) too
much/overdose; ingention of a drug intended for external use or buildup of the
drug in the blood because of impaired metabolism or excretion; elderly/kids at
risk, kidney/liver
o Allergy = anaphylactic reaction (occurs immediately after the drug is
administered), doesn’t mean you had side effects of a drug
o Drug interactions – occurs when the administration of one drug before, at the
same time as, or after another drug alters the effect of one or both drugs;
contraindications, drug compatibility
• Actions
o Half-life – amount of time for half the med to get out of the body
o Onset – the time it takes for the med to start work
o Peak plasma level – highest level of med. PO (30-60) IV (med is done)
o Trough – Right before dose (lowest amount)
• Pharmacokinetics
o Absorption – the process by which a drug passed into the bloodstream; first step
messages.downloaded_by
, in the movement of the drug through the body
o Distribution – the transportation of a drug from its site of absorption to its site of
action
o Biotransformation (metabolism) – process by which a drug is converted to a less
active form, mostly takes place in the liver- products called metabolites
o Excretion – process by which metabolites and drugs are eliminated from the
body
• Factors affecting med action
messages.downloaded_by
, o Developmental – pregnancy, kids (immune body systems), older adults
(decreased renal function *start low go slow* - safety tops on pill bottles)
o Sex – Males = more protein & metabolize faster; females = more adipose tissue
o Genetic – genetic testing
o Diet – effects absorption (Coumidin – Vit K)
o Psychological – think it won’t work, won’t take certain meds, generic vs brand
names
o Disease- Cancer, circulatory issues, gut, renal, liver
o Time of administration – some drugs have to be taken with food or without food,
or am/pm
• Oral
o SAFEST ROUTE/MOST CONVIENENT – does not break skin barrier
o Tablets – can be scored/crushed as long as not enteric coated
o Capsules, liquid
o Sublingual (under tongue - NITROGLYCERIN)
o Buccal (Cheek)
o Enteral – tube feed, crushed or liquid
▪ If a person is on suction, stop suction before giving meds – wait 30 mins
to start suction again
o How to measure and administer liquid medication?
▪ Thoroughly mis the medication before pouring. Discard any medication
that has changed color or turned cloudy.
▪ Remove cap and place upside down on the countertop (avoids
contamination)
▪ Place medicine cup on a flat surface at eye level and fill it to the desired
level, using the bottom of the meniscus to align with the container scale
(ensures accurate measurement)
▪ Wipe the lip of bottle off with paper towel before capping bottle
• Transdermal
o Applied to skin, local and maybe systemic effects
o Lotion, creams, ointments, patches
o Soap/water, gloves, pat dry and apply
o Wrap in glove and put in sharps container
o Rotate sites
• Parenteral
o Injected VIA
▪ Intradermal – under the epidermis (into the dermis)
▪ Subcutaneous – into the subcutaneous tissue, just below the skin
▪ Intramuscular – into a muscle
▪ Intravenous – into a vein
• ANY TIME YOU SUSPECT AN ALLERGIC REACTION – GIVE BENADRYL
o Do not need to stop and ask – emergency protocol
• Topical
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