Administering Oral Medication for Medication Aide Course

Administering Oral Medication for Medication Aide Course

Skill 34-1 Administering Oral Medication

Administering Oral Medications 


Equipment Needed

  1. Medication or cart tray
  2. Disposable medication cups
  3. Glass of water, juice, or preferred liquid
  4. Drinking straw
  5. Pill-crushing or pillating device (optional)
  6. Paper towels
  7. MAR or computer printout

Administering Oral Medications

  1. Assess for any contraindications to client receiving oral medication: Is client able to swallow? Is client suffering from nausea/vomiting? Is client diagnosed as having bowel inflammation or reduced peristalsis? Has client had recent GI surgery? Does client have gastric suction?
    1. Check the client’s swallow, cough, and gag reflexes if in doubt about client’s ability to manage oral medications. Withhold medication if swallow, cough, or gag is impaired and notify prescriber.
  2. Assess client’s medical history, history of allergies, medication history, and diet history
  3. Gather physical examination and laboratory data that may influence medication administration
  4. Assess client’s knowledge regarding health and medication use
  5. Assess client’s preferences for fluids.
  6. Check accuracy and completeness of each MAR or computer printout with prescriber’s written medication order. Check client’s name, medication name and dose, route of administration, and time for administration.
  7. Prepare medications
    1. Wash hands.
    2. Arrange medication tray and cups in medication preparation area or move medication cart to position outside client’s room
    3. Unlock medicine drawer or cart.
    4. Prepare medication for one client at a time. Keep pages of MARs or computer printouts for one client together
    5. Select correct medication from stock supply or unit-dose drawer. Compare label of medication with MAR or computer printout.
    6. Calculate medication dose as necessary. Double-check calculation.
    7. To prepare tablets or capsules from a floor stock bottle, pour required number into bottle cap and transfer medication to medication cap. Do not touch medication with fingers. Extra tablets or capsules may be returned to bottle. Medications that need to be broken to administer half the dose can be broken using a gloved hand, or cut with a pill crushing device. Tablets that are to be broken in half must be prescored. Prescored tablets are identified by a manufactured line that transverses the center of the tablet.
    8. To prepare unit-dose tablets or capsules, place packaged tablet or capsule directly into medicine cup. (Do not remove wrapper.)
    9. All tablets or capsules to be given to client at same time may be placed in one medicine cup except for those requiring preadministration assessments (e.g., pulse rate or blood pressure).
    10. If the client has difficulty swallowing, ask physician to substitute with liquid. If liquid medications are not an option, use pill-crushing device such as a mortar and pestle to grind pills. If a pill-crushing device is not available, place tablet between two medication cups and grind with a blunt instrument. Mix ground tablet in small amount of soft food (custard or applesauce).
    11. Prepare liquids:
      1. Remove bottle cap from container and place cap upside down.
      2. Hold bottle with label against palm of hand while pouring
      3. Hold medication cup at eye level and fill to desired level on scale. Scale should be even with fluid level at its surface or base of meniscus, not edges.
      4. Discard any excess liquid into sink. Wipe lip and neck of bottle with paper towel.
      5. Some liquid medications are in unit-dose containers. Draw up volumes of less than 10 ml in syringe without needle.
    12. When preparing narcotics, check narcotic record for previous medication count and compare with supply available.
    13. Check expiration date on all medications
    14. Compare MAR or computer printout with prepared medication and container.
    15. Return stock containers or unused unit-dose medications to shelf or drawer and read label again.
    16. Do not leave medications unattended.
  8. Administering medications:
    1. Take medications to client at correct time.
    2. Identify client by comparing name on MAR or computer printout with name on client’s identification bracelet. Ask client to state name.
    3. Explain purpose of each medication and its action to client. Allow client to ask any questions about drugs.
    4. Assist client to sitting or side-lying position if sitting in contraindicated.
    5. Administer medications properly:
      1. Client may wish to hold solid medications in hand or cup before placing in mouth.
      2. Offer water or juice to help client swallow medications. Give cold carbonated water if available and not contraindicated.
      3. For sublingual-administered medications, have client place medication under tongue and allow it to dissolve completely. Caution client against swallowing tablet.
      4. For buccally administered drugs, have client place medication in mouth against mucous membranes of the cheek until it dissolves. Avoid administering liquids until buccal medication has dissolved.
      5. Mix powdered medications with liquids at bedtime and give to client to drink.
      6. Caution client against chewing or swallowing lozenges.
      7. Give effervescent powders and tablets immediately after dissolving.
    6. If client is unable to hold medications, place medication cup to the lips and gently introduce each drug into the mouth, one at a time. Do not rush.
    7. If tablet or capsule falls to the floor, discard it and repeat preparation.
    8. Stay until client has completely swallowed each medication. Ask client to open mouth if uncertain whether medication has been swallowed.
    9. For highly acidic medications (e.g., aspirin), offer client nonfat snack (e.g., crackers) if not contraindicated by client’s condition.
    10. Assist client in returning to comfortable position.
    11. Dispose of soiled supplies and wash hands.
  9. Return within 30 minutes to evaluate client’s response to medications.
  10. Ask client or family member to identify medication name and explain purpose, action, dosage schedule, and potential side effects of drug.
  11. Always notify prescriber when the client exhibits a toxic effect or allergic reaction, or with the onset of side effects. Withhold further doses.



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