Nursing Process in

Drug Administration
1. Assessment
• Determine whether the patient has food or drug allergies,
document clearly on the patient’s chart all food and drug
allergies
• Find out:
• Which prescription and non prescriptions medications
the patient currently takes
• The frequency of administration
• The purpose for each medication for the patient
• Whether the patient has expected adverse effects

• Note: OBTAIN MEDICAL HISTORY OF THE PT.

• PERFORM PHYSICAL EXAMINATION(paying
particular attention to body systems)
2. Nursing Diagnosis
• Develop a nursing diagnosis consisting of
the patients disease and its etiology
• Begin by addressing problems that pose
immediate threat to the patients health
• COMMON nursing dx:
• -Deficient knowledge
• -Risk for injury
• -Inefffective therapeutic regimen
• -Noncompliance
3. Planning
• Develop outcomes using the nursing
diagnosis(obtain input from the pt
and family)

• Use these goals as outcome criteria

for evaluation
4. Implementation
• Put the care plan into action

• Include all relevant nursing

interventions( drug therapy , to meet
the pts. health care needs)

• A multidisciplinary team approach is

usually needed
5.Evaluation
• Evaluate whether interventions enabled
the patient to achieve the desired
outcomes

• E.g. -complies with the therapeutic

regimen
-therapeutic drug levels are
maintained
 AVOIDING
MEDICATION
ERRORS
1. Follow the 10 Rights of Drug
Administration
• VERIFY THE ORDER FOR THE RIGHT DRUG
Composed of: “Five plus five rights” in drug administration
a. Right client
b. Right drug
c. Right assessment
d. Right dose
e. Right time
f. Right route
g. Right to education
h. Right to evaluation
i. Right to refuse
j. Right documentation
Topics for Patient discussions
• 1. Drug’s name and purpose
• 2.How to monitor the drugs
effectiveness
• 3.Drugs that could interact with the
prescribed drug
• 4. Possible adverse effects
Medication Administration
Guidelines
• 1. Never give a drug poured or prepared by
someone else.

• 2. Never allow the medication cart or tray out

of your sight once you have prepared a dose.
• 3. Never leave a drug at a patients bedside
rather watch the patient swallow the drug.

• 4. Never return unwrapped or prepared drugs

to the stock supply instead dispose the
medication and notify the pharmacist
• 5. Keep the medication supply or cart
secure at all times

• 6. take care to avoid medication errors

that can easily be caused by similar
sounding drug names, unclear orders,
worn route of administration,
miscalculations of dosages
When to question a medication
order?
• 1. when handwriting is difficult to read
• 2. When the drugs used in the patients
condition is questionable
• 3. When drug incompatibilities or
interactions may occur
• 4. consider ethical principles when dealing
with medication errors, medications
during pregnancy, and investigational
protocols
NOTE:
• Consider ethical principles when
dealing with medication errors,
medications during pregnancy,
and investigational protocols
Drug Administration Routes
•1. ORAL
• -most common prescribed route (safe,
convenient, least expensive)
• -administer in higher doses than
parenteral (first-pass metabolism, poor
bioavailability)
• -formulations: tablets, enteric – coated
tablets, capsules , syrups elixirs, oils, liquids,
suspension, powders, and granules
• -requires special preparations (mixing with
foods to improve palatability
• -Maybe administered via :

NGT –tablet should be crushed

buccal –between teeth and cheek
sublingual – under the tongue
Buccal and sublingual- immediately absorbed
into the systemic circulation by pass the
digestive tract
NOTE: Buccal and sublingual should not be
SWALLOWED
2. Parenteral Administration
• -Maybe used when medications cants be
delivered orally
• -injections are delivered directly into the:

• vein (I.V.)
• Muscle (I.M)
• Subcutaneous tissue (SubQ)
• Intradermally (skin thru IV administration)
TOPICAL Administration
• Application directly to the skin
• Includes lotion, creams, ointments and
transdermal patches

• NOTE: Transdermal patches effect: SYSTEMIC –

designed to deliver drugs into the
systemic circulation after absorption
to the skin
• Apply drugs to only areas of skin that are intact,
clean and dry avoid impaired absorption
Ophthalmic Administration
• Used for local effects within
the eye
• Absorbed into the mucus
membrane
• Available: OINTMENTS AND
DRUGS
Otic Administration
• Involves instilling drugs into the ear

• Treat: local infections and inflammations

soften cerumen
local anesthesia
Inhalation Administration
• Administer topical medications via
the respiratory tract for local and
systemic effects

• NOTE: lungs mucosal lining absorbs

the drug almost immediately
Vaginal Administration
• Administering topical treatments for
vaginal infections and
inflammation

• Includes used of : suppositories and

creams
Rectal Administration
• Used when other routes of administration
aren’t available

• Used to treat: constipation, nausea and

vomiting, hemorrhoids, colitis
and pain
Specialized (site-specific)
infusions
• Epidural – infuses drug into the epidural space
• Intrapleural - infuses drug into the pleural
cavity
• Intraperitoneal- infuses drug into the peritoneal
cavity
• Intraosseous- administers drug into the vascular
network of a long bone
• Intra-articular- administers drug directly into
the joint