Frequently Asked Questions
Chapter 30: Medication Administration

What are some examples of the types of oral medication preparations that require special considerations for administration?

Examples of the special considerations for administration some types of oral medication preparations require include (1) chewable tablets must be chewed thoroughly before swallowing because chewing enhances gastric absorption, (2) buccal and sublingual medications must dissolve completely before the client can eat or drink, and (3) suspensions and emulsions should be administered immediately after shaking and pouring from a bottle.

What is the affect of age on pharmacokinetics?

Absorption of oral medications is delayed in young infants because they have less gastric acidity than adults. Infants also have a lower protein-binding, allowing a greater amount of “free” medications in the blood. The infant’s urine is also less acid, slowing the excretion of certain medications in the urine.

Older people often have more body fat, so fat soluble medications have a longer half-life and longer duration of action. Water soluble medications are more concentrated because older people have less body water. Due to decreased liver or liver functioning, medication is metabolized and eliminated slower in older people, resulting in a greater number of side effects and drug toxicities. Some of the medications often prescribed for older people, such as medication for gastric acid reflux, slow absorption of other medications.

Why are peak and trough drug levels measured?

Peak and trough drug levels are measured in clients who are on medications that are toxic to the kidneys or the ears. The prescribing practitioner, knowing a client’s peak and trough levels, can adjust doses of medication to maintain a therapeutic drug level and avoid a toxic level.

In a hospital, what happens after the prescriber orders a medication?

After the prescriber orders a medication in the hospital, the nurse checks the order for completeness and clarity and the nurse or ward clerk transcribes the order, sending it on to the pharmacist. The pharmacist processes the order, clarifies any unclear material, and prepares the medication. Pharmacists monitor medications for incompatibilities, appropriate timing, and appropriate dosage. The nurse is responsible for understanding the actions of a drug and questioning any orders that are not clear or appear to be inappropriate. Nurses teach clients and families about the medications. They administer medications according to “Five Rights:” the right medication to the right client, in the right dose, by the right route, at the right time.

How can the nurse protect the safety of clients when administering medications?

The nurse protects the safety of clients when administering medications by (1) following the “five rights” of medication administration; (2) asking another nurse or the pharmacist to check drug calculations; (3) checking the placement of the decimal point of the dose ordered or calculated]; (4) understanding the client’s history and the actions, side effects, and doses of medications given; (5) asking for clarification of any orders; (6) not leaving medications at the bedside for the client to take; (7) checking the client’s name band before administering medications; (8) teaching clients about the medications they take; and (9) consulting the pharmacist and drug references for any questions.