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Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Chapter 36
Calculation of Medication Dosage
and Medication Administration
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Legal and Ethical Implications of Medication Administration
• Laws vary from state to state
• Thorough knowledge of medications administered to patient
• Ethical considerations– Using drugs for personal benefit
– Proper authorization
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Legal and Ethical Implications of Medication Administration
• The medication order– Given by provider
• The prescription– Written legal document that gives directions for
compounding, dispensing, and administering medication to patient
– Eight parts
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Legal and Ethical Implications of Medication Administration
• The prescription– Two types of medicines
• Prescription
• Over-the-counter (OTC)
– Prescriptions for controlled substances
– Approved prescription abbreviations and symbols
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Calculation of Drug Dosages
• Understanding ratio– Ratio expressed as a quotient
– Ratio expressed as a fraction
– Ratio expressed as a decimal
• Understanding proportion– Means and extremes
– Solving for X
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Calculation of Drug Dosages
• Weights and measures– Metric system guidelines
– The seven common metric prefixes• Micro-
• Milli-
• Centi-
• Deci-
• Deka-
• Hecto-
• Kilo-
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Calculation of Drug Dosages
• Weights and measures– Fundamental units
– Household measurements
– Metric system conversion• Proportional method for converting metric equivalents
• Moving the decimal in the correct direction
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Medications Measured in Units
• How to calculate unit dosages– Proportional method
– Formula method
• Insulin– Individualized needs and treatment
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Medications Measured in Units
• Types of diabetes– Type I insulin-dependent diabetes mellitus
– Type II noninsulin-dependent diabetes mellitus
– Type III gestational diabetes
– Type IV other types of diabetes
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Medications Measured in Units
• Importance of exact dosage
• Precautions to observe when administering insulin
• Expressing the weight of medication
• Expressing the volume of medication
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Calculating Adult Dosages
• The proportional method
• The formula method
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Calculating Children’s Dosages
• Young’s, Clark’s, and Fried’s rules replaced by more exact methods
• By body surface area (BSA)– Nomogram
– Used for infants and children up to 12 years of age
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Calculating Children’s Dosages
• By kilogram of body weight– Mathematical process
– Proportional method
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Administration of Medications
• The “Six Rights” of proper drug administration
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Administration of Medications
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Administration of Medications
• Medication errors– When a medication error occurs
– Standard procedure for reporting errors
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Administration of Medications
• Patient assessment– Age
– Physical condition
– Body size
– Gender• Muscular build
• Skin texture
• Injection sites to avoid
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Administration of Oral Medications
• Equipment and supplies for oral medications
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Administration ofParenteral Medications
• Parenteral routes– Subcutaneous
– Intramuscular
– Intradermal
• Multiple dose form
• Unit dose forms
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Administration ofParenteral Medications
• Hazards associated with parenteral medications
• Reasons for parenteral route selection– Rapid response time to medication
– Accuracy of dosage
– Need to concentrate medication in specific body part or area
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Administration ofParenteral Medications
• Reasons for parenteral route selection– Inability to administer orally because medication is
destroyed by gastric juices or patient is incapable of taking medication orally
– Liquid or powder form
– Expressed in terms of volume
– Ordered in terms of weight and volume
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Parenteral Equipment and Supplies
• Syringes– Disposable syringes
– Non-disposable syringes
– Combination disposable and non-disposable cartridge-injection syringes
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Parenteral Equipment and Supplies
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Parts of a Syringe
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Parts of a Needle
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Parenteral Equipment and Supplies
• Safe disposal of needles and syringes– Sharps containers
– Needlesticks
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Parenteral Equipment and Supplies
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Principles of Intravenous Therapy
• Patient needs and conditions
• Patient safety• Types of solutions• Legal aspects
Basic IV
Administration
Set >>
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Site Selection for Injections
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Injection Angles
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Site Selection and Injection Angle
• Marking the correct site for intramuscular injection– Dorsogluteal site
– Ventrogluteal site
– Deltoid muscle
– Vastus lateralis site
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Basic Guidelines forAdministration of Injections
• Withdrawing medication– Withdrawing medication from a vial
– Withdrawing medication from an ampule
• Reconstituting a powder medication
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Basic Guidelines forAdministration of Injections
• Administering subcutaneous, intramuscular, and intradermal injections
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Basic Guidelines forAdministration of Injections
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Z-track Method ofIntramuscular Injection
• Given to avoid irritation to subcutaneous tissues– Imferon is an example of a medication given by this
route
• Pull skin to side before inserting needle
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Z-track Method ofIntramuscular Injection
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Administration of Allergenic Extracts
• MAs may administer allergenic extracts– Always follow guidelines
– Have emergency supplies on hand
• Allergic reactions– Observe the patient for 20-30 minutes after
administration
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Administration ofInhaled Medications
• Inhalation therapy– Inhaler may be used to administer medication to the
lungs
• Implications for patient care
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Administration ofInhaled Medications
• Administration of oxygen– Hypoxemia
– Oxygen tanks
– Dosage
– Methods of oxygen delivery
• Oxygen safety precautions