Session 5Administration of Drugs by Oral Route

Session 5Administration of Drugs by Oral Route

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Learning Objectives

Learning Objectives

By the end of this session, students are expected to be able to:

Describe drug administration by oral route

Discuss advantages and disadvantages of drug administration by oral route

Describe techniques of administering drug by oral route

Demonstrate skills in the administration of drugs orally

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Descriptions of Oral Route of Drug Administration

Descriptions of Oral Route of Drug Administration

Oral route is the most common method of administering medication by mouth.

The use of oral route of giving a drug offers a safest, most convenient, and most economical method available.

As long as a client can swallow and retain the drug in the stomach, this is the route of choice.

Oral medications are contraindicated when a client is vomiting, has gastric or intestinal suction or is unconscious.

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Medication administration is a complex process and not simply a psychomotor task.

Medication administration is a complex process and not simply a psychomotor task.

The health care provider needs to have knowledge on drug action, side effects, indication and contraindication.

Drugs administered by mouth may be in solid or liquid form.

Some of the solid forms are tablets, pills and capsules; liquids can be syrups or mixtures.

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Advantages and Disadvantages of Oral Route Drugs Administration

Advantages and Disadvantages of Oral Route Drugs Administration

Advantages for Oral Route Drugs Administration

Most convenient and acceptable

Usually least expensive

Safe does not break skin barrier

Administration usually does not course stress

Easy to instruct patient and independently when is at home

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Disadvantages for Oral Route Drugs Administration

Disadvantages for Oral Route Drugs Administration

Some oral preparations have unpleasant taste or odour

Some may cause gastric irritation resulting in nausea and vomiting

Some oral drugs may harm teeth enamel

Certain drug may be partially absorbed or destroyed by the gastric juice

Oral route has limited use e.g. cannot be used for unconscious patient

Some drugs cannot be used be certain diagnostic test or surgical procedures

Inappropriate when gastrointestinal tract has reduced motility

Drugs can be aspirated by seriously ill clients

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Techniques of Administering Drug by Oral Route

Techniques of Administering Drug by Oral Route

Before administering oral drugs it is essential to conduct an assessment of the patient’s condition to medication, then planning for the administration, implementation and the actual performance of administering the medication to patient.

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Assessment

Assessment

Assess the patient for

Allergies to medication

Client ability to swallow the medication

Presence of vomiting or diarrhea that would interfere with the ability to absorb the medication

Specific drug action, side effects, interactions and adverse reactions.

Ask if they have a history of diabetes, heart or vascular conditions, respiratory, kidney, dermatological and neurological conditions and how the patient was treated in the past.

Client’s knowledge and learning needs about the medication.

Perform appropriate assessments (e.g. vital signs ,lab results specific to the medication)

Determine if the medication data influence the administration of the medication (i.e. is appropriate to administer the medication or does the medication need to be held and the physician notified?)

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Planning

Planning

The following equipments and materials need to be prepared before the procedure of administering medication.

A Trolley with

Medicine or drugs

Patients’ treatment charts/cards or prescription

Plastic calibrated medication cups for liquid (plastic cups usually come with the liquid medication which are discarded after completion of the medication)

Pill crusher

Straws to administer medications that may discolour the teeth or to facilitate the ingestion of liquid medication for certain clients

Jug of drinking water and a glass

Medicine plates and spoons

Medicine droppers

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Technique (procedure) for Oral Administration of Drugs

Technique (procedure) for Oral Administration of Drugs

Wash hands and observe other appropriate infection control procedures.

Inform the patient about the procedure and make them comfortable.

Select correct drug for the patient, by reading the medication before taking from the cupboard, shelf draw or refrigerator.

Use only medications that have clear legible labels to ensure accuracy.

Compare the label of the drug container or unit dose package against the patient prescription.

This is a safety check to ensure that the right medication is given.

Check the expiry date of the medication, expired medication should not be administered.

Calculate medication dosage accurately without contamination.

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Ask the patient’s name for verification and compare with the treatment card/chart or prescription.

Ask the patient’s name for verification and compare with the treatment card/chart or prescription.

This is the second safety check to reduce chances of error.

Make sure that you know the patient’s diagnosis; purpose of medications, therapeutic effects and possible side effects.

Verify the client’s ability to take medication orally.

Administer the drug and ensure the patient has taken the medicine before you leave.

Break only scored if necessary to obtain the correct dosage.

Use a file or cutting device if needed.

Record date, time, dose, route and type of medicine given.

If the patient refuses medication or the assessment data indicate the drug should be withheld an opened unit dose package can usually be returned to the medication cupboard; this information must be recorded and reported.

Return the medicines, equipments and patients records to their proper places for security.

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Administering Tablets, Capsules or Pills and Powder Medications

Administering Tablets, Capsules or Pills and Powder Medications

Place the package unit dose capsules or tablets directly into medicine cup.

Do not remove the medication from the wrapper until at bed side, as the wrapper keeps the medication clean.

Also facilitates identification of the medication in the event the client refuses the drug or assessment data indicates the drug should be held.

An unopened unit dose packages can be returned to the medication cupboard for reuse when necessary.

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Break only scored tablets if necessary to obtain the correct dosage, use or a cutting device if needed.

If using a stock container pour the required number into the bottle cap/lid and then transfer the medication to the disposal cup without touching the tablet.

Keep narcotics and medications that require specific assessment, such as pulse, measurements, respiratory rates or depth, or blood pressure separate from the others.

This reminds the health care provider to complete the needed assessment(s) in order to decide whether to give the medication or withhold the medication if indicated.

Break only scored tablets if necessary to obtain the correct dosage, use or a cutting device if needed.

Give the tablet to patient with drinking water; make sure patient swallows the medication before leaving.

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Administering Mixtures or Suspension

Administering Mixtures or Suspension

Thoroughly mix the medication before pouring, shake the bottle gently, remove cap or lid place the cap upside down on the trolley.

Discard any medication that has changed colour or turned cloudy.

Hold the bottle so that the label is at uppermost and pour the medication away from the label to prevent from being soiled and illegible.

Hold calibrated medicine cup at eye level and pour the medication to desired measurement.

This method ensures accuracy of measurement.

Wipe rim of bottle with paper tissue/towel, this prevents the cap from sticking.

Replace cap or lid firmly.

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Keep unit dose liquids in their package and open them at the bed side.

When giving small amounts of liquids e.g. less than 5 mls prepare the medication in a sterile syringe without the needle.

Keep unit dose liquids in their package and open them at the bed side.

Give the drug to the right patient.

Make sure the patient drinks the medication before leaving and record according to hospital policy.

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Key Points

Key Points

Oral route is the most common route

Oral medications are contraindicated to patients who are vomiting and have stomach or intestinal irritation

Health Care Providers must always assess the clients status before administering medication

Before administration prepare the necessary equipments, supplies and medication

The health care provider identifies the client appropriately before administering medication and stays with client until the medication is taken

Medications once given are documented as soon as possible after administration.

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Evaluation

Evaluation

What is oral route of drug administration?

What are the types of drugs given orally?

What are the advantages and disadvantages of oral route drug administration?

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References

References

Adams, M. P. et al. (2008). Pharmacology for Nurses. A Pathophysiologic Approach.

(2nd ed.) New Jersey: Pearson.

Kozie, B. et al. (2004). Fundamentals of Nursing. Concepts Process and Practice. (7th ed.) New Jersey: Pearson Education, Inc.

MOHSW (2008). Basic Nursing Procedures. A manual for Nursing Practice in Tanzania. (3rd ed.). Dar es Salaam, Tanzania: Ministry of Health and social Welfare

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NO FREE LUNCH IN AFRICA

NO FREE LUNCH IN AFRICA

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