before you prepare an oral medication verify the health care providers orders gather your supplies and perform hand hygiene as you work avoid interruptions keep the door to the medication room closed and don't take telephone calls follow your agencies no interruptions own policy arrange the medication tray and cup in a drug preparation area prepare drugs for one patient at a time as you proceed observe the six rights of medication administration right medication right patient right dose right root right time and right documentation for details see the video skill insuring the six rights of medication administration obtain the correct drug from the automated dispensing system unit dose drawer or stock supply all medications must be verified three times confirm the name of the medication by comparing the label with the MA R this is your first check if the dosage is given on the labels don't match check or calculate the correct amount to give double check any calculations you make return any expired meds to the pharmacy place the packaged unit-dose tablets or capsules directly into the medication cup without unwrapping them if any medication is not clearly labeled don't administer it if you'll be giving tablets and capsules use a single medication cup for some meds you'll need to do an assessment first such as taking a blood pressure or pulse place those medications in a separate cup as a reminder to perform the assessments if your patient needs only half a pill or tablet the pharmacy will split label and package the dose that way or you can ask them to do so if you have to break a pill yourself place the scored tablet into a clean pill splitting device split the tablet and discard the other half don't split any pill that has not been scored by the manufacturer if the patient has trouble swallowing crush the pill with a pill crusher then mixed the crushed tablet with a small amount of soft food such as applesauce or custard remember to give each crushed medication separately controlled substances such as opioids will be stored in a secure locked compartment of the dispensing unit when you retrieve such a medication compare the count in the record with the supply of controlled drugs remaining to be sure they match and of course never leave any medication unattended before you go to the patient's room verify the patient's name on the ma R this is your second patient identification check you will perform the third check at the patient's bedside if you use the automated dispensing system log out after you remove the drugs to administer an oral medication take it to the patient at the correct time stat and now doses must be given precisely when ordered as you proceed continue to apply each of the six rites of medication administration perform hand hygiene ensure privacy and introduce yourself to the patient identify him using to identify errs and can you tell me your full name Tom Williamson and your date of birth 616 62 remember to ask him if he has any allergies did you get the crackers that we gave you earlier highly acidic medications such as aspirin can be given with a snack such as crackers if food is not contraindicated at the patient's bedside again match up the ma R with the names of the medications as shown on their labels and with the patient's name this is your third check if needed perform pre administration assessments such as taking a pulse or blood pressure discussed purpose of each medication its action and its possible side-effects give the patient an opportunity to ask questions administer tablets or capsules with the patient in a seated or sideline position let him swallow them with water juice or whatever he likes to drink but make sure the medication is compatible with it he may want to hold the pills in his hand or in a cup before swallowing them to prepare a liquid gently shake the bottle to thoroughly mix it unless it's in a unit dose container in that case it's not necessary to shake it if the medication is in a multi dose bottle remove the cap set it upside down on the med cart and hold the label of the bottle against your palm to protect the labels integrity place the medication cup on a level surface where you can read it at eye level then pour the liquid into the cup the printed or embossed line indicating the correct dosage should be even with the bottom of the fluid meniscus that is the surface of the liquid when you're finished wipe the lip and neck of the bottle with a clean paper towel and replace the cap if you're giving a dose of less than 10 milliliters draw the liquid into an oral syringe don't use a hypodermic syringe or any syringe that has a needle orally disintegrating formulations of tablets or strips must be removed from the package just before you administer them tear open the package carefully don't try to push the tablet through the foil place the medication on top of the patient's tongue and remind her not to chew it a buccal drug must be in contact with the mucous membranes of the cheek a sublingual drug as its name suggests is placed under the tongue advise the patient that a sublingual or buccal drug must dissolve in the mouth in order to be absorbed through the oral mucosa if the tablet is chewed or swallowed it can't be absorbed properly in the GI tract likewise lozenges should be allowed to dissolve in the mouth to administer a powdered medication mix it with liquid at the bedside as directed by the manufacturer it's a powder that I mix with water and give it to the patient to drink if the patient has trouble holding a medication place the cup spoon or straw to her lips and gently introduce each drug one at a time be patient and don't rush it stay until the patient has swallowed each medication if you're not sure ask her to open her mouth and take a look document the medication immediately after administration not before as part of your follow-up care keep an eye on the patient to see how he responds to the medication review the drug regimen with the patient or family