Oral Medication Administration (Nursing)

00:04 Let's talk about oral administration for medications.

00:07 So, this is the most common medication administration that you're gonna do.

00:12 You're gonna have patients sometimes that have almost like 20 pills believe it or not.

00:17 So, this is really important to be conscious of and to get used to and practice in your lab setting or even your clinical setting with supervision.

00:26 So, what are we gonna need? First of all, of course, the medication and then a cup and maybe make sure the patient has a cup of water before you even go into the room or whatever they prefer.

00:38 So, here's a little pro tip for you.

00:40 Very common that we take one medication cup for a medicine, go to our patient room and oops, we dropped the med cup on the floor.

00:48 Well, always good to have some backups in your pocket when you're going into a patient's room.

00:53 So, now, when we go give medications, don't forget about those seven rights of medication administration.

01:01 We're gonna do this every single time before every patient each time.

01:06 So, once we perform those, we're gonna take the meds from the wrapper or the foil pack.

01:11 Believe it or not, this is a skill in itself and, so, this is a great practice piece in lab.

01:17 Alright, then, we're gonna take the cup and give it to the patient.

01:21 We're gonna allow them to swallow those meds as indicated.

01:24 So, here's something else to think about.

01:27 Some of your population, if you put the pills in the cup and hand it to them, some of your patients may have tremors for example or they may have poor eyesight and it's hard for them to see. So, please assess your patient and keep this in mind.

01:41 So, sometimes, you may give them a pill and they may be shaky and they can lose the pill in their covers and it's really hard to find.

01:48 So, please help them and assist your patient appropriately.

01:52 Once the patient's able to get the meds, give them water to help with swallowing if it's indicated.

01:58 Now, this is where we have to be conscientious about checking our patient's orders.

02:03 Some patients can't swallow water safely because it's too thin and they can choke or otherwise known as aspirate on that.

02:11 So, we need to be diligent in checking.

02:14 Sometimes your patients may need thickened liquids for example or we may even need to crush the pills if that's appropriate.

02:22 Some patients for example, they just get stuck in the back of your throat.

02:25 So, sometimes they like pills and maybe a little bite of applesauce or if you're a really nice nurse, maybe a little bit of ice cream if that's okay.

02:33 So, just keep that in mind when you give oral medications.

02:37 Then, lastly, we wanna verify that that med's been swallowed.

02:41 It seems kind of silly but believe it or not, sometimes those meds can get stuck back in their cheek or the patient just has them around in their mouth and they haven't fully swallowed.

02:51 We wanna make sure we don't turn and the patient doesn't spit them out.

02:55 So, make sure the patient's able to swallow those completely and at this time, it's a great time to assess your patient's swallowing.

03:04 One last thing guys in regards to oral administration.

03:07 I want you to consider one more route. It's called sublingual.

03:11 So, you won't see this super common but a very common sublingual medication is called nitroglycerin.

03:18 So, what's special about this type? Now, sublingual medication is the type, typically a pill that's gonna go underneath the tongue and allow to be dissolved.

03:28 Key points with sublingual is we do not crush it and we don't chew it.

03:33 So, again, a sublingual medicine such as nitroglycerin, we use that med to treat chest pain for example.

03:40 We're gonna put that underneath the tongue, allow it to be dissolved for treatment for a patient.

03:46 Let's look at some things to consider with oral medication administration.

03:50 So, some things we don't do is don't forget to check those very important allergies and two patient identifiers.

03:57 We commonly overlook that some meds are going to interact with maybe foods or drink that the patient may use. Here's a great example.

04:07 Warfarin for example is a really common blood thinner that many patients are on for maybe an abnormal heart rhythm for example or an artificial heart valve.

04:17 So, if a patient's on Warfarin, it is definitely contraindicated with food like grapefruit for example or even alcohol.

04:24 So, the other things we want to consider which are do's with this type of medication administration is making sure with oral meds, we assess the patient's swallowing ability.

04:37 So, this is really important that we give oral meds to someone that can safely swallow them.

04:43 So, if you give meds to someone who has issues swallowing, if you do give those meds, you may see signs of aspiration for example, maybe choking when they do the meds or they swallow the meds and they start frequently coughing a lot, excessively.

05:00 That is a cue we may wanna stop giving those meds and consult the physician.

05:05 Lastly, don't forget about pharmacy. They're a great resource for us as a nurse.

05:10 So, some medications may need to be crushed because of the patient's swallowing ability or other reasons.

05:17 Now, the problem with that is some medications, it is not appropriate or safe to crush that med.

05:23 So, we wanna check with our pharmacist.

05:25 Here's a great example of those type of drugs that we do not wanna crush.

05:30 So, anything that says "controlled release" or CR, anything that says "extended release" or ER on the end of that drug name or anything that you see is SR is "sustained release", you do not want to crush those drugs. Now, why is that? So, the reason why that is, if I crush that type of drug that's meant for slow release, when I take it orally, it's already crushed, it's going to hit our bloodstream, it's going to give way too much drug at once and that is essentially overdosing our patient.

06:06 That is not what is meant to be therapeutic for that patient.

06:10 So, why those drugs are so important when we take them orally, they are meant to go down our digestive track, go through our GI system and absorb and slowly release appropriately and safely for our patient and it gives us the best medication effect.