copyright © 2010 delmar, cengage learning. all rights reserved. chapter 36 calculation of...

Chapter 36

Calculation of Medication Dosage

and Medication Administration

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

• The medication order– Given by provider

• The prescription– Written legal document that gives directions for

compounding, dispensing, and administering medication to patient

– Eight parts

• The prescription– Two types of medicines

• Prescription

• Over-the-counter (OTC)

– Prescriptions for controlled substances

– Approved prescription abbreviations and symbols

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

• Weights and measures– Metric system guidelines

– The seven common metric prefixes• Micro-

• Milli-

• Centi-

• Deci-

• Deka-

• Hecto-

• Kilo-

• Weights and measures– Fundamental units

– Household measurements

– Metric system conversion• Proportional method for converting metric equivalents

• Moving the decimal in the correct direction

Medications Measured in Units

• How to calculate unit dosages– Proportional method

– Formula method

• Insulin– Individualized needs and treatment

• 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

• Importance of exact dosage

• Precautions to observe when administering insulin

• Expressing the weight of medication

• Expressing the volume of medication

Calculating Adult Dosages

• The proportional method

• The formula method

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

Calculating Children’s Dosages

• By kilogram of body weight– Mathematical process

– Proportional method

Administration of Medications

• The “Six Rights” of proper drug administration

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• Medication errors– When a medication error occurs

– Standard procedure for reporting errors

• Patient assessment– Age

– Physical condition

– Body size

– Gender• Muscular build

• Skin texture

• Injection sites to avoid

Administration of Oral Medications

• Equipment and supplies for oral medications

Administration ofParenteral Medications

• Parenteral routes– Subcutaneous

– Intramuscular

– Intradermal

• Multiple dose form

• Unit dose forms

• 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

• 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

Parenteral Equipment and Supplies

• Syringes– Disposable syringes

– Non-disposable syringes

– Combination disposable and non-disposable cartridge-injection syringes

Parts of a Syringe

Parts of a Needle

• Safe disposal of needles and syringes– Sharps containers

– Needlesticks

Principles of Intravenous Therapy

• Patient needs and conditions

• Patient safety• Types of solutions• Legal aspects

Basic IV

Administration

Set >>

Site Selection for Injections

Injection Angles

Site Selection and Injection Angle

• Marking the correct site for intramuscular injection– Dorsogluteal site

– Ventrogluteal site

– Deltoid muscle

– Vastus lateralis site

Basic Guidelines forAdministration of Injections

• Withdrawing medication– Withdrawing medication from a vial

– Withdrawing medication from an ampule

• Reconstituting a powder medication

• Administering subcutaneous, intramuscular, and intradermal injections

Z-track Method ofIntramuscular Injection

• Given to avoid irritation to subcutaneous tissues– Imferon is an example of a medication given by this

• Pull skin to side before inserting needle

Z-track Method ofIntramuscular Injection

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

Administration ofInhaled Medications

• Inhalation therapy– Inhaler may be used to administer medication to the

• Implications for patient care

Administration ofInhaled Medications

• Administration of oxygen– Hypoxemia

– Oxygen tanks

– Dosage

– Methods of oxygen delivery

• Oxygen safety precautions

copyright © 2010 delmar, cengage learning. all rights reserved. chapter 36 calculation of...

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