Oral Medication Administration at the Bedside: Special Considerations (Nursing)

00:04 I wanna take a special look at administering meds directly at the bedside.

00:09 So, why are we even talking about this? There's lots of little caveats I wanna talk to you about today that will make your practice a lot more efficient.

00:17 So, I've already entered my room and I'm already here.

00:20 So, don't forget the first thing, after I've introduced myself, make sure you do those two patient identifiers.

00:27 Guys, I can't stress this enough.

00:28 There can be lots of John Smith's throughout the hospital.

00:32 I need to make sure I've got the right patient with including their name and their date of birth.

00:37 And your patient can verbalize this.

00:39 So, what happens if my patient can't tell me their name and date of birth? Well, we have options. We can look at the patient's bracelet for example.

00:48 Sometimes, we can also rely on if a spouse or a family member or a partner's at the bedside, we can check with that individual as well and make sure that this is the right patient with the right date of birth.

01:02 So, sometimes, those little things will come up. Next, don't forget about allergies.

01:06 Now, sometimes, patients have a lot of those but really important to slow down and make sure we check these when we give our patients our medications.

01:16 This is such a common issue that can happen in the hospital.

01:20 So, check the allergies of the patient and make sure the meds you're giving are not going to interact with that.

01:27 Alright, so, we've talked about identifiers. We've talked about allergies.

01:31 So, one other thing as a nursing student, this is where that teaching and critical thinking comes in.

01:38 Let me give you a scenario. Let's say you walk into a patient room.

01:42 We've identified, done our allergies and I've gotta give them a blood, excuse me, a blood pressure lowering medication.

01:50 So, what's very important that we check? Guys, vital signs, right? A blood pressure.

01:56 So, if I give a medicine to lower blood pressure without checking their vital sign, hey, what can happen to a patient, right? This can be really poor outcomes.

02:06 So, now, as a nursing student, I need to assess my meds, look at what type of meds I give and do I need to check any lab values maybe or a set of vital signs before we administer? This is definitely gonna help you evaluate later and also promote safety in your patient.

02:25 Alright, so, once we've checked all of those values, now, we're gonna actually administer the medications.

02:31 So, this may seem a little silly to you but a little method I like to use when I go give medications at the bedside. So, let's say we have multiple meds.

02:39 To me, it's very important to remember those rights of medications.

02:44 So, anytime I talk to a patient, they absolutely know what they're getting.

02:48 Here's a great example. So, I'll start off with my meds.

02:53 Please note that I've got my pill cup here. They're in their package.

02:58 I'm gonna say, "Hey, Mr. Jones, I just wanna let you know, I've got your acetaminophen, 500 milligrams.

03:05 This is for your back pain." So, notice what I just told him there.

03:09 I told him the name of the drug, the dose, and what it's for.

03:14 So, this is covering some of your rights of medication administration.

03:18 One thing that we underestimate is talking about, "Hey, this is the med, this is the dose that's so important and this is what it's for." I'll give you a great example of why dose for instance is so important.

03:33 Some medications can be given at very high milligrams or maybe even three times a day.

03:40 If a patient's on that med and we're not giving enough, we cannot be giving the patient a therapeutic response for that or what if we go in and say, "Mr. Jones, this is 500 milligrams." And he says, "Whoa, wait a minute, that's -- I take 250 milligrams at home." As a nurse, we need to communicate with our patient, pause, check our medication records and listen to our patient. Sometimes your medication or, excuse me, your patient can be the key to save you from a medication error.

04:13 Not only that, explaining the med, the dose, and what it's for, this is gonna increase compliance with medication with your patients.

04:23 So, once we've discussed what the pills are for, we're gonna open these.

04:27 So, these can be very tricky.

04:30 So, when we go to open meds, I'm gonna move these aside here, we go to open meds, every type of med, I don't know why, is packaged a little bit differently.

04:41 Some are super easy. You can just tear but lots of these are gonna come in like a foil pack like this.

04:47 So, something to consider and this is a great time for lab practice to get used to these or clinical.

04:53 So, when you go to give meds like these in a pill pack, it's really good of why I put on gloves.

04:59 For whatever reason, if I'm having a hard time getting that pill out, I can touch it with my hands without touching it with my skin.

05:07 So, let's say I'm gonna come open this pill.

05:09 So, when I go to open this pill, Notice I'm putting my thumb and I'm pushing down and popping that thing out. Now, see, this one? This is a great example for you to see.

05:21 Some meds will pop right out and it's easy but some, it's really hard to do that.

05:26 So, if you will look at the side, notice how this will peel away the foil from the package.

05:36 This is also helpful to know. So, every package is a little bit different.

05:40 So, now, I'm gonna peel this open and notice where it's above my cup.

05:45 I don't have my med way high to where if it drops out, it bounces and hits the floor.

05:50 We don't want that. So, this, I'm just gonna push it out and it's very close to my med cup and not up here.

05:58 So, keep that in mind when you give meds. I like to explain to the patient what it is, the dose, and what it's for. So, let's say we're doing that and we've gone through our pills and the patient says, "Oh, no, hold on, I don't want that. I've already taken that today." for example.

06:16 The patient always has a right to refuse their meds.

06:19 So, this is why I never open the pills until I've explained them to the patient.

06:26 So, what I like to do is I like to take that unopened pill and place it very much away from the pills that I'm going to administer.

06:34 So, just a little tip for you.

06:36 The other thing I want you to consider, it's up to you but I typically give the less invasive meds first.

06:44 So, typically, I like to give the oral meds and then, maybe if I have to give injection, I'll do that for last.