Guidelines for Preparing Various Forms of Medication
| Guideline | Rationale | |
|---|---|---|
| 1 | Most agencies require that certain medications (e.g., heparin, insulin, IV digoxin) be checked by a second nurse during preparation. Check agency policy and procedure manuals for the full listing of these drugs. | Prevents error in preparation of drugs with potentially lethal effects |
| 2 | Do not open unit-dose packages in advance if dosages are exact (i.e., pills, oral liquids, and suppositories). Open just before administering. | Provides identifying drug information Prevents waste |
| 3 | Do not crush pills that are enteric coated and do not open pills that are in capsular form. Check with the pharmacy and doctor on alternatives for route administration. | Prevents client internal injury and/or severe effects—Many drugs are long acting and meant to be released over a period of time |
| 4 | When preparing topical, nasal, ophthalmic, and other boxed medications, remove medication from box and check labels of actual containers. | Prevents administration of wrong drug |
| 5 | If pouring pills from multiple-dose containers, pour pill into cap and then into medicine cup. | Maintains asepsis |
| Pour liquids with label facing palm of hand. | Prevents destruction of label | |
| Read amount of medication poured in medicine cups at bottom of meniscus (Fig. 5.1). | Measures liquid drug correctly | |
| 6 | Separate drugs requiring preassessment data, such as vital signs. | Prevents administration before vital sign assessment |
| 7 | When preparing any drug, check for expiration date. | Eliminates administering drugs that no longer have full therapeutic effect |
| 8 | Be aware of “Look Alike Sound Alike” drugs. Keep a list close by and be familiar with the list. Check drugs closely, identifying with generic and brand name. Be aware of the reason the client is taking the drug. | Prevents administration of the wrong drug to the client. |