Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 5-5

Mixing Medications From Two Vials in

One Syringe

Goal:The proper dosage of medication is withdrawn into a

syringe using sterile technique. Comments

1. Gather equipment. Check medication order against the
   original order in the medical record, according to facility
   policy.


2. Know the actions, special nursing considerations, safe dose
   ranges, purpose of administration, and adverse effects of
   the medications to be administered. Consider the appropri-
   ateness of the medication for this patient.


3. Perform hand hygiene.


4. Move the medication cart to the outside of the patient’s
   room or prepare for administration in the medication area.


5. Unlock the medication cart or drawer. Enter pass code and
   scan employee identification, if required.
   6.Prepare medications for one patient at a time.


6. Read the CMAR/MAR and select the proper medications
   from the patient’s medication drawer or unit stock.


7. Compare the labels with the CMAR/MAR. Check expira-
   tion dates and perform calculations, if necessary. Scan the
   bar code on the package, if required.


8. If necessary, remove the cap that protects the rubber stop-
   per on each vial.
   10.If medication is a suspension (e.g., NPH insulin), roll and
   agitate the vial to mix it well.


9. Cleanse the rubber tops with antimicrobial swabs.


10. Remove cap from needle by pulling it straight off. Touch
    the plunger at the knob only. Draw back an amount of air
    into the syringe that is equal to the dose of modified
    insulin to be withdrawn.


11. Hold the modified vial on a flat surface. Pierce the rubber
    stopper in the center with the needle tip and inject the
    measured air into the space above the solution. Do not
    inject air into the solution. Withdraw the needle.


12. Draw back an amount of air into the syringe that is equal
    to the dose of unmodified insulin to be withdrawn.

ExcellentSatisfactoryNeeds Practice