The Nursing Process and
Medication Administration
Assessing the patient is the first step in administering medication. This might
seem unusual because the prescriber—prior to writing the prescription for the
medication—has already assessed the patient. However, the patient’s condition
can change between the prescriber’s assessment and the time the medication
is administered. Assessing the patient also provides a baseline from which
you can compare the patient’s reaction to the medication after administering
the medication.
The assessment is divided into two areas. First is a general assessment that is
necessary for every medication. Then there is an assessment that is required for
specific drugs. The general assessment must determine:- Is the therapeutic action of the drug proper for the patient?
This, too, appears unusual since the prescriber has already made this
determination. However, the nurse is responsible to independently verify that the
drug is proper for the patient. You do this by reading the patient’s diagnosis in
the patient’s chart and looking up the medication in the drug manual where it
will state the approved use of the drug.
If the drug isn’t used for the patient’s condition, then the nurse should con-
tact the prescriber. Nurses may not administer drugs that are being used for pur-
poses other than those approved by the FDA. It is important to realize that in
some situations, the prescriber will be using the drug for a secondary thera-
peutic effect that addresses the patient’s condition which is acceptable if that
purpose is FDA approved. - Is the route proper for the patient?
Some drugs can be administered using more than one route. Although the
prescriber specifies a route in the medication order, the patient’s current condi-
tion might indicate a different route is appropriate.
For example, the prescriber might order antibiotics PO. However, the
patient might have a very high fever that needs immediate relief by adminis-
tering antibiotics IV. In another situation, the patient might be experiencing
stomach pains and vomiting, which is a clear indication that PO isn’t the
desired route. If the route is no longer appropriate, then the nurse should con-
tact the prescriber and obtain an order to use an alternate route that is appro-
priate for the patient’s condition.
(^82) CHAPTER 5 Medication Administration