Chapter 14: Medication Administration and Intravenous Therapies

Students learn the metric system as the standard measurement framework in clinical settings, along with alternative systems occasionally encountered in practice, including milliequivalents and units as specialized dosing measures. The chapter emphasizes the critical role of nurses in verifying medication prescriptions for completeness and accuracy before administration, including verification of medication names, doses, routes, and frequencies. A cornerstone concept is adherence to the rights of medication administration, a comprehensive framework that extends beyond the traditionally taught five rights to encompass assessment, documentation, patient education, evaluation, and the patient's right to refuse treatment. For oral medications, the chapter distinguishes between tablet types, highlighting that enteric-coated and sustained-release formulations must never be crushed due to their specialized absorption mechanisms. Parenteral administration routes require precise technical knowledge including appropriate needle gauges, insertion angles, and volume limitations specific to intramuscular, subcutaneous, and intradermal injection sites. Students must master syringe selection based on medication type and dose precision requirements, with particular attention to insulin administration protocols and proper needle safety techniques. Dosage calculation competency is developed through multiple mathematical approaches including ratio and proportion, the standard formula, and dimensional analysis, with emphasis on appropriate rounding practices for different patient populations. The chapter concludes with intravenous therapy fundamentals, covering manual flow rate calculations using drop factors and macrodrip versus microdrip tubing selection, as well as specialized calculations for medications administered by continuous IV infusion such as heparin. Throughout all topics, patient safety remains paramount, with repeated emphasis on verification steps, red flags for unusual dosing orders, and monitoring for adverse effects related to medication administration.