ADMINISTERING ORAL MEDICATIONS

口服给药

Assessment

评估

1. Identify the drug(s) ordered: action, purpose, normal dosage and route, common side effects, time of onset and peak action, and nursing implications.

1、确认药物：作用、目的、正常剂量及给药途径、常见副作用、起效和药峰时间、和护理含意。

2. Assess for any contraindications to oral medication.

2、评估是否有口服禁忌。

3. Check allergies and replace any missing or faded identification bracelets.

3、检查过敏资料，补充遗失或替换退色的识别腕带。

4. Assess client's knowledge regarding medications.

4、评估病人的药物知识。

5. Assess client's preferences for fluids. Maintain fluid restrictions as prescribed.

5、评估病人液体喜好。按处方维持液体限制。

Implementation

实施

1. Use Standard Protocol.

1、按标准程序开始操作。

Preparing medications

准备药物

2. Compare medication administration record with scheduled medication list. If discrepancies exist, check against original physician orders.

2、对照用药记录与药物单。如有异议，应核对原始医嘱。

Nurse alert: Review five rights.

注意：药物“五对”。

3. Arrange cups in medication preparation area or move medication cart to position outside client's room.

3、在药物准备区备好杯子，或将药车推到病房外。

4. Unlock medicine drawer or cart.

4、打开药柜或药车。

5. Prepare medications for one client at a time.

5、准备药物，一次准备一个病人。

6. Select correct drug from stock supply or unit dose drawer. Compare label of medication with MAR or computer printout.

6、从备用药或单位剂量抽屉中选择所需药物。

7. Check drug dose. If label dose differs from ordered dose, calculate correct amount to give.

7、核对药物剂量。如标签剂量不同于医嘱剂量，应算出正确剂量。

8. To prepare unit dose tablets or capsules, place packaged tablet or capsule directly into medicine cup without removing wrapper.

8、准备单位剂量药片或胶囊时，直接将包装好的药片或胶囊放入药杯，无需除去包衣。

9. To prepare tablets or capsules from a floor stock bottle, pour required number into bottle cap and transfer medication to medication cup. Do not touch medication with fingers; return extra tablets or capsules to bottle.

9、从原料瓶准备药片或胶囊时，将所需药物倒入瓶盖，再转到药杯，勿使手指触碰药品。将剩余药片或胶囊倒回药瓶。

10. Check the expiration date of each drug. Return all outdated drugs to pharmacy.

10、核对每种药物的有效期。将过期药品退还药房。

11. Place all tablets or capsules requiring preadministration assessments (e.g., pulse rate, blood pressure) in a separate cup.

11、单独放置需要进行药前评估的药品（如脉率、血压)。

12. Medications that need to be broken in order to administer half the dose can be broken using a gloved hand or cut with a cutting device.

12、需切半服用的药物可带手套用手掰开或用刀具切开。

13. When preparing liquids, thoroughly mix before administering. Check and discard medications that are cloudy or have changed color:

13、药液：用前需摇匀。检查并弃用混浊或变色药品。

• Place cap upside down while pouring.
• Hold label against palm of hand while pouring.
• Place medication cup at eye level and fill to desired level.
• Wipe lip of bottle with paper towel.
• If client has difficulty swallowing, use a mortar and pestle to grind pills or a pill-crushing device. Mix ground tablet in small amount of soft food.

• 倒药液时将盖底朝上。
• 倒药液时手心贴住标签。
• 药杯与眼同高，倒药液至所需刻度处。
• 用纸巾擦净瓶口。
• 如病人吞药有困难，可用药臼或碎药器研碎药片。用少量软食混合药末。

14. If giving less than 5 ml of liquids, prepare medication in a sterile syringe without a needle.

14、如所给药液少于5毫升，备药时可使用无针头注射器。

Nurse Alert: EC or SR tablets may be available in liquid or suppository form. Crushing alters absorption rate.

注意：肠衣片或缓释制剂有液剂和栓剂两种，研碎后可改变吸收率。

15. Narcotic preparation. Check narcotic record for previous drug count and compare with supply available.

15、麻醉药品。核对用药记录，检查以前 用药数量及可用药品。

16. Sign out narcotics according to agency policy.

16、根据医院规定登记麻醉药品使用情况。

Administering medications

发药

17. Take medications to client within 30 minutes before or after scheduled time. 医学 全在.线提供www.med126.com

17、在预定给药时间30min内携药品至病人床前。

18. Identify client.

18、确认病人。

19. Perform necessary preadministration assessment for specific medications.

19、实施特定药品的用前评估。

20. Discuss the purpose of each medication and its action with client. Allow client to ask any questions about drugs.

20、与病人讨论每种药品的用药目的及其作用。允许病人询问药品相关问题。

21. Assist client to sitting or side-lying position.

21、协助病人取坐位或侧卧位。

Nurse Alert: Check ability to swallow if appropriate.

注意：检查吞药能力。

22. Administer drugs properly:

22、正确给药：

• Client may wish to hold solid medications in hand or cup before placing in mouth.
• If client is unable to hold medications, place medication cup to the lips and gently introduce each drug into the mouth, one at a time. Do not rush.
• Offer water or juice to help client swallow medications. Give cold carbonated water if available and not contraindicated.

Nurse Alert: Decide on sequence of administration.

• For sublingual-administered drugs, have client place medication under tongue and allow it to dissolve completely. Caution client against swallowing tablet.
• For buccal-administered drugs, have client place medication in mouth against mucous membranes of the cheek until it dissolves.
• Mix powdered medications with liquids at bedside and give to client to drink.
• Caution client against chewing or swallowing lozenges.
• Give effervescent powders and tablets immediately after dissolving.

• 病人可能会在药品入口前将固体药放在手里或杯中。
• 如病人无法持药，可将药杯放在病人唇边，轻轻将药片喂进嘴里，一次一片。不要催促。
• 提供水或果汁帮助病人吞药。如无禁忌，也可用碳酸水送服。

注意：确定给药顺序。

• 服舌下药时，应让病人将药放于舌头下待其完全溶化。提醒病人不能吞药。
• 颊部给药时，应让病人将其放入口腔贴在面颊粘膜直至溶化。
• 粉剂可在床边用液体混合后给病人服用。
• 提醒病人不能咀嚼或吞咽锭剂。
• 腾粉剂和片剂应在溶解后立即服用。

23. Stay until client has completely swallowed each medication. If concerned about ability or willingness to swallow, ask client to open mouth and inspect for presence of medication.

23、确认病人服下全部药物后方可离开。如担心病人吞咽能力或不愿意吞咽药物，应要求病人张嘴检查口腔内是否存有药物。

24. For certain medications that should not be given on an empty stomach, offer client nonfat snack.

24、有些药物不能空腹服用，服用时应向病人提供非脂肪食物。

25. Replenish stock such as cups and straws, return cart to medicine room, and clean work area.

25、补充备用品，如药杯和吸管。推车返回药房，清洁工作区。

26. Use Completion Protocol.

26、按标准程序完成操作。

Evaluation

评价

1. Return within appropriate time to determine client's response to medications.

1、及时返回病房确定病人对药物的反应。

2. Evaluate client's learning needs.

2、评价病人学习需要。

3. Identify Unexpected Outcomes and Nursing Interventions

3、确认意外结果和护理措施。

Record and Report

记录和报告

1. Actual time given and signature according to agency policy.

1、按医院规定登记实际给药时间及签名。

2. Drugs withheld and reason.

2、停用药物及理由。

3. Adverse effects/client response.

3、不利效应及病人反应。