Eight Rights of Medication Administration - Archer NCLEX Review

welcome everyone this video will cover

the fundamental topic of the eight

rights of medication administration I

know this information is very basic but

it is pertinent here and clicks exam you

will certainly have questions with these

topics embedded in them so let's get

started the first right is the right

patient this means that first and

foremost you must verify your patient's

name using to identify errs this could

be their name and medical record number

that's the most common combination you

also need to check their name on the

order for the medication and their

identification band usually on their

wrist that band has to be attached

directly to them not sitting on the

keyboard or attached to the bed but

attached directly to the patient you

also need the patient to identify

themselves by setting their name and

birth date if they're able to obviously

if somebody is in a coma

they are not conscious or maybe not in

the right state of mind this wouldn't be

appropriate but for most patients have

them state their name and birthday check

their band attached to their wrist and

verify their mrn okay our second right

is the right medication you will need to

verify the name of the medication check

the medication that label and check the

order be very cautious of any look-alike

sound-alike medications as with those

long generic names it can be quite easy

to confuse two medications that look


so just remember for the right

medication to verify the name the check

the label of the medication and of

course compare all of that to the order

our third right is the right dose you

need to verify the dosage written in the

order and then you need to make sure

that that dosage is actually appropriate

for your patient so find a current drug

reference find the safe dosage range

remember this can be different with age

geriatric patients don't clear drugs

quite as quickly so they may need a

smaller dosage and same thing with

Pediatrics we always verify a pediatric

patient dose

way in kilograms to make sure that the

medication they are receiving is within

a safe dosage range remember also that

patients with renal insufficiency may

need lower doses because their kidneys

are not as effective in clearing the

drug from their system so you need to

calculate this dose check that it is

correct and have another nurse calculate

the dose independently to double-check

you're both getting the same answer this

means that the dose is appropriate per a

current drug reference and that the

milligrams are correct for the number of

milliliters you're administrating or

whatever the case may be so that is

right dose fourth we have our right

route you need to check the order for

the route that is ordered how the doctor

wants you to give this medication then

you need to ask yourself is it safe to

give the medication this way and can the

medication be given this way to this

patient for example do you have a

patient who's at major risk for

aspiration but the provider has ordered

a lot of Pio medications per mouth or

are they ordering IV medications and you

don't have IV access those are two

routes that would not work in that

situation also remember that dosage can

depend on the route so your previous

right the right dose will depend on this

right the right route next we have right

time you need to confirm that you are

administering the medication at the time

it is ordered but you also need to

verify the frequency with which you're

giving that medication for example do

they have IV Tylenol ordered every four

hours just because you're giving that

dose at noon when it is ordered it may

be too frequent for our example here

with acetaminophen or Tylenol if you're

giving that dose of Tylenol a thousand

milligrams at noon and it's ordered at


q four well yes it's ordered at noon

you're giving it at the right time but

if you're gonna continue giving that q

four after a whole day

they would get 6,000 milligrams of

acetaminophen far more than the maximum

recommended dose of four grams or 4,000

milligrams so verifying the frequency is

just as important to making sure that

the dose is being given at the ordered

time you also want to double-check what

time the last dose of the medication was

given because if it was given late you

might need to adjust the time you're

giving this medication to make sure the

frequency remains safe and that you're

not giving it too close together all

right six we have our right

documentation I know you've heard this

before if it wasn't documented it wasn't

done this four means four medication

administration if you don't chart in

your MA are that you give that the team

will think the patient did not get that

medication and they might change dosage

or something depending on your actions

so you need to document these following

components the time you give the Med the

route it is ministered and any pertinent

vital signs so for route if you used an

IV document the access if you gave them

an injection what site did you use for

vital signs this is common sense

any thing that you're looking to change

and give a certain response to the

patient a before and after needs

documented so for this example

antihypertensives we need to document a

blood pressure also a side note you

should never ever pre chart medication

administration you never know what's

gonna happen that patient could throw up

the medication the IV that you're

supposed to be giving it in maybe went

bad and it's not working maybe the

patient or the family refuses you simply

don't know until that medication is

successfully administered what is going

to happen so don't ever preach art next

up we have the right reason I think this

is pretty self-explanatory but before

administering any medication you need to

always ask yourself why the patient

needs this medication look through their

history what conditions they have and

what the indications for this medication

are also is this an older

patient or a patient with a chronic

condition that has many many medications

or all of these medications still

indicated just some of them have

potential side effects when given

together or synergistic effects where

the dosages may need to be altered you

as the nurse are the primary patient

advocate so take the time to think

through these situations and raise

questions to the providers if it seems

like something is out of whack or

there's not a good indication for giving

this medication last but not least we

have right response so you have verified

your patient the medication the dose the

route the time the documentation you

gave the drug for the right reason now

you need to monitor the patient to

verify that they have the response you

are expecting so did that

antihypertensive lower the blood

pressure did your potassium supplement

increase their potassium level whatever

vital sign or lab value you're trying to

affect you need to watch it

and document document all of your

monitoring follow-up those lab values

take your vital signs and document them

show that your medication has had the

right response and if it hasn't contact

your health care provider

all right let's wrap things up with one

NCLEX question which of the following

fall under the right dose for the eight

rights of medication administration

select all that apply a using a drug

reference to verify the dose ordered is

appropriate B identifying the patient

using two separate identifiers C having

a second nurse and dependently calculate

the medication dosage or D double

checking the last time the medication

was administered

the correct answer was a and C a is

correct using a drug reference to verify

the dose ordered is appropriate is a

part of the right dose check in the

eight writes of medication

administration the nurse should always

verify that this dose is appropriate by

checking a current drug reference for

the medication and verifying what is

ordered is in the safe range and

remember this can be different for

different patient populations B it was

an incorrect answer because identifying

the patient using two separate

identifiers falls under the right

patient part of the right eight rights

of medication administration C was

correct having a nurse independently

calculate the medication dose a second

nurse is an important part of verifying

the right dose and D was incorrect

double-checking the last time the

medication was administered is a part of

the right time and staff so as you can

see these are fairly straightforward you

should be able to get these questions

right no problem as long as you review

what the rights are and kind of know how

to put them into practice let us know if

you have any questions about this though

and as always good luck with your