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Helping Your Family Member Adjust to Nursing Home Living-Tip #30

To ensure accurate and proper “med pass,” the nurse must adhere to the Ten Rights of Medication Administration. The fourth right, the right route requires a sharp nurse to recognize how and where the medication enters the body. The most common route medication enters the body is by mouth. Other routes include through the skin, eyes, ears, nose, lungs, rectal, vaginal or by a feeding tube in the stomach. Medication can be administered in the form of tablets, capsules, liquids, syrups, injections, intravenous/infusion, patches, creams, ointments, drops, inhalants, sprays and suppositories. Again, the nurse must complete the routine checks (tip #28) prior to administering any medication. The pharmacy is also responsible for recognizing route issues when reviewing the physician orders. If a resident who normally takes medication orally, develops an inability to swallow, the nurse must recognize the change in condition, hold medication, notify the physician and obtain further orders.  Mistakes can happen when a nurse gives several medications by different routes at the same time, such as ear drops and eye drops. Another common error can occur when a medicated patch is placed on the skin (frequently replaced once a day, to every three days, to weekly). Patches are commonly utilized for control of blood pressure or pain, and the old patch is typically removed when a new one is placed. If the nurse forgets to remove the old patch, additional medication would be absorbed through the skin which could lead to adverse consequences. These steps must be followed to ensure safe administration of the right route. This is basic training, usually taught to nursing students before they ever actually pass medication to residents. If there is any doubt about a medication that a nurse gives to your loved one, ask the nurse to confirm if it is the correct medication and/or if it was actually ordered.