Medication Assistance and Observation
Scope and concepts
In many settings, nursing assistants may assist with medications but may not administer them; know your scope of practice and follow facility policy. Key concepts include the "rights" of medication administration (right resident, drug, dose, route, time, documentation), observing for side effects, and reporting changes. Know common high-risk medications in older adults: anticoagulants, insulin, opioids, diuretics, and sedatives. Observe for bleeding, hypoglycemia, sedation, and dehydration.
Observation and documentation
Report side effects such as rash, confusion, dizziness, or gastrointestinal upset. Do not crush medications unless ordered. Do not leave medications at the bedside. Store medications securely and follow policy for controlled substances. If a resident refuses medication, report it rather than forcing.
Traps
A common trap is choosing to administer a medication when the aide's role is only to assist or remind. Another is crushing a medication that is extended-release. Questions may test whether you report a missed dose or a side effect rather than "wait and see." Also watch for answers that ignore the resident's right to refuse.
Worked example
A resident on a diuretic becomes confused and has low urine output. The correct action is to report these signs to the nurse; the wrong action is to give extra fluids without an order. Rule of thumb: observe, report, and document - do not adjust medications yourself.