This high-yield episode of Think Like a Nurse tackles the single most tested concept in nursing pharmacology — medication administration and safety. Brooke Wallace and the team break down the Six Rights every nurse must know (right patient, medication, dose, route, time, and documentation), plus modern additions like the right to refuse and right reason. You’ll learn the “IO Anticoagulants Potassium Dig” mnemonic for remembering high-alert drugs — insulin, opioids, anticoagulants, IV potassium, and digoxin — and how to prevent the medication errors that most often appear on the NCLEX. We also cover real-world safety pearls, like the two-second scan to prevent bedside errors and critical hold parameters for digoxin and warfarin. Finish strong with a practice NCLEX question to test your mastery and apply what you’ve learned.
Topic: Medication Administration and Safety for nursing students
Why It Matters:
The pharmacological and parenteral therapies category makes up 12–18% of the NCLEX-RN, and safety principles appear throughout the exam.
Safe med administration is the foundation of every pharmacology question — mastering it means mastering NCLEX logic.
Core Concepts:
The Six Rights:
Right Patient
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
The Two-Second Scan:
Pause before giving a med. Check the wristband, MAR, and drug label consciously to prevent bedside errors.
High-Alert Drugs — “IO Anticoagulants Potassium Dig” Mnemonic:
I – Insulin
O – Opioids (morphine, fentanyl)
Anticoagulants – Heparin, Warfarin
Potassium – IV Potassium Chloride
Dig – Digoxin
High-Alert Safety Pearls:
Always use an independent double-check for insulin and IV potassium.
Never pre-label syringes or walk away from unlabeled meds.
Clarify unclear orders — safety over hierarchy.
Hold parameters:
Digoxin: Hold if apical pulse <60 (adult).
Warfarin: Hold if INR above therapeutic range.
No aspiration for subcutaneous heparin — prevents bruising and hematoma.
Practice NCLEX Question:
A nurse is preparing to administer heparin subcutaneously to a client. Which action indicates a need for further teaching?
A. Verifying client identity using two identifiers
B. Checking the medication label against the MAR three times
C. Aspirating before injecting the medication ✅
D. Documenting administration immediately after giving
Rationale:
Aspirating before giving sub-Q heparin can cause tissue trauma and hematoma formation.
Nursing Pearls:
“High alert means high attention.”
The MAR is your legal record — document accurately, every time.
Safety trumps hierarchy: Always question unclear or unsafe orders.
Build habits: check, pause, verify.
Key Takeaway:
Safety is the heart of nursing pharmacology. Nail the Six Rights, know your high-alert drugs, and you’ll have a rock-solid foundation for both the NCLEX and real-world practice.