Name: ________________________________________
Date: _________________________________________
Procedure 54-7:
Reconstituting a Powdered Medication for Administration
Objective: Reconstitute a powdered medication.
Equipment and Supplies: Alcohol wipe; disposable gloves; medication label; medication order
signed by physician; pen; sterile needle; sharps container; vial of medication and vial of diluent
Affective Behaviors: Affective behaviors provide a professional approach to a skill that enhances
the patient encounter. These behaviors may also display sensitivity to a patient’s rights and
enhance communication. Pay close attention to these skills, which will be in bold, italicized font.
Skills Assessment Requirements
Read and familiarize yourself with the procedure. Complete each procedure within a reasonable
amount of time, with a minimum of 85% accuracy.
Documentation
Use the area below for any documentation needed to complete the procedure.
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Name: ________________________________________
Date: _________________________________________
POINT VALUE
= 3–6 points
= 7–9 points
GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
1. Gather supplies, perform hand
hygiene, and apply gloves.
2. Select the correct medication
and diluent. As instructed in the
“three befores,” verify the dosage
against the physician’s order, and
calculate dosage if necessary.
3. Remove the top from the powder
medication and the top from the
diluent, then wipe the tops of both
vials with separate alcohol swabs.
4. Insert a sterile needle through
the rubber stopper on the vial of
diluent.
5. Withdraw the appropriate amount
of diluent and add to the powder
medication.
6. Remove the needle and syringe
unit from the medication vial and
discard the needle and syringe in
the sharps container.
7. To ensure that the medication is
mixed well, roll the vial between
the palms of your hands.
8. Label the mixed vial with
the strength of the prepared
medication, time and date, your
initials, and the expiration date.
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Name: ________________________________________
Date: _________________________________________
POINT VALUE
= 3–6 points
= 7–9 points
GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
GRADING
Points Earned
Points Possible 54 54
Percent Grade (Points Earned/
Points Possible)
PASS: YES
NO
N/A
YES
NO
N/A
Instructor Sign-O
Instructor: ______________________________________________ Date: _________________________
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