; rectal
Learning Center
Plans & pricing Sign in
Sign Out
Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>



  • pg 1
School staff___________________________      Date_______________________

School nurse/Trainer____________________

SKILL                                +   -     COMMENTS
State name and purpose of
Identify the student & the
student medication record.
Identify all medications to be
Identify the medication(s) to be
given at this time.
Identify the amount of
medication to be given.
Check if order is current.
Check for any allergies.
Check for special instructions
regarding administration.
Identify type of medication.
Determine if the dose for this
time period has not been given.
During entire procedure respect
student’s privacy.
Read entire name and dose of
medication to be given for this
student at this time.
Obtain the medication from the
secure storage area.
Check the expiration date on the
label of package or container and
read the label carefully.
Place the bottle or container by
the name of the drug on the
medication record and be positive
the label on the container and the
medication record coincide.
If they do not coincide, do not
give the medication until there
has been clarification regarding
medication. Contact the LSN/RN

Rectal                                                                 1
immediately, explain the situation
and seek clarification. If no
LSN/RN; clarification should be
sought according to school policy.
Identify student to receive the
medicine. Call the student by
name and check with picture ID if
Explain to the student you are
giving his/her medication for that
specific time. Know what the
student is taking the medication
for. Ask student about any side
effects of the medication.
Explain the procedure to the
Position the student on his or her
left side unless contra-indicted.
Wash hands.
Put on gloves.
Prepare medications for insertion
according to directions and
individual student health plan.
Report any unusual student
complaints or observations.
Slowly insert the medication into
the rectum well beyond the
muscle at the opening
(sphincter), pushing gently.
Leave the student in a
comfortable position lying down
for about 15 minutes and
supervise as indicated following
observation of the results.
Remove gloves and dispose of
other materials according to
school policy.
Wash hands.
Documentation &
Document in ink.
Document appropriately for the
specific hour and date, this
indicates you have given the
medication for that time.
(medication given, the dose or
amount given, results of the
medication application after the

Rectal                               2
prescribed length of time).
Note and document unusual
complaints and action taken.
Note and document results
achieved by giving the medication
after the prescribed length of
Write initials, full name, and title
in space provided for signatures.
Wash hands before contact with
another student.
Report any problems or concerns
to the School Nurse.

Note: Long fingernails may interfere with or make it difficult to administer medications
properly and interfere with cleanliness.

Additional comments:

Evaluation results (check and provide information as appropriate):

Successfully completed skill checklist: ____

Needs to review and repeat: ____

         Areas that need review:

Date of next review: ____________________________

School Staff Signature______________________________________________

School Nurse/Trainer Signature_______________________________________

Rectal                                                                                     3

To top