Administration of Medications : Administration of Medications Medication : Medication A substance administered for the diagnosis, cure, treatment, relief or prevention of disease. Types of Doctor’s Order: : Types of Doctor’s Order: Standing Order- it is carried out until the specified period of time or until it is discontinued by another order.
Single Order- it is carried out for one time only. Slide 4: Stat Order- it is carried out at once or immediately.
PRN Order- it is carried out as the patient requires. Principles in Administering Medications : Principles in Administering Medications Observe the “7 Rights” of drug administration.
Right time Slide 6: Right patient
Right Recording Slide 7: 2. Practice asepsis
3. Nurses who administer medications are responsible for their own actions. Question any order that you consider incorrect.
4. Be knowledgeable about medications that you administer. Slide 8: 5. keep narcotics and barbiturates in locked place.
6. Use only medications that are clearly labeled containers in.
7. Return liquid that are cloudy or have changed in color to the pharmacy. Slide 9: 8. Before administering a medication, identify the client correctly.
9. Do not leave the medications at the bedside.
10. If the client vomits after taking oral medication, report this to the nurse in charge and/or physician. Slide 10: 11. Pre-operative medications are usually discontinued during the post-operative period unless ordered to be continued.
12. When a medication is omitted for any reason, record the fact together with the reason.
13. When a medication error is made, report it immediately to the nurse in charge/or physician. Routes of Drug Administration. : Routes of Drug Administration. Oral Route
Forms: a) solid: tablet, capsule, pill, powder.
b) liquid: syrup, suspension, emulsion.
Enteric coated tablets should not be crushed before administration. Slide 12: Suspensions are never administered intravenously.
If the patient vomits within 20 – 30mins of taking the drugs, notify the physician. Do not readminister the drug without a physicians order. Slide 13: 2. Sublingual- drug placed under the tongue, where it dissolves.
3. Buccal- medication is held in the mouth against the mucous membranes. of the cheek until the drug dissolves. Slide 14: 4. Topical
a) Dermatologic- lotions, liniments, ointment, pastes and powders.
b) Ophthalmic- instillations and irrigations.
c) Otic Slide 15: d) Nasal
f) Vaginal- tablet, cream, jelly, foam, suppository
5. Rectal- (objectionable taste or odor) Slide 16: 6. Parenteral- administration of medications by needle.
a) Intradermal (ID)- under the epidermis (into the dermis).
b) subcutaneous (SC)- in the subcutaneous tissue (also, hypodermic) Slide 17: c) intramuscular (IM)- into the muscle.
d) intravenous (IV)- into a vein.
e) intraarterial- into an artery.
f) intraosseous- into the bone. Intradermal (ID) : Intradermal (ID) Intradermal (ID)- indicated for allergy and tuberculin testing and for vaccination.
- inner lower arm
*Left arm- for tuberculin test
* Right arm- for all other test Slide 19: Upper chest
Back, beneath the Scapula
What to observe?
- less hairy Needle gauge #
- less pigmented - #25,26,27
- less vascularized Needle length
- less keratinized - 3/8”, 5/8”,1/2” Slide 20: Angle- 10 to 15 degrees angle, bevel up
Inject a small amount of drug to form a wheal or bleb.
Do not massage the site of injection Subcutaneous (SC) : Subcutaneous (SC) Subcutaneous (SC)- drug administered subcutaneous are as follows:
= Vaccines, pre-operative medications, narcotics, insulin, heparin. Slide 22: SITES: - outer aspect of the upper arm
- anterior aspect of the thigh
- scapula areas of the upper back.
- upper ventrogluteal and dorsogluteal area. Slide 23: Needle angle- 45 degrees angle if 5/8” needle
-90 degree angle if ½” needle
(heparin and insulin) Intramuscular (IM)- ordered for the following reasons: : Intramuscular (IM)- ordered for the following reasons: Rapid absorption because of rich blood supply
Muscles can take a greater volume of fluid without discomfort ( adult can tolerate up to 3ml in large DG or VL muscles)
Medications that irritating may safely be given by intramuscular injection. Slide 25: Needle length- 1” , ½”, 2”, (3” if obese)
Needle gauge- 20, 21, 22 , 23
Ventogluteal site- uses gluteus minimus muscle.
Dorsogluteal site- use gluteus medius muscle. Slide 26: - not to be used for children <3 yrs. of age unless the child has been walking for 1 yr.
- avoid hitting the sciatic nerve Slide 27: 3. Vastus Lateralis Site- recommended site of injection for infants.
- located at the middle third of an anterior lateral aspect of the thigh..
4. Rectus Femoris Site- anterior aspect of the thigh. Slide 28: 5. Deltoid site-
Z-tract injection(variation) = for parenteral iron preparation.
- to seal the drug deep into the muscle.
- prevent permanent staining of the skin. Intravenous (IV) : Intravenous (IV) Intravenous (IV)- direct IV, IV push, IV infusion.
- most rapid route of absorption of medication.