2.4 Medication Administration (PART 3)

Question 1

Oral Administration

Answer 1

• Preferred method
• If medication says empty stomach allow at least 30 minutes before or after feeding
• Risk of drug interactions are higher with this method
• Check expiration date
• Check patient allergies
• Check with physician about certain drugs if a patient is NPO (Nothing by mouth). Sometimes can still be taken, sometimes needs to be held.

Question 2

Forms of Solid Medications

Answer 2

Tablets - Powdered molded into shapes
Scored Tablets - Pill with marks that can be split 1/2
Caplets - Tablets with coating to ease swallowing
Enteric-Coated Tablets - Special coating that protects against gastric secretions. Do not CRUSH or CHEW
Sublingual Tablets - Placed under tongue, do not swallow.

Question 3

Forms of Solid Medications (cont)

Answer 3

Buccal Tablets - Paced between gums and cheeks. Do not swallow
Layered Tablets - 2 medications with different compounds
Capsules - Contain powder or liquid, do not crush, chew, or break without pharmacist consultation.

Question 4

Administration of Solid Medications

Answer 4

Pills/Capsules - Most Common

Enteric Coatings are absorbed more slow or not broken down until they reach stomach. (do not crush)

Question 5

Measuring Oral Medication

Answer 5

Standard calibrated measuring cup
(Capacity of 30mL-1floz) - Read at level of meniscus
Calibrated Droppers and syringes
(tsp/mL) - Used to administer to eyes, ears, nose, and oral (pediatric). Pour medication into cup than syringe. Do not use for parental meds. Used for accuracy

Question 6

Measuring Oral Medications (cont)

Answer 6

• Shake liquid thoroughly before pouring.

- Do not dilute liquid cough medicines.

Question 7

Administering Oral Medications

Answer 7

• Administered via Cup/Syringe (child)
• Place syringe in cheek of child in small amounts
• Make sure to use correct syringe
• Mark syringe with permanent marker to help parents know how much to administer

Question 8

Administering Oral Medications

Answer 8

• Administered via Cup/Syringe (child)
• Place syringe in cheek of child in small amounts
• Make sure to use correct syringe
• Mark syringe with permanent marker to help parents know how much to administer

Question 9

Administer Inhalation Medication

Answer 9

• Pressurized Meter-Dose Inhalers(MDI) spray medication that reach lungs. Patient needs sufficient hand strength and coordination to push button.
• Breath Actuated Meter-Dose Inhalers (BAIs) Use dry powder into lungs. Activated by breath.
• Dry Powder Inhalers (DPI) Activated by breath and must be breathed deeply
• Make sure to rinse teeth after use.

Question 10

Topical Drugs

Answer 10

• Applied to skin
• Wear gloves
• Clean skin if it is an adhesive
• Use sterile techniques if patient has open wound

Question 11

Transdermal Patch

Answer 11

• Remove old patch then apply new one
• Document location of new patch
• Apply label if difficult to see
• Document removing patch

Question 12

Administering Medications via Irrigation

Answer 12

• Cleanse area or instill medication.
• Most commonly is sterile water, saline, or antiseptic solutions.
• Use aseptic techniques if there is break in skin.

Question 13

Nasal Instillation

Answer 13

• Sprays, drops, or tampon
• Patient may need to sniff
• Provide tissue
• Avoid blowing nose

Question 14

Nasogastric Route

Answer 14

• Through nose and extended to stomach
• For patients who cannot swallow
• Meds must be crushed or liquified.
• Flush medicine with at least 30mL of warm water

Question 15

Eye Instillation

Answer 15

• Pulldown lower eye sac and apply in sac.
• Gently apply pressure for a minute
• Use gloves
• Avoid cornea
• Avoid eye lids with dropper or tubes
• Do not share

Question 16

Ear Instillation

Answer 16

• Make sure ear canal is straight. Different age different angle
• Rest on unaffected side for 15 minutes
• Do not drop directly into ear canal
• Use sterile solutions. Check for eardrum rupture if there is ear drainage. Never occlude ear canal

Question 17

Vaginal Instillation

Answer 17

• Cream, tablet, or suppository inserted using applicator or finger.
• Administered at bedtime so patient is lateral and sleeping (for meds to work)
• Advise patient it will be expelled when she stands up.
• Separate labia majora and minora at the introitus to ease insertion.

Question 18

Rectal Instillation

Answer 18

• Suppository or Cream
• Separate buttocks
• Use lubricant
• Insert suppositories 1 and a half inches using finger.
• Cream you can use applicator

Question 19

Neonatal considerations

Answer 19

• Offer popsicles to numb taste buds
• Mix with teaspoon of fruit puree, ice-cream, or syrup
• Pinch nostrils closed and drink through straw
• Distract child with conversation or toy
• Use decorative bandages

Question 20

Starting IV

Answer 20

• Attach IV Tubing, Open Roller Clamp, and begin Infusion
• Tape IV down “H technique”
• Cover IV site with Tegaderm
• ## Label IV with date, time and initials, then secure with last piece of tape

Question 21

Intradermal Injection

Answer 21

• Very shallow, right underneath skin
• Very small gauge
• The lower the gauge the thicker the needle
  “Bleb” - Raised area under skin filled with medication
• Equalize pressure in medicine vile by pushing amount of air into vile with needle then flip over and fill syringe.
• Introduce needle at 10 degrees to skin and only far enough to cover the slanted bevel (tip of needle) under the skin. Also bevel must be pointed up (where medication comes out of)

Question 22

Subcutaneous Injection

Answer 22

• Insulin syringe has orange cap and only to be used for insulin.
• Insulin syringes are in units not mL (also cc)
• 45 degree angle. Those with little subcutaneous tissue, pinch skin up, those with a lot use 90 degrees.

Question 23

Intramuscular Injections

Answer 23

• Use Filter Needle for Ampule Containers to draw med
• Change Filter Needle to Patient Needle after drawing
• IM Injection uses 1 - 1-1/2 size needle. 5/8 for children
• Goes in at 90 degree angle

Question 24

How to Reconstitute powdered medication

Given mostly via IV

Answer 24

• Use saline solution and inject saline into vile of medication. If you hit resistance while injecting saline, pull up on syringe to let some air out then keep plunging
• Y Connector is usually at the end of an IV
• Roll vile between hands to reconstitute (gently)
• Clean IV port, check IV is still where it needs to be, then flush IV with saline solution.
• Then Inject medication
• After injecting medication flush again with saline.