Ch.33 Topical and Inhalants Medications (FON)

Question 1

Explain how topical medications are administered and commonly applied.

Answer 1

• Drugs given by the topical route (the administration of medications to the skin or mucous membranes) can be applied externally or internally.
• Topically applied drugs have a local or systemic effect.
• Many are administered to achieve a direct effect on the tissue to which they are applied.

Question 2

Identify forms of drugs applied by the transdermal route and principles to follow when applying a skin patch.

Answer 2

Skin patches and drug paste.

Transdermal patches are typically applied to the chest, buttocks, stomach, and upper arms.

The patch is marked with date and time of administration, and the location is documented in the medication administration record.

Each time a new patch is applied, it is placed in a slightly different location.

Clipping hairy skin areas before an application may help adhesion.

After initial application of a patch, it may take 30 minutes to 8 hours for the drug to reach a therapeutic level.

Question 3

Describe where eye medications are applied.

Answer 3

Ophthalmic medications are either supplied in liquid form and instilled as drops or applied as ointments along the lower lid margin.

Blinking, rather than rubbing, distributes the drug over the surface of the eye.

Question 4

Explain how the administration of ear medications differs for adults and children.

Answer 4

When administering ear medications for a child the nurse pulls the ear down and back with an adult the nurse pulls the ear up and back.

Question 5

Explain the rebound effect that accompanies the administration of nasal decongestants.

Answer 5

When topical nasal decongestants are used more frequently than recommended by a client.

The emergence or re-emergence of symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage.

Question 6

Describe the difference between sublingual and buccal administration.

Answer 6

Sublingual: A drug placed beneath the tongue.

Buccal Administration: A drug placed against the mucous membranes of the innercheck.

*During sublingual or buccal administration, the client is instructed not to chew or swallow the medication. Eating and smoking are also contraindicated during the brief time needed for a solid medication to dissolve.

Question 7

Name a common reason for vaginal applications.

Answer 7

Vaginal applications are used to treat vaginal infections.

Question 8

Give the form of medication used most often for rectal administration.

Answer 8

Suppositories

Question 9

Explain why inhalation is a good route for medication administration.

Answer 9

The inhalation route adminsters drugs to the lower airways, this is effective because the lungs provide an extensive area from which the circulatory system can quickly absorb the drug.

Question 10

Name types of inhalers and alternatives for administering inhaled medications.

Answer 10

Two types of inhalers are dry powder inhaler and metered dose inhaler.

A spacer and nebulizer are alternatives to inhalers.

Question 11

A(n) ____________ is a medication incorporated into an agent that is administered by rubbing it into the skin.

Answer 11

Inunction

Question 12

Drugs incorporated into patches or pastes are administered as ____________ applications.

Answer 12

Transdermal

Question 13

A(n) ____________ contains a drug within a thick base and is applied not rubbed, into the skin.

Answer 13

Paste

Question 14

Monitoring heart rate and blood pressure of older adults who use inhaled ____________ is important because these medications commonly cause tachycardia and hypertension.

Answer 14

Bronchodilators

Question 15

A(n) ____________ application is a drug instilled in the outer ear.

Answer 15

Otic

Question 16

A tablet given by ____________ application is placed under the tongue to dissolve slowly and become absorbed by the rich blood supply in the area.

Answer 16

Sublingual

Question 17

Symptoms of a(n) ____________ infection include intense vaginal itching and a white vaginal discharge.

Answer 17

Yeast

Question 18

The ____________ route administers drugs to the lower airways.

Answer 18

Inhalant

Question 19

A(n) ____________ results after a liquid drug is forced through a narrow channel using pressurized air or an inert gas.

Answer 19

Aerosol

Question 20

Drugs administered rectally are usually in the form of ____________; however, creams and ointments also may be prescribed.

Answer 20

Suppositories

Question 21

Identify what the patient is doing.

Answer 21

The figure shows an inhaler.

Question 22

What does this device consist of?

Answer 22

Inhalers are hand-held devices for delivering medication into the respiratory passages.

They consist of a canister containing the medication and a holder with a mouthpiece through which the aerosol is inhaled.

Question 23

Administration of the medication to the skin and mucous membrane

Answer 23

Topical Route

Question 24

Drugs rubbed into or placed in contact with the skin

Answer 24

Cutaneous applications

Question 25

Drugs bonded to an adhesive bandage and applied to the skin

Answer 25

Skin patches

Question 26

Swelling of the nasal mucosa within a short time of drug administration

Answer 26

Rebound effect

Question 27

Drugs placed against the mucous membranes of the inner cheek

Answer 27

Buccal application

Question 28

Presented here, in random order, are steps that occur during instillation of ear medication. Write the correct sequence in the boxes provided.

1. Place a small cotton ball loosely in the ear to absorb excess medication.
2. Tilt the client’s head away from the ear into which the medication will be instilled.
3. Press and release the tragus, the projection of skin-covered cartilage at the opening of the external ear, to facilitate moving the medication toward the eardrum.
4. Manipulate the client’s ear by straightening the auditory canal.
5. Compress the container and instill the prescribed number of drops on the side of the ear canal rather than directly onto the tympanic membrane.
6. If a bilateral administration is prescribed, wait at least 5 minutes before instilling medication in the opposite ear.

Answer 28

4. Manipulate the client’s ear by straightening the auditory canal.
5. Tilt the client’s head away from the ear into which the medication will be instilled.
6. Compress the container and instill the prescribed number of drops on the side of the ear canal rather than directly onto the tympanic membrane.
7. Press and release the tragus, the projection of skin-covered cartilage at the opening of the external ear, to facilitate moving the medication toward the eardrum.
8. Place a small cotton ball loosely in the ear to absorb excess medication.
9. If a bilateral administration is prescribed, wait at least 5 minutes before instilling medication in the opposite ear.

Question 29

What are skin patches?

Answer 29

Skin patches are drugs bonded to an adhesive bandage and applied to the skin.
Several drugs are now prepared in patch form, including nitroglycerin, scopolamine, and estrogen. Nicotine withdrawal therapy and contraceptive drugs also are available as skin patches.

Question 30

What are otic applications?

Answer 30

An otic application is a drug instilled in the outer ear. It usually is administered to moisten impacted cerumen or to instill medications to treat a local bacterial or fungal infection.

Question 31

What warning should a nurse give to a client who uses over-the-counter decongestant nasal sprays frequently?

Answer 31

Nurses warn clients who use over-the-counter decongestant nasal sprays that, if they use the medication too frequently or administer more than the recommended amount, a rebound effect—the swelling of the nasal mucosa—can occur within a short time of drug administration.

Question 32

What nursing instruction should a nurse give during the administration of sublingual or buccal application?

Answer 32

When giving sublingual or buccal administrations, nurses instruct clients not to chew or swallow the medication.

Eating and smoking also are contraindicated during the brief time needed for the medication to dissolve.

Question 33

What are the advantages of administering drugs through the inhalant route?

Answer 33

The inhalant method of medication administration is effective because the lungs provide an extensive area from which the circulatory system can quickly absorb the drug.

Question 34

What are the types of inhalers available to administer medication?

Answer 34

There are two types of inhalers:

1. a dry powder inhaler holds a reservoir of pulverized drug and a carrier substance
2. A metered-dose inhaler that delivers aerosolized medication, which is a liquid drug forced through a narrow channel via a chemical propellant.

Question 35

Ophthalmic application is a method of applying drugs to the mucous membrane of one or both eyes. Answer the following question related to the nurse’s role when administering ophthalmic drugs.

A nurse is caring for a client with conjunctivitis at the health care facility.

What care should the nurse take when administering ophthalmic medication to this client?

Answer 35

Ophthalmic medications are supplied either in liquid form and instilled as drops or as ointments applied along the lower lid margin.
The nurse should ask the client to blink (rather than rub) the eyes to distribute the drug over the surface of the eye.
The eye is a delicate structure susceptible to infection and injury, just like any other tissue.
Therefore, nurses take care to keep the applicator tip of the medication container sterile.