L3+4 AOM Flashcards
Type of drug
Aerosal spray
Caplet
Capsule
Cream
Elixir
Gel
Lotion
Lozenge
Ointment
Powder
Suppository
Syrup
Transdermal patch
Tablet
Legal aspect of drug administration
Nurse cannot prescribe medicine without authorised provider’s order.
Responsible to their own actions
Responsible to administrate medicine correctly
Proper handling and safe custody of medicine
Educate client and caregiver
Report medication incident
Upkeeping knowledge of medication
AOM safely
Wear a DO NOT DISTURB vest
Question any order feeling incorrect
Do not use cloudy liquid medication, check expire
Only administrate self-prepared medicine
Record with reason whenever drug is omitted
Medication dispense system
Medicational cabinet
Medicational cart
Medication room
IPMOE
—)reduce medication error
Improve efficiency
Improve medication documentation
Improve communication between caregivers
Process of administering medication
1.Indentify the client
2.inform the client
3. Administrate drug
4. Provide indicated intervention
5. Record drug administrated
6. Evaluate client’s response to drug
- Administrate the drug
- Check MAR adn read aloud
First check - Read MAR after taking medicine from drawer
Verify client name and address room no. - Compare label vs MAR
- Check for expiratory dates
Second check
5. Check with label vs MAR before pour
Third check:
6. Check the drug label vs MAR before giving to client/ return
Parental medication
ID (intradermal)
SC (subcutaneous)
IM (intramuscular)
IV (intravenous)
Equipement
Syringe and needle
3-5mL for hypodermal
Larger (10-50) for irrigating wound)
Different kind of syringe
Insulin syringe
Insulin pen with cartidge, easy to use
50mL non luer-lok syringe: for wound/ tube irrigation
Intradermal
Very few amount （0.1mL）
For allergy test/ TB screening
At inner lower arm
Chest
Back beneath scapule
SC subcutaneous injection
Can minimise tissue damage—) reduce lipohypertrophy
Choose site free of tenderness, sweeling, scarring,
Itching, burning or inflammation
Clean with antiseptic swab from center to 5cm circumference
Remove needle cap
Pinch tissue 1/ 2’’
1’’ then 45 degree
2’’ then 90 degree
Inject by holding syringe steady+ push the plunger slow and evenly
Leave 5sec after injection to ensure complete delivery of drug
Pressing the skin and withdraw the syringe with dominant hand
Discard used needle
Perform hand hygiene
Document all related info
Intramuscular (IM)
Absorb quicker than SC—) more blood supply
Concern: find safe site locating away from large vessel
Deltoid <1mL, ventrogluteal site<3mL
Why ventrogluteal preferrede?
No large nerve
Great thickness of muscle include
Gluteus medius and gluteus minimus
Less fat
IM injection procedures
Opposite hand or the hip
Sidelying
Palm heel put on joint of greater tronchanter
Finger pointing head
Index finger: superior iliac spine
Middle finger: below iliac crest
Center of two finger= injection point
Intramuscular injection procedures (deltoid)
Opposite hand on deltoid
1 finger on acromion process(膊頭骨）
3 on deltoid
Thumb on line of top of axilla
Triangle formed ard 2”= injection site
IMPORTANT
IM injection technique
- perform hand hygiene
- Provide privacy
- Select skin without leshion, scar, inflammation,
- tenderness, swelling
- Assisting client to appropriate position
- Clean site from center to 5cm
- Remove needle cover
8 z track technique
Push away on side, 90 degree insertion - No blood- slow injection (mL per 10s)
- Wait 10s for complete injection
- Same angle withdrawal
- Apply pressure with dry sponge to stop bleeding
13 discard needle& syringe to sharp box - Perform hand hygiene
15 documentation.
IV
Why?
Rapid effect
For those too irritating to other injection e.g. IMI
Have an existing IV site
Type of IV
- Large volume infushion
- Intermittent intravenous infusion( piggyback)
- Intravenous push
- Intermittent injection port
Large volume infusion of intravenous fluid
Safest+ easiest
250mL-1000mL
Main danger—) circulatory overload—) edema
Potassium chloride/ vitamin
- Intermittent intravenous infusion
50-100mL
Regular interval but in short period( 30-60 min)
Tandem: bag with secondary port to add medication
Syringe pump: medication is mixed in a syringe that connect to primary IV line thru syringe pump
Intravenous push/ bolus
Intravenous administration direct to systemic circulation without diluting
Advantage: rapid serum concentration
Effect immediately
Disadvantage: mistakes cannot be corrected
Intermittent injection device
Needleless
Topical medication
Skin application
Nasal medication
Ophthalmic medication
Rectal medication
Otic medication (耳)
Percutaneous medication- transdermal patch
Cauction+ type?
- Apply to clean, hairless area
- Avoid client using heating pad
- Clean with soap before applying
- Wear gloves when administering
Ointment
Cream
Lotion
Powder
spray.
skin application preparation
Powder: dry area
Spread apart skin fold
Cover with fine thin layer of powder
Aerosol spray
Shake the container to mix the content
Spray with 15-30cm distance
Cover with towel if is on neck or chest
Suspension based lotion
Shake and use gauze to wipe
Stroke evenly
Cream
Warm and soften the cream with gloved hand
Ophthalmic medication-form of ointment/ liquid to eye
Otic medication— instillation or irrigation for external auditory canal
Cleaning purpose/ antiseptic
Nasal med
Nose drop/ spray
To: shrink swollen mucous membrane
Loosen secretion
Rectum: suppository
Good for nausea, vomit client
Good for medicine with odor
Release slow but steadily
Local effect
Nebulizer
Fine spray (mist or fog)
Inhaler
Pressurised container— release in mouthpiece
Pressurized container helps larger particle in the solution can be breakup to finer size
