learning activity 6, 2nd semester Flashcards
1
Q
Define drugs:
A
Any chemical that affects the physiological processes of a living organism
2
Q
What is the chemical name?
A
Describes the drug’s chemical composition and molecular structure
eg. (+/-)-2-(p-isobutylphenyl) propionic acid
3
Q
What is the generic name?
A
Name given by Health Canada under the Food and Drugs Act and Food and Drug Regulations
eg. ibuprofen
4
Q
What is the property name?
A
The drug has a registered trademark; use of the name restricted by the drug’s patent owner (usually the manufacturer)
eg. Motrin®, Advil®
5
Q
What are enteral Routes of Administration
A
Oral Buccal Sublingual Rectal PEG (percutaneous endoscopic gastrostomy or feeding tube)
6
Q
What are topical Routes of Administration
A
Optic Otic Inhaler (MDI or metered dose inhaler) Aerosal Transdermal Vaginal Intrauterine
7
Q
What is the Parenteral Route?
A
Intradermal Subcutaneous Intramuscular Intraosseus Intravenous Intra-arterial Intraperitoneal Intrasynovial Intrathecal Epidural
8
Q
Describe tablets:
A
Scored
caplet
Enteric coated
9
Q
Describe capsules:
A
Capsules
sustained release
10
Q
Describe Syrup:
A
Syrup – a concentrated solution of sugar & H2O + drug
11
Q
Describe Elixir:
A
Elixir – a sweetened , aromatic hydroalcoholic liquid used in compounding of medications
12
Q
Describe Suspension:
A
Suspension – State of solid when its particles do not dissolve in fluid
13
Q
What are the Eight Rights of Medication Administration?
A
The right medication The right dose The right client The right route The right time The right documentation The right to refuse The right reason
14
Q
A medication order is required for any medication administered by the nurse, therefore a nurse must check?
A
Check all transcribed orders against the prescriber’s order
Ensure that the prescription has all the necessary components
Assess patient’s history of allergies
Give medication within 30 minutes
15
Q
When preparing medication a nurse must?
A
- Ensure medication order has not expired
- Review assessment data that may influence drug administration ie. vital signs, lab reports
- Check the label against the MAR
- Take time to calculate drug doses accurately
- Complete 3 checks
- Administer only personally prepared medication
- Do not give medication from labels that are illegible or unmarked
16
Q
When Administering Medications to Patients a nurse must?
A
- Correctly identify patient
- Inform patient of drug’s name, purpose, action, and side effects
- Respect patient’s right to refuse medication
- Discard unused medication once it has been removed from the container
- Remain with the patient until medication is taken
17
Q
With Postadministration Activities a nurse must?
A
Record medication immediately once given
Record any data pertinent to patient’s assessment or response to medication
Record reason for refusal of medication
Monitor the patient for any serious side effects
18
Q
When Administering Oral Medication:
A
Assess sensory function
Use clean technique
Evaluate each medication for potential drug-drug interaction
Evaluate whether drug can be given with food or dairy products
Not all tablets can be crushed or broken in half
Liquids
Remove bottle cap, and place cap upside down
Pour at eye level away from the label
Discard any excess into the sink (never back into the bottle)
Wipe lip of bottle with paper towel
19
Q
When Administering Rectal Suppositories
A
Provide privacy
Wash hands, assemble supplies, don gloves
Assist patient to a left side-lying position with upper leg flexed, keeping patient draped
Palpate rectal walls, dispose gloves
Remove supp from foil, lubricate rounded end
Have patient take
slow deep breaths
Insert gently through anus,
and against rectal wall (4”)
20
Q
When Administering Topical Medication a nurse must?
A
Determine allergies Provide privacy Wash hands. Assemble supplies, reading application directions. Don clean/sterile gloves Wash affected area – remove debris and previous medication Pat skin dry or air dry. Don new gloves Assess condition of patient’s skin Application of: Creams, ointments, oil-based lotions Nitroglycerin
21
Q
When Administering Eye Drops a nurse must?
A
Wash hands, assemble supplies
Ask patient to lie supine or sit in chair with head hyperextended
If drainage present, gently wipe clean from inner to outer canthus
*Instruct patient to look up to the ceiling
Hold dropper 1 to 2 cm above conjunctival sac
Instill gtts into lower third of conjunctival sac
Apply gentle pressure to nasolacrimal duct for 30 sec
22
Q
When applying Eye Ointment a nurse must?
A
Apply thin ribbon of ointment evenly along inner edge of lower conjunctival sac holding tube 2 cm from inner to outer canthus
Ask patient to close eyelids gently and move eyes
23
Q
When administering Ear Drops a nurse must?
A
Cleanse outer ear canal
Pull pinna up and back in adults and children > 3 yrs
Pull pinna down and back in children < 3 yrs.
Apply gentle pressure to tragus
Ask patient to remain in side-lying position 5 – 10 min
24
Q
When administering nose drops a nurse must?
A
Instruct pt to clear nose gently (unless contraindicated)
Sphenoid & ethmoid sinuses – tilt head back
Frontal & maxillary sinuses – tilt head back over edge of bed with head turned to affected side
Hold dropper 1 cm above nares and instill drops toward midline of ethmoid bone
Have patient remain supine for 5 minutes
25
When administering nasal spray a nurse must?
Instruct patient to gently blow nose (unless contraindicated)
Have patient assume upright sitting position
Block one nostril
Hold spray bottle upright, shake the bottle
Insert tip in to the nostril. Have patient inhale through the open nostril and squeeze a puff of spray into the nostril at the same time
Instruct patient that overuse of nasal decongestants can cause “rebound effect”
26
When adminstering an inhaler
```
Without aerochamber
Place inhaler 1 to 2 cm from mouth with opening toward back of throat.
Inhale slowly and deeply while simultaneously depressing cannister
With aerochamber (preferrable)
Place spacer mouthpiece into mouth leaving exhalation ports open
Spray 1 puff into cannister
Inhale slowly and fully for 5 seconds
Hold breath for 5 – 10 sec
*Patient teaching
Shake cannister prior
to use
Take as prescribed
Wait 2 – 5 minutes
between inhalations
Clean valve
post-inhalation
Instruct pt to rinse
mouth following
steroid inhalations
```
27
****List the eight "rights" of medication administration:****
```
The right medication
The right dose
The right client
The right route
The right time
The right documentation
The right to refuse
```
The right reason
28
When Receiving Medication Orders a Nurse must:
A medication order is required for any medication administered by the nurse
Check all transcribed orders against the prescriber’s order
Ensure that the prescription has all the necessary components
Assess patient’s history of allergies
Give medication within 30 minutes
29
What is Half-life?
The time it takes for one half of the original amount of a drug in the body to be removed
A measure of the rate at which drugs are removed from the body
30
Describe Onset, Peak, and Duration:
Onset
The time it takes for the drug to elicit a therapeutic response
Peak
The time it takes for a drug to reach its maximum therapeutic response
Duration
The time a drug concentration is sufficient to elicit a therapeutic response
31
What are some Drug Reactions?
```
Desired action/therapeutic effect
Side effect
Adverse effects
Toxic effects
Allergic Reactions
Anaphylaxis
Idiosyncratic reaction (occurs rarely & unpredictably)
Medication Interactions
Synergistic/potentiative effect
Inhibitory effect
```
32
How to Prevent Medication Errors:
Minimize verbal or telephone orders
Repeat order to prescriber
Spell drug name aloud
Speak slowly and clearly
List indication next to each order
Avoid medical shorthand, including abbreviations and acronyms
Never assume anything about items not specified in a drug order (i.e., route)
Do not hesitate to question a medication order for any reason when in doubt
Do not try to decipher illegibly written orders; contact prescriber for clarification
NEVER use “trailing zeros” with medication orders
Do not use 1.0 mg; use 1 mg
1.0 mg could be misread as 10 mg, resulting in a tenfold dose increase
ALWAYS use a “leading zero” for decimal dosages
Do not use .25 mg; use 0.25 mg
.25 mg may be misread as 25 mg
“.25” is sometimes called a “naked decimal”
Check medication order and what is available while using the “8 Rights”
Take time to learn special administration techniques of certain dosage forms
Always listen to and honour any concerns expressed by clients regarding medications
Check client allergies and identification
33
What is Autonomy
self governing
34
What is Beneficence
action for the benefit of others
35
What is Confidentiality
set of rules that limits access on certain information
36
What is Justice?
moral rightness based on ethics, rationality, law, religion, equity or fairness
37
What is Nonmaleficence?
do no harm
38
What is Veracity?
conformity to facts, adherence to the truth
39
Ethnocultural Considerations are?
```
Assess the influence of a client’s cultural beliefs, values and customs
Drug polymorphism
Adherence to therapy
Environmental considerations
Genetic factors
Varying responses to specific agents
Health beliefs and practices
Past uses of medication
Folk remedies
Home remedies
Use of nonprescription drugs and natural health remedies
OTC (over the counter) treatments
Usual response to treatment
Client’s response to treatment
Religious practices and beliefs
Dietary habits
```
40
The canadian nurses associatiom Code of Ethics for registered nurses is a statement of the?
Ethical value of nurses and of nurses commitment to persons with health care needs and persons receiving care.
41
What is the purpose for the code of ethics?
serves as a foundations for nurses and ethical practices. The codes provides guidelines for ethical relationships, responsibilities, behaviours and decision making, and it is used in conjunction with the professional standards, laws, and regulations that guide practice. It serves a a means of self evaluation and self reflection
42
Nursing values and ethical responsibilities describes?
the core responsibilities central to ethical nursing practice.
Articulated through 7 primary values:
1. providing safe, compassionate, competent and ethical care.
2. Promoting health and well being
3. Promoting and respecting informed decision making
4. Preseving dignity
5. Maintaining privacy and confidentiality
6. Promoting justice
7. Being accountable
43
Ethical uncertainty occurs when?
a nurse feels indecision or lack of clarity, or is unable to even know what moral problem is, while at the same time feeling uneasy or uncomfortable
44
What are ethical dilemmas or questions?
they arise when there are equally compelling reasons for and against two or more possible courses of action, and where choosing one course of action means that something else is relinquished or let go.
45
When does ethical distress arise?
it arises in situations where nurses know or believe they know the right thing to do, but various reasons do not or cannot take the right action or prevent a particular harm.
46
What is ethical residue?
Ethical residue is what nurses experience when they seriously compromise or allow themselves to be compromised.
47
What is ethical disengagement?
Ethical disengagement can occur if nurses begin to see the disregard of their ethical commitments as normal
48
What are ethical violations?
involves actions or failures to act that breach fundamental duties to the persons receiving care or to colleagues and other health care providers.
49
What is ethical courage?
ethical courage is when a nurse stands firm on a point or a moral principle or a particular decision about something in the face of overwhelming fear of threat to himself or herself.
50
If you are unsure if the right drug is being prescribed, you should:
a) Clarify with the physician
b) Ask the patient to clarify
c) Check the drug reference book
d) Confer with another nurse
A- Clarify with physician
51
Drug calculations should be verified by another nurse? T or F
True
52
List three ways that you can verify the identication of a patient:
4. Check client’s ID band; Ask client to state their name if cognitively stable, and ask a family member to verify client’s name
53
it is a nursing responsibility to check patient allergies prior to adminsteing medications T or F
True
54
The oral route is the easiest way to administer medications? T or F
True
55
List four forms of oral medications:
2. Tablets, capsules, powders and liquids
56
Small doses of liquid medications should be given woth another liquid such as juices or water T or F
False
57
To ensure the correct dosage, tablets must be pre-scored if they need to be broken in half. T or F
True
58
All tablets can be crushed and mixed with soft food if the patient has difficulty swallowing, T or F
False
59
Prepare medications for a group of patients to work safley and efficiently T or F
False
60
If a patient refuses a medication:
a) Document the refusal and notify the physician
b) encourage the patient to comply with the prescribed tx
c) Call the pharmacy
d) Disguise the medication with food and the next meal tray.
a) Document the refusal and notify the physician
61
If the patient has multiple oral medication, leave them at the bedside so that the patient can take them slowly. T or F
false
62
Documentation of medication administered should be:
a) Accurate and complete
b) Only the dose that you administered or witnessed a patient taking
c) Administration witnessed and given by another nurse
d) A and B only
e) All of the above
d) A and B only
63
Care not documented is care not done. T or F
True
64
Medications administered should be documented by the end of each shift. T or F
False
65
A nurse may accept a directive for medication from an optometrist. T or F
True
66
The nurse may accept a telephone or verbal order from a prescriber. T or F
True
67
The prescriber is ultimately responsible for ensuring that the prescribed dosage is correct. T or F
False
68
The prescriber is ultimately responsible for checking to determine whether the patient has allergies and sensitivities to medication T or F
False
69
A patient has the right to refuse medication: T or F
TRUE
70
Medication may be a form of a restraint, T or F
True
71
The responsibility for documenting the effectiveness of a medication is with the nurse administering it. T or f
True
72
When administering medication, a patient's identity can be verified be asking " are you Mrs. ___?" T or F
False
73
A nurse may administer medication poured by another nurse. T or F
False
74
A nurse may document medication given by another nurse. T or F
False
75
What components should a prescription for medication include:
```
Order date
Clients name
Medication name
Dose in units
Route
Frequency
Purpose
Prescirber's name
Signature and designation
```
76
What is required on a medication label?
the medication trade name in large letters, the generic name in smaller letters, the form of the medication, dose, expiration, lot number, and the manufacturer's name.
77
What are the nursing responsibilities in receiving a medication order ?
A medication order is required for any medication administered by the nurse
•Check all transcribed orders against the prescriber’s order
•Ensure that the prescription has all the necessary components
•Assess patient’s history of allergies
•Give medication within 30 minutes
78
What are the nursing responsibilities in administering medication ?
During your assessment, you are accountable for determining that the medication prescribed is appropriate for the client. You must be knowledgeable about the factors that influence the administration of a particular drug, such as: a client’s age a client’s weight laboratory results or the need for a medication to be taken with food. For example, you should know of a client’s allergies or other sensitivities that contraindicate the administration of a medication. If you determine the medication is inappropriate, you must withhold it and talk with the prescriber in a timely manner.
•Correctly identify patient
•Inform patient of drug’s name, purpose, action, and side effects
•Respect patient’s right to refuse medication
•Discard unused medication once it has been removed from the container
•Remain with the patient until medication is taken
79
What “three checks” are required when preparing medication?
Before administering medication, it is critical to have five areas of information correct: patient identification, medication, dosage, time, and route. But, it's not only critical to ensure this information is correct, you should check three times:
1. The first check is when the medications are pulled or retrieved from the automated dispensing machine, the medication drawer, or whatever system is in place at a given institution.
2. The second check is when preparation of the medications for administration takes place.
3. The final check occurs at the patient's bedside just before medications are given. This is also an outstanding opportunity to teach the patient about the medications.
80
List the nursing responsibilities associated with administration of oral medication
pg. 704 p&p
81
When is it appropriate to “crush” a medication and which medications should never be crushed?
A common reason for crushing a tablet or capsule is for use by a hospitalized patient with an enteral feeding tube. A recent review in the American Journal of Health-System Pharmacy provides more details about administering medications in patients with enteral feeding tubes.2 Oral solutions can be used when commercially available and medically appropriate. If an oral solution or suspension is not available, the hospital pharmacy should be consulted to determine if a liquid formulation of the product can be extemporaneously prepared. In some cases, after careful consideration of compatibility, stability, and drug absorption changes, an injectable formulation of a product may be used. You should always consult your hospital pharmacist for information on this modality of drug administration.
Some patients have difficulty swallowing tablets or capsules; some dislike the taste. In these cases, crushing of medication for powdered delivery (to be mixed with food or beverages) should be considered. But beware of certain caveats, as not all medications are suitable for crushing. Generally, meds that should not be crushed fall into one of these categories:
• Sustained-release tablets, which can be composed of multiple layers for different drug release times, as can beads within capsules.
• Enteric-coated tablets, which are formulated because certain drugs can be irritating to the stomach or are degraded by stomach acid. By enteric-coating tablets or capsule beads, the drug’s release can be delayed until it reaches the small intestine.
82
When is it appropriate to halve a tablet or caplet?
Pill-splitting refers to the practice of modifying a tablet, capsule or pill to obtain a lower dose of the active ingredient, or to obtain multiple smaller doses, because the drug is not available in the dose desired. Often, pills that are meant to be split (Aspirin for instance) come pre-scored so that one may easily divide the pill into halves or quarters.
83
How can you decrease a medication’s unpleasant taste?
Mix the drug with a small amount (about 1 teaspoon) of a sweet-tasting
substance, such as jam, applesauce, sherbet, ice cream, or fruit puree.
Do not use honey in infants because of the risk for botulism.
84
,How can you facilitate the administration of oral medications to a debilitated client?
1 Perform hand hygiene.
2 If the medication is not compatible with the feeding solution, or
if patient needs to take medication on an empty stomach, stop
the feeding 15 to 30 minutes before medication
3 Prepare medications for instillation into feeding tube. Check
label against MAR three times (see Skill 21-1). Fill graduated
container with 50 to 100 mL of tepid water.
a Crush tablets using a pill-crushing device to grind pills
into a fine powder. If a pill-crushing device is not available,
place tablet between two medication cups and grind
with a blunt instrument. Dissolve in at least 30 mL of
warm water.
b Capsules: Ensure that contents of capsule (granules or
gelatin) can be expressed from the covering (consult with
pharmacist). Open capsule, or pierce gelcap with sterile
needle, and empty contents into 30 mL of warm water.
You can also dissolve gelcaps in warm water.
4 Identify patient using two identifiers and comparing these
identifiers with the information on patient’s identification
bracelet. Ask patient to state name. Check name on patient’s
identifi cation bracelet.
5 Prepare patient by placing in a high-Fowler’s position (if not
contraindicated by patient’s medical condition).
6 Apply clean gloves
7 If a continuous enteric tube feeding is infusing, adjust the infusion
pump to hold the tube feeding.
8 Check placement of feeding tube by observing gastric contents
and checking pH of aspirate contents. Gastric pH should
be 4 or less
9 Check for gastric residual. Connect syringe to end of feeding
tube, then pull back slowly to aspirate gastric contents. Return
aspirated contents to stomach.
10 Pinch nasogastric/enteric tube, and remove syringe. Draw up
30 mL of water in syringe. Reinsert tip of syringe into nasogastric/
enteric tube, and flush tube. Pinch tube again, and remove
the syringe.
Flushing ensures tube is patent.
a Some nasogastric/enteric tubes are connected to continuous
feeding tubing with a stopcock apparatus, such as a
Lopez valve, that contains a medication port (see illustration).
If present, attach the tip of the syringe to the medication
port on the stopcock, and turn the “off” setting of
the stopcock away from patient and toward the infusion
tubing. Flush the enteric tube, then set stopcock “off”
again to the medication port. Remove the syringe.
11 Remove bulb or plunger of syringe. Reinsert syringe into enteric
tube (or medication port).
12 Administer first dose of dissolved medication by pouring into
syringe.
a) If giving only one dose of medication, fl ush with 30 mL of
water after administration.
b To administer more than one medication, give each
separately, and flush between medications with 15 to 30 mL
of water.
c Follow last dose of medication with 30 to 60 mL of water.
13 When a tube feeding is not being administered, clamp the
proximal end of the feeding tube, and cap end of tube.
14 When continuous tube feeding is being administered by an
infusion pump:
a Follow medication administration Steps 1 to 12. If the medications are not compatible with the feeding solution,
then hold the feeding for an additional 30 to
60 minutes.
15 Assist patient to comfortable position, but keep the head of the
bed elevated for 1 hour after administering the medication.
16 Dispose of soiled supplies, rinse graduated container and
syringe with tap water, remove and dispose of gloves, and
perform hand hygiene.
85
List some factors that contribute to medication errors.
A medication error is any event that could cause or lead to a client either receiving inappropriate medication therapy or failing to receive appropriate medication therapy. Most errors made by nurses are medication errors. A medication error can cause or lead to inappropriate medication use or client harm. A medication error can occur when you neglect routine procedures, such as checking dose calculations; administer unfamiliar medications; neglect to administer an ordered medication; fail to comply with the seven rights of medication administration; and fail to perform necessary assessments before medication administration (e.g., monitoring the client’s blood glucose levels or blood pressure). Additional system issues that can lead to medication errors include distraction, illegible orders, transcription errors, and inappropriate use of abbreviations. Hospital medication delivery systems should be designed so that a system of checks and balances help reduce medication errors. prepare for only one patient at a time, do not used unmarked/illegible containers, do not allow interruptions and double check calculations
86
What are the differences in medication administration for infants, children, adults, and older adults.
Calculating children’s medication doses requires caution. Children metabolize medications at different rates compared with adults. Other factors that influence medication dosages in children include the difficulty in evaluating the desired effect and the hydration status of the child. In most cases the prescriber will calculate the dose for a child before ordering the medication. However, it is your responsibility to be aware of the safe dosage range for any medication administered to a child.
Older adults require special consideration during medication administration. The changes of aging alter pharmacokinetics (Table 20-3). As a result, nurses caring for older adults must be aware of drug dosing and alterations in drug response (Hunter and Cyr, 2006). Chronic disease is more prevalent among older adults, and multiple disease states also affect medication use and response. A common problem for older adult patients is polypharmacy, the use of a number of different medications, prescribed or not, for one or more health problems (McKenry and others, 2006).When several medications have similar effects, polypharmacy increases the chances of medication interactions. These interactions can be mistaken as medication toxicity, an increase in disease severity, suboptimal treatment, or an unrelated event.
Review the special considerations associated with the administration of controlled substances and experimental drugs.
87
An appropriate administration route depends on?
1. the dosage form in which the drug is available
2. the patient’s age
3. the patient’s condition, e.g. level of consciousness, etc.
88
Each route of administration has distinct advantages and disadvantages. The same drug administered via a certain route
1. may be therapeutic
2. or the same drug may be
a. ineffective
b. harmful
c. sometimes even fatal
89
Some drugs are approved for use via more than one route and are manufactured in more than one dosage form appropriate for these routes, e.g.
1. sublingual tablets
2. sublingual spray
3. ointment for transdermal application
4. intravenous solution for infusion
90
oral – the most convenient and most commonly used route of administration
List advantages:
1. examples are tablets, capsules, and liquids
2. patients with dysphagia can usually swallow liquids without problems
3. infants may be given drugs in liquid form mixed with some formula or juice in a nipple
4. unconscious patients can receive liquid medications via NG tube (nasogastric)
5. oral route usually abbreviated as p.o. or PO (Latin per os, meaning through the mouth.)
91
oral – the most convenient and most commonly used route of administration
List Disadvantages:
1. some drugs, especially certain penicillins, cannot be administered orally as they become inactivated by the stomach acid, therefore must be administered via intramuscular or intravenous injection.
2. some drugs are so quickly metabolized by the liver after oral administration that as they pass through the portal circulation that therapeutic levels cannot be reached in the systemic circulation. These drugs must be administered via intravenous injection, e.g. lidocaine (Xylocaine) for cardiac dysrhythmias
3. some drugs combine chemically with certain foods or beverages to form an insoluble complex or interact to produce adverse side effects, e.g. tetracycline cannot be taken with dairy products
92
Describe intradermal injection:
injection of a liquid into the dermis, just below the epidermis; when correctly administered the tip of the needle is still visible through the skin, e.g. Mantoux test for TB
93
Describe subcutaneous injection:
injection of a liquid into the fatty layer of tissue just below the dermis of the skin but above the muscle layer
1. slower absorption of the drug because only few blood vessels in this layer as compared to intramuscular injection, e.g. insulin, heparin, allergy shots
2. no official abbreviation but commonly accepted are: s.q., SQ, subQ, s.c., S.C., or subcu
94
Describe intramuscular injection:
injection of liquid into the belly (area of greatest mass) of a large muscle
1. large muscles well supplied with blood vessels
2. provides for more rapid absorption than via subcutaneous injection
3. only five intramuscular injection sites that allow for administration with lowest risk of damage to adjacent nerves and blood vessels
a. deltoid – located on upper arm, lateral aspect
b. vastus lateralis – located on midthigh, lateral aspect
c. rectus femoris – located on midthigh, anterior aspect
d. . ventrogluteal – located on the side of the hip over gluteus muscle between anterior and superior spines of the iliac crest
e. dorsogluteal – located over gluteus minimus and edge of gluteus maximus muscles in upper outer quadrant
95
Valium, Librium are drugs that:
are not water soluble and would precipitate out in muscular tissue, therefore are not acceptable to be administered intramuscularly
96
Describe intravenous injection:
1. therapeutic effect can be seen immediately
2. drug does not need to be absorbed
Examples are:
a. Pantothal for induction of general anesthesia
b. Valium for control of continuous epileptic seizures
c. chemotherapy drugs for cancer treatment
d. antibiotics in high dosages
97
IV injection can be accomplished in three ways:
I.V. push - the administration of a drug bolus by injecting a single dose of drug directly into the vein or through a port (rubber stopper) into an existing intravenous line in a very short time
b. I.V. drip - mixing the drug with fluid in an I.V. bag or bottle to be administered continuously over several hours
c. I.V. piggyback – mixing the drug in a very small I.V. bag or bottle connected through tubing to a port in the existing primary I.V
98
Describe sublingual admin:
the drug, usually in tablet form, is placed under the tongue and allowed to dissolve slowly.
1. the tablet is NOT swallowed.
2. the drug is absorbed quickly through oral mucous membranes into the large blood vessels under the tongue.
3. sublingual application provides a faster therapeutic effect than the oral route, e.g. nitroglycerin tablets and spray for angina
99
Describe rectal admin:
reserved for certain clinical situations, such as a vomiting patient and medication not available in injectable form, e.g. Tylenol.
1. preferred route when drugs are administered to relieve constipation or hemorrhoids
2. absorption via rectal route slow and often unpredictable in effectiveness
100
Describe vaginal admin:
used to treat vaginal infections and vaginitis with creams and suppositories, e.g. Monistat suppositories, Premarin vaginal cream; also route of administration for vaginal contraceptive foams and gels
101
Describe topical admin:
applied directly to the skin or the mucous membranes of the eye, ear, nose, or mouth
• effect usually local, not systemic, e.g. bacitracin antibiotic ointment, Sudafed nasal decongestant, Timoptic eye drops
102
Describe transdermal:
applied to the skin via physical delivery through a porous membrane, e.g. nitroglycerin transdermal patch
1. therapeutic effects felt systemically
2. usually releases drug slowly over time, providing sustained therapeutic blood levels
103
Describe inhalation admin:
administration involves inhaling of a drug in gas or liquid form; drug is absorbed through alveoli of the lungs,
