LEC 6: Oral, Topical, Rectal, Vaginal, Eyes, Ears, Nasal, Inhalation Medication Administration Flashcards
What patient aspects need to be considered before administering an oral medication to them?
Can the patient swallow? Are they having difficulty swallowing?
- May not be able to give them medication orally
- May need to break the pill down
- Need to get patient in a sitting position
What are two things that need to be considered before breaking a pill down?
- Can only cut a pill in half if they have a score line
- Can only crush a pill if safe; need to check medication guidelines
What are the benefits of oral medication?
- Less painful
- Could potentially last longer
What are the risks of oral medication?
- Aspiration if trouble swallowing
- If they have nasal gastric tube; don’t want medication to get sucked out
What are medications that should NOT be crushed?
- SR: Sustained release
- XR: Extended release
- LA: Long acting
- DA: Delayed action
- ER: Enteric release
- EC: Enteric coated
- Medications that are irritants
- Medications that stain teeth
- Buccal or sublingual medication
How do you prepare liquid and oral syringe medication?
- Always measure with meniscus
- If liquid is less than 5 mL, will use oral syringe to draw up medication
- If you need to be precise, use a oral syringe
*Oral syringes are orange, safety mechanism; cannot attach to saline lock to pass medication through IV
Why do we give medication though sublingual or buccal administration?
- Absorbed quickly because we have large blood vessels in those areas
- No eating or drinking until the medication is fully absorbed
What are the four steps of oral administration?
- Assess
- Swallowing
- GI alteration
- Medical history
- Allergy history - Gather information
- Physical exam
- Lab work
- Vital signs - Verify
- 10 rights
- 3 checks - Administer medication
- Right to refuse
What are the 3 ways to administer inhalation medication?
- Metered-dose inhalers
- Dry powder inhaler
- With a holding chamber with mask
Metered Dose Inhaler
Need to coordinate the patients breathing when using the inhaler
- Administer a certain dose of medication with each inhalation
Dry Powder Inhaler
- Activated with patient breath, do not need to inhale
When do you want to do a “test spray” for inhalers?
Push a “test spray” into the air if not used for serval days or is a new inhaler
What are the three steps the patient needs to do when taking their inhaler?
- Instruct the patient to tilt their head back slightly and inhale slowly and deeply through the mouth for 3 to 5 seconds while depressing the canister fully
- Instructed the patient to hold the breath for approximately 10 seconds
- Instruct the patient to remove the MDI from the mouth and to exhale through pursed lips
How long should the patient wait between inhalations of medication?
The patient needs to wait at least 20 to 30 seconds between inhalations of medication
If two medications are given, what one needs to be administered first?
If two medications are to be administered give the bronchodilator first
Why do patients want to rise their mouths after using an inhaler or nebulizer?
To prevent getting thrush
Nebulizers
- Inhaled medication but delivered in droplet form and mixed with compressed air to create a mist
- Will add medication in recevoir
- Tubbing attaches to wall to create the mist; turn up to 6mL/min
- Always attach to medical air
- Patient needs to breath in and out nice and slow
Topical Administration
Applied to skin or mucous membranes to achieve local effect
What are types of topical administration?
- Transdermal patches
- Lotions, ointment, powders, pastes, and liniment
What are the steps to adminsitering topical medications?
After 10 rights and 3 checks:
- Hand hygiene
- Put on gloves
- Clean/ assess skin
- Want to remove any previous cream/ medications
- Want to assess skin to make sure the site is intact - Apply medication
- Document
- MAR
- Where you applies medication
- Condition of the skin
Transdermal Patches
- Want to asses site
- Do not apply patch to skin that has lesions/ open wounds
- Know the medication and were it needs to be applied
- Document where you placed the patch
- Remove patch when it says to remove it
- Rotate the patch, does not go in the same exact spot
Administering a Vaginal Medication: Suppositories
- Remove wrapper and apply lubricant to suppository and dominant index finder
- Retract labial fold
- Insert rounded end into canal 7.5 to 10cm or as far as it will go
- Withdraw and wipe away excess lubricant
- Patient needs to stay in position for 5 to 10 minutes
*Ensure privacy
Administering a Vaginal Medication: Foams, Jellies, Creams
- Fill applicator according to package directions
- Retract labial folds
- Insert applicator about 5 to 7.5 cm. Push applicator plunger
- Withdraw and wipe away excess medication
- Patient needs to stay in position for 5 to 10 minutes
Where are vaginal medications administered into?
Inserted into the body cavity and melt into the mucus membrane
