med admin

Question 1

oral med pre assessments

Answer 1

ability to sit upright, ability to swallow, abdominal distention/nausea/vomiting

Question 2

general pre assessments

Answer 2

allergies, VS if indicated, lab values if indicated, pain, contraindications

Question 3

buccal and sublingual med pre assessments

Answer 3

integrity of oral mucosa (lesions, masses, and skin breakdown) and any signs of lesions, discoloration

Question 4

buccal and sublingual special considerations

Answer 4

tablet or film is to be dissolved, not chewed

Question 5

topical pre assessments

Answer 5

skin condition for irritation, pruritus, burning, lesions, breakdown, or rashes. determine if patient has reaction to creams or lotions

Question 6

topical: when applying paste

Answer 6

remove old dose, rotate sites

Question 7

topical: when applying ointment/creams/oil based lotions

Answer 7

place required amount in gloved hands and soften by rubbing briskly between hands
spread evenly over skin using long even strokes in the same direction as hair growth
skin may feel greasy
apply cover paper per medication instructions

Question 8

topical: when applying nitroglycerin (antianginal) ointment

Answer 8

remove old dose, rotate sites, avoid hairy areas, apply further from head if patient complains of headache, apply cover paper

Question 9

topical: when applying a patch/disc

Answer 9

remove old patch, cleanse area, rotate sites, immediately apply patch and press firmly especially around the edges, apply overlay if provided, s

Question 10

vaginal med pre assessments

Answer 10

ask patient if she is experiencing any burning, pruritus, or discomfort

Question 11

vaginal med admin special considerations

Answer 11

patient should lie in dorsal recumbent position or supine with legs abducted, offer perineal pad

Question 12

vaginal: to administer a suppository

Answer 12

remove suppository from wrapper, apply lubricant to smooth or rounded end, should be at room temperature, lubricate gloved index finger of dominant hand
separate labial folds with non dominant hand and insert suppository an entire fingers length with other hand
withdrawal finger and wipe away excess lubricant, instruct patient to lay on her back for the recommended period of time

Question 13

vaginal: applying cream, foam, or jelly

Answer 13

fill applicator with prescribed dose, separate labial folds, insert applicator one fingers length, push plunger, withdrawal applicator and set aside on paper towel, wide off any residual, instruct patient to lay on back for recommended period of time, wash applicator

Question 14

vaginal: irrigation/douche

Answer 14

place patient on bedpan with absorbent pad underneath, ensure fluid is at body temperature, prime the tubing by running fluid through container nozzle, raise fluid container above the level of the vagina, insert nozzle the length of a tampon, allow solution to flow with rotating, administer all solution, withdrawal nozzle and sit up patient on bedpan, complete peri care, dry, wash applicator

Question 15

otic med pre assessments

Answer 15

assess external ear structures and canal for redness, drainage, irritation
ask about hearing loss or ringing in the ears

Question 16

otic med admin special considerations

Answer 16

should be at room temperature
position the patient in a side lying position or sit in char with head tilted
straighten ear canal (up and back)
hold dropper 1cm above ear canal
have patient remain in this position for 5 minutes, gently massage tragus to distribute medication
evaluate ear again

Question 17

rectal med pre assessments

Answer 17

assess rectal tone

Question 18

rectal med admin special considerations

Answer 18

left side lying sims position with right knee and upper hip bent up toward chest
lubricate index finger and suppository, instruct patient to take a slow deep breath through the mouth to relax, insert about 1 finger’s length, keep finger there for several seconds to ensure it passed the internal sphincter, wipe excess lubricant
patient should lay flat or on side for a few minutes

Question 19

nasal med pre assessments

Answer 19

integrity of nasal mucosa such as lesions, assess patency

Question 20

nasal med admin special considerations

Answer 20

palpate sinuses for tenderness
patient should blow nose
offer tissue after administration
assess patency again

Question 21

nasal: to instill nose drops

Answer 21

patient in supine position
breathe through mouth
hold dropper just inside nose without touching sides and instill the prescribed number of drops towards the midline
have patient remain supine for a few minutes

Question 22

nasal: to instill nose spray

Answer 22

position patient in upright position with head tilted slightly forward
insert tip of nasal spray into one nostril and occlude other nostril, point spray tip toward nasal turbinates and away from nasal septum
instruct patient to inhaled with mouth closed

Question 23

nebulized med pre assessments

Answer 23

pulse, respirations, breath sounds, pulse oximetry, peak flow measurement

Question 24

nebulized med admin special considerations

Answer 24

assemble nebulizer equipment per manufacturer’s directions
add prescribed med and diluent of needed to nebulizer cup
ensure sufficient mist forms
hold mouthpiece between lips, slowly take deep breath, inhale slightly more than normal
tap cup occasionally
monitor pulse during procedure
rise mouth and gargle with warm water
reassess heart rate, pulse oximetry, respirations, breath sounds, and peak flow measurement

Question 25

optic med pre assessments

Answer 25

assess the condition of the external eye structures for redness/drainage/irritation

Question 26

optic med admin special considerations

Answer 26

patient should lie supine or sit in chair with neck slightly hyperextended
gently wipe any drainage or crust present, wipe in to out
admin drops first, wait 3-5 minutes, then admin ointment
replace clean eyepatch

Question 27

optic: to administer eye drops

Answer 27

hold cotton ball just below lower eyelid, gently press down with thumb or forefinger against bony orbit, hold dropper perpendicular to conjuctiva, allow 5 minutes between drops, patient should close eye for 1 minute, wipe off any excess

Question 28

optic: to administer eye ointment

Answer 28

draw down lower eyelid, apply thin ribbon of ointment along inner edge of lower eyelid on conjuctiva, have patient blink to spread, wipe excess

Question 29

inhalation med pre assessments

Answer 29

pulse, respirations, breath sounds, pulse oximetry, and peak flow measurement
assess respiratory pattern and breath sounds

Question 30

inhalation med admin special considerations

Answer 30

shake inhaler gently before using
tilt head back slightly
spacer may be used
wait 5-10 min for another inhaled med
rise mouth afterwards
assess respirations, breath sounds, and peak flow after