Medical Administration Flashcards
Oral Administration
Aspiration occurs when
food, fluid, or medication intended for GI administration inadvertently
enters the respiratory tract. Protect a patient from aspiration by assessing
his or her ability to swallow. Allow patient to self-administer medications if possible.
• Know signs of dysphagia (difficulty swallowing): cough, change in
voice tone or quality after swallowing, delayed swallowing,
incomplete oral clearance or pocketing of food, regurgitation.Assess patient’s ability to swallow and cough by checking for
presence of gag reflex. Position the patient in an upright seated position at a 90-degree angle
with feet on the floor, hips and knees at 90 degrees, head midline, and
back erect if possible and if not contraindicated by his or her
condition.
• Suggest that the patient slightly flex the head in a chin-down position
before swallowing.Administer pills one at a time, ensuring that each medication is
properly swallowed before next one is introduced.Some medications can be crushed and mixed with pureed foods if necessary. Refer to a medication reference to identify medications that
are safe to crush.Avoid straws because they decrease the control the patient has over
volume intake, which increases risk of aspiration.
• Have patient hold and drink from a cup if possible.
Skin Applications
Use sterile technique if a patient has an open
wound. Skin encrustation and dead tissues harbor microorganisms and
block contact of medications with the tissues to be treated. Before applying
medications, clean the skin thoroughly by washing the area gently with
soap and water, soaking an involved site, or locally debriding tissue.
Ask patients if they take any topical medications.
When applying a transdermal patch, ask the patient whether he or she has an existing patch. Before applying a new patch, don disposable gloves and remove the
old one. Medication remains on the patch even after its recommended
duration of use. Nurses and patients have inadvertently left old
transdermal patches in place, resulting in the patient receiving an
overdose of the medication
Wear disposable clean gloves when removing and applying transdermal patches.
If the dressing or patch is difficult to see (e.g., clear), apply a noticeable label to the patch.
Document patch or medication location on the MAR
Document patch or medication removal on the MAR
Nasal Instillation
Methods
Spray
Drops
Tampons
Decongestant spray or drops most common
Caution patients to avoid the rebound effect
Serious systemic effects also develop if excess decongestant solution is swallowed, especially in children
Administer nasal drops:
a. Help patient to supine position and position head properly.
(1) For access to posterior pharynx, tilt patient’s
head backward.
(2) For access to ethmoid or sphenoid sinus, tilt
head back over edge of bed or place small
pillow under patient’s shoulder and tilt head
back (see illustration).
For access to frontal and maxillary sinus, tilt head back over edge of
bed or pillow with head turned toward side to be treated
Eye Instillation
Instillation Avoid the cornea. Avoid touching eye or eyelid with droppers or tubes. Use only on the affected eye. Never share eye medications. Intraocular instillation Disk resembles a contact lens. Teach patients how to insert and remove the disk. Teach about adverse effects.
Ear instillation
Eardrops
Instill eardrops at room temperature to prevent vertigo,
dizziness, or nausea.
Use sterile solutions.
Check with the health care provider for eardrum rupture if patient has ear drainage.
Never occlude the ear canal.
Irrigation
Performed to remove cerumen that cannot be removed with wax softeners
Performed only in cases of hearing deficit, ear discomfort, or to visualize the tympanic membrane
Vaginal Instillation
Vaginal medications Inserted with a gloved hand Suppositories Administered with an applicator inserter Foam Jellies Creams
Rectal Instillation
Rectal suppositories
Thinner and more bullet-shaped than vaginal suppositories
Rounded end prevents anal trauma during insertion
Contain medications that exert local effects
A small cleansing enema may be required before inserting a suppository
Administering Medications By Inhalation
Pressurized metered-dose inhalers (pMDIs)
Require hand strength and hand-breath coordination
May be used with a spacer - This helps the medication get deeper into the lungs and enhances
absorption. Spacers are helpful when a patient has difficulty coordinating
the steps involved in self-administering medications. However, patients
who do not use their spacers correctly do not receive the full effect of the
medication. BAIs and DPIs do not use spacers.
BAIs release medication when a patient raises
Breath-actuated metered-dose inhalers (BAIs)
Release depends on strength of patient’s breath on inspiration
Dry powder inhalers (DPIs)
Activated by patient’s breath
Deliver more medication to the lungs
Administering Medications By Irrigations
Some medications irrigate or wash out a body cavity and are delivered
through a stream of solution. Irrigations most commonly use sterile water,
saline, or antiseptic solutions on the eye, ear, throat, vagina, or urinary
tract. Use aseptic technique if there is a break in the skin or mucosa. Use
clean technique when the cavity to be irrigated is not sterile, as in the case
of the ear canal or vagina. Irrigations cleanse an area, instill a medication,
or apply hot or cold to injured tissue
Parenteral Administration of Medications
Parenteral administration of medications is the administration of
medications by injection into body tissues. This is an invasive procedure
that is performed using aseptic techniques (Box 31.19). A risk of infection
occurs after a needle pierces the skin. This is an invasive procedure that is
performed with the following aseptic techniques:
• To prevent contaminating the solution, draw up medication quickly.
Do not allow ampules to stand open.
• To prevent needle contamination, avoid leing a needle touch
contaminated surfaces (e.g., outer edges of ampule or vial, outer
surface of needle cap, nurse’s hands, countertop, table surface).
• To prevent syringe contamination, avoid touching length of plunger
or inner part of barrel. Keep tip of syringe covered with cap or needle.
• To prepare skin, wash with soap and water if soiled with dirt,
drainage, or feces, and dry. Use friction and a circular motion while
cleaning with an antiseptic swab. Swab from center of site and move
outward in a 5-cm (2-inch) radius.
