Medication Administration

Question 1

Three Routes used to administer medications?

Answer 1

1. ) Enteral (mouth/feeding tube)
2. ) Parenteral (IV Feedings, Central or Peripheral)
3. ) Transcutaneous (via skin for systemic distribution)

Question 2

Explain difference between “AGONIST”….”ANTAGONIST” and “PARTIAL AGONIST”

Answer 2

AGONIST drugs–occupy the receptor and activates them ANTAGONIST drugs- blocks receptors-keeping them from being activated by other PARTIAL AGONIST-Acts as both agonist and antagonist

Question 3

If medications directives advise to administer “on an empty stomach”….how long before/ or after a meal should it be given?

Answer 3

BEFORE MEAL–30-60 minutes AFTER MEAL–2 hours after

Question 4

Contraindications for oral administration of medication (5)

Answer 4

Vomiting decreased GI MOTILITY absence of gag reflex difficulty swallowing decreased LOC

Question 5

How is sublingual medication given

Answer 5

under the tongue

Question 6

How is buccal medication given

Answer 6

between cheek and the gum

Question 7

EYE MEDICATIONS: When instilling more than one (1) drop in the same eye then you should wait ________ minutes before instilling the second drop

Answer 7

5 minutes

Question 8

How is eye ointment administered?

Answer 8

Apply thin ribbon to the edge of the lower eyelid from inner to outer canthus.

Question 9

Describe the process of instilling medication

Answer 9

-Seated upright or on their side -ADULTS–pull auricle upward and outward -CHILDREN (<3 yrs)- pull auricle down and back -Hold dropper 1cm above ear canal-instill med -apply gentle pressure to tragus -DO NOT PUT COTTON INTO EAR CANAL —-IF NEEDED- place cotton into outermost part of ear canal

Question 10

Rectal suppositories should be inserted while patient is in which position?

Answer 10

_Left lateral position (AKA: SIMS)

Question 11

IM Injection Sites

(4)

Answer 11

Question 12

Types of Injections

(4)

Answer 12

Question 13

Intramuscular Injections

Sites?

Amount permitted to be injected?

Needle Gauge & Length?

Angle of injection?

Answer 13

SITES

^{Ventrogluteal}

^Deltoid

^{Vastus Lateralis}

^{Dorsogluteal (NO LONGER RECOMMENDED)}

AMT to INJECT

^{1-3 ml (>3 ml requires two syringes & two different sites)}

NEEDLE GAUGE

^{18-27 gauge}

NEEDLE LENGTH

^{1- to 1.5-inches long}

ANGLE of Injection

^{90 degrees}

Question 14

SUBCUTANEOUS Injections

• SITES*?
• Amt permitted to inject?*
• Needle Gauge & Length?*
• Angle of injection?*

Answer 14

SITES

^{Outer aspect upper arm (ie, back of arm)}

^{Abdomen–4cm (2 in) from umbilicus}

^{Anterior aspect of thigh}

^buttocks

AMT to INJECT

^{no more than 1.5 ml}

NEEDLE GAUGE

^{25-31 gauge}

NEEDLE LENGTH

^{3/8” to 5/8”}

ANGLE of Injection

^{<span>PINCH SKIN and inject at a <strong>45-degree</strong> angle <u>(average size patient)</u></span>}

^{<span> OR <strong>90-degree angle </strong>for <u>(obese sized patient)</u></span>}

Question 15

INTRADERMAL INJECTIONS

SITES?

Amount able to inject?

Needle Gauge & Length?

Angle of administration?

Answer 15

SITES

^{Inner surface of mid-forearm}

AMT to INJECT

^{0.01 to 0.1 ml}

NEEDLE GAUGE

^{26-27 gauge}

NEEDLE LENGTH

1/4” to 5/8”

ANGLE of Injection

10-15 degree angle

Question 16

The expected effect of a medication is

known as the ____________ effect

Answer 16

THERAPEUTIC

Question 17

These are undesirable and potentially

dangerous responses to a medication known

as ____________ effect

Answer 17

ADVERSE

Question 18

“Time-Critical” medications must be administered within what

time frame?

Answer 18

30 minutes before/after the

prescribed time

Question 19

“NON-TIME” Critical medications that are

prescribed DAILY, WEEKLY or MONTHLY

must be administered within what time frame?

Answer 19

2 hours of the prescribed time

Question 20

“NON-TIME” Critical medications that are

prescribed MORE THAN ONCE DAILY

must be administered within what time frame?

Answer 20

within 1 hour of the prescribed time frame

Question 21

Infiltration of a nonvesicant solution

1. ) FINDINGS?
2. ) Treatment?

Answer 21

1. FINDINGS
   
   1. ^Pallor
   2. ^{Swelling at site}
   3. ^{decreased skin temperature}
   4. ^{damp dressing}
   5. ^{slowed infusion}
2. TREATMENT
   
   1. ^{Stop infusion & remove the catheter}
   2. ^{Elevate extremity}
   3. ^{encourage active ROM}
   4. ^{apply cold/warm compress}
   5. ^{Notify provider - determine if IV therapy is still needed. If so re-start the infusion <strong><em>proximal </em></strong>to the site or in another extremity}

Question 22

INFILTRATION OF A VESICANT (Extravasation)

• 1.) FINDINGS….*
• 2.) TREATMENT….*

Answer 22

1. FINDINGS:
   
   1. ^Pain
   2. ^Burning
   3. ^redness
   4. ^swelling
2. TREATMENT
   
   1. ^{Stop infusion / notify provider}
   2. ^{Follow facility protocol}
      
      1. ^{May need to withdraw vesicant from IV site and infuse antidote through catheter}