medication route funda Flashcards
ADMINISTERING NASAL MEDICATION
equipment
- Prescribed medication with clean dropper or spray container
- (Nose drops/nasal spray in water soluble form)
- Medication tray
- Medication card
- Tissue
- Gloves
ADMINISTERING RECTAL MEDICATION
a. Identify patient. Prevents error
b. Explain the procedure to the patient and Provide for patient privacy. Promotes cooperation
c. Assist client to appropriate position
Vaginal: dorsal recumbent position with knees flexed.
Rectal: Assist client in assuming a side-lying or Sims’ position with upper leg flexed
upward. Provides easy access to and good exposure
d. Don gloves Prevents contamination.
e. Insert suppository with gloved hand. Ask client to take slow deep breaths through mouth and to relax sphincter Helps to relax sphincter muscles.
f. Lubricate gloved index finger of dominant hand.
suppository
Insert suppository gently through anus, pass internal sphincter and against rectal wall, 10 cm (14 inches) in adults and 5 cm (2 inches) in children and infants.
*Ask client to remain flat or on side for
5 minutes. If medication is to stimulate bowel movement, instruct the client to hold
suppository in place as long as possible
(approximately 5 minutes; 30 minutes
for laxatives).
*If suppository is given to stimulate
bowel movement, assist the client to
bathroom, or with bedpan, as necessary
used when the client is nauseated or vomiting or the medication has an objectionable odor or taste when given orally, this route does not irritate the upper GIT (ex., cream and retention enemas)
- Rectal
ADMINISTERING vaginal MEDICATION
a. Identify patient. Prevents error
b. Explain the procedure to the patient and Provide for patient privacy. Promotes cooperation
c. Assist client to appropriate position
Vaginal: dorsal recumbent position with knees flexed.
Rectal: Assist client in assuming a side-lying or Sims’ position with upper leg flexed
upward. Provides easy access to and good exposure
d. Don gloves Prevents contamination.
e. Insert suppository with gloved hand. Ask client to take slow deep breaths through mouth and to relax sphincter Helps to relax sphincter muscles.
f. Lubricate gloved index finger of dominant hand.
Insert rounded end suppository along posterior wall of vagina as far as it can go using entire length of finger (8 to 10 cm or 3 to 4 in.)
* Instruct client to remain flat on
back for at least 5 – 10 minutes. The hips may also be elevated on a pillow
ADMINESTERING SUBCUTANEOS
a. Identify patient. Prevents error
b. Explain the procedure to the patient and provide for patient privacy. Don gloves if policy requires Promotes cooperation
Prevents potential contact with patient’s blood.
c. Select the correct injection site
(abdomen, upper anterior arm, and
anterior thigh) Promotes absorption
d. Using antiseptic wipe, cleanse the
injection site starting at the center of the site and clean in a widening circle to about 5 cm (2 in.). Allow the area to air dry completely. The mechanical action of swabbing
removes skin secretions, which contain microorganisms.
e. Inject the medication:
* Hold the syringe with dominant hand between thumb & forefinger finger with palm facing to the side or upward for a 45 degree angle insertion or at 90 degree angle depending on the length of the needle.
- Using the non-dominant hand pinch or spread the skin at the site and insert the needle using the dominant hand and a firm steady push
- Move non-dominant hand to the barrel of the syringe and the dominant hand to the end of the plunger
- Aspirate to check if blood appears in the syringe. If blood is present, withdraw the needle, discard the syringe and prepare a new injection. If blood does not appear, inject the medication by holding the syringe steady and depressing the plunger with a slow even pressure Pinching the skin desensitized the area and lessens the sensation of needle insertion.
Spreading the skin can make it firmer and facilitate needle insertion. - Place and hold the swab between the third and fourth fingers of the nondominant hand, or position the swab on the client’s skin above the intended site
f. Withdraw the needle and apply gentle
pressure. DO NOT massage after insulin
or heparin injection. Disperses the medication in the tissues and facilitate absorption. Massage is omitted with heparin and insulin injection because it could cause bleeding and ecchymoses hasten drug absorption.
ADMINISTERING SUBCUTANEOUS MEDICATIONS
EQUIPMENT/SUPPLIES:
- A hypo tray containing:
- 1 cc – 3 cc syringe
- gauge 25 - 26 needle and 3/8 – 5/8 inches long
- antiseptic swab / cotton balls with alcohol
- prescribe medication (ampule or vial)
- medication card
- gloves (per institution policy)
place under tongue and allow to dissolve completely. Caution client against swallowing the tablet.
sublingual
place between cheeks and gums then allow to dissolve completely. Caution client against swallowing the tablet.
buccal
dissolve powders and tablets in water and give immediately
effervescen
, place on tongue and allow to dissolve completely. Caution client against swallowing the lozenge
lozenge
ADMINISTERING ORAL MEDICATIONS
Tablet or Capsule
a. To prepare tablet or capsule from a bottle, pour required number into the bottle cap and transfer medication to medication cup. Maintains cleanliness.
b. To prepare unit dose tablet or capsule, place package tablet or capsule directly into medicine cup (Do not remove wrapper). The wrapper keeps the medication clean. Keeping the wrapper intact facilitates identification of the medication in case the client refuses to take the medication, or assessment data indicate to hold the medication. Unopened unit-dose packages can usually be returned to the medication cart.
LIQUID MEDICATIONS
a. Mix medications thoroughly and discard if it has changed color or become cloudy Ensures potency of medication
b. Remove bottle cap from container and place cap upside down. Prevents contamination of the inside of the cap.
c. Hold bottle with label against the palm of the hand while pouring. Prevents the label from becoming soiled and illegible from spilled liquids.
d. Hold medication cup at eye level and fill to desired level. Ensures accuracy of measurement.
e. When giving small amounts of liquids (e.g., less than 5 mL), prepare the medication in a clean syringe without the needle or in a specially designed oral syringe. Affix and label. Any oral solution removed from the original container and placed into a syringe should be labeled to avoid medications being given by the wrong route (e.g., IV). This practice facilitates client safety and avoids tragic errors.
7. Compare MAR (treatment chart, Kardex, medicine sheet, card) with prepared medication and container. Second accuracy check: Reading label of
medications in multiple-dose containers
reduces administration error
8. Return unused unit dose medication to drawer and read label again. Third accuracy check: Reading label of
medications in multiple-dose containers
reduces administration error
9. Administer medication
a. Identify patient. Prevents potential error
b. Explain the procedure to the patient Promotes cooperation
c. Give medications to client within 30 minutes before or after the prescribed time.
Give pills first, then liquids, then sublingual medications. Give water to facilitate swallowing. Ensures intended therapeutic effect. Give
STAT medications immediately or single order medications at time ordered.
ADMINISTERING EAR (OTIC) MEDICATION
a. Identify the patient Prevents error
b. Explain the procedure to the patient Promotes cooperation
c. Have client assume side lying position
with ear to be treated facing up. To expose the area
d. Don gloves Prevents contamination.
e. Straighten client’s ear canal by gently
pulling pinna down and back (infant
small child) or upward and backward
(adult or over four years of age).
10. Instillation of ear drops:
a. Holding dropper 1/2in. above ear canal
direct toward the side
b. Ask client to remain in side lying position
5 to 10 min. Apply gentle massage or
pressure to tragus for ear with finger.
ADMINISTERING OPHTHALMIC INSTILLATION AND IRRIGATION
a. Identify patient. Prevents error
b. Explain the procedure to the patient Promotes cooperation
c. Ask client to lie supine or sit back in chair
with head slightly hyperextended and have
the patient turn his or her head slightly to
the side (away from eye being medicated)
d. If crusts or drainage are present along eyelid margins and eyelashes or inner canthus, gently wash away. Crusts or drainage harbor microorganisms.
Soaking allows easy removal, thus
preventing pressure from being applied
directly over eye
e. With tissue or cotton ball resting below
lid, gently press downward with thumb or
forefinger against bony part. Exposes lower conjunctival sac. Retraction against bony orbit prevents pressure and trauma to eyeball.
f. Ask client to look at the ceiling Reduces simulation of blink reflex.
Instillation of eye drops:
Instillation of eye ointment:
Instillation of eye ointment
- Wipe the eyelids gently from the inner to the outer canthus to collect excess medication. Keeps the area clean and dry.
