Module 10 & 11: Administration of Medication via Sublingual, Buccal, Nasal, Optic, or Otic Route/ Dermal, Vaginal, or Rectal Route

Question 1

Administering Eye Instillation’s

Answer 1

• Available in drops, ointments, or intraocular disk
• Avoid instilling directly onto cornea
• Assess condition off external eye structure, cleanse if necessary
• Avoid touching eyelids or other eye structures with droppers or ointment tubes
• Supine position if possible, wait 5 min before administering second medication to same eye
• When administering drops that can cause systemic effects, apply gentle pressure with finger and tissue on patients nasolacrimal duct for 30-60 seconds

Question 2

Administering Nasal Drops (gtts)

Answer 2

• Gently roll or shake medication container
• Instruct patient to clear or blow the nose gently unless contraindicated
• Supine position, remain supine for 5 min following medication administration for nose drops
• High fowlers or sitting position for spray
• Assess if patient prefers to self administer sprays
• Explain to the patient what sensations to expect ( burning/stinging of mucosa, choking sensation)

Question 3

Administering Nasal Sprays

Answer 3

• High fowlers or sitting position
• Close off opposite nostril
• Do not tip spray
• Aim towards back of nostril
• May self administer

Question 4

Nasal Installations

Answer 4

The most commonly uses nasal installations are decongestants.

Question 5

Administering Otic Instillations (gtts)

Answer 5

• Position patient in side-lying position
• For children- straighten ear canal by pulling the auricle down and back
• For adults- straighten ear canal by pulling the auricle upward and outward
• Hold dropper 1cm above ear canal
• Following administration remain side-lying for 2-3 minutes, apply cotton ball if needed
• If cotton ball is needed, place in outermost canal and remove after 15 minutes
• Apply gentle intermittent pressure to tragus 3 or 4 times unless contraindicated due to pain

Question 6

Dermal Administration- Creams, lotions, gels, powders, pastes

Answer 6

• Forms include creams, lotions, gels, powders, pastes, sprays, ointments and patches
• Use gloves for application
• Preparation of skin- cleanse skin, rotate sites and avoid open areas (unless indicated)
• Use sterile technique if pt has open wound
• Clean area thoroughly as ordered
• For patches label with date, time and initials
• If indicated, cover with gauze dressing to prevent soling of clothes and wiping away of med

Question 7

Dermal Administration- Patches

Answer 7

• Use gloves for application
• Preparation of skin- cleanse skin, rotate sites and avoid open areas (unless indicated)
• Ensure previous patches have been removed and disposed of properly
• If using transdermal ointment, apply ordered amount in an even line on pre-measured paper
• Apply to clean, dry, hairless skin
• Rotate sites to avoid irritation
• Label patch with date, time and initials

Question 8

Vaginal Installations

Answer 8

• Available as suppositories, foam, jellies, and creams
• Patients often prefer administering independently
• Bladder to be emptied prior to administering
• Dorsal recumbent position
• Explain what sensation to expect (moisture, wetness_
• Provide privacy and apply gloves
• Inspect condition of external genitalia and vaginal canal noting any discharge
• If using suppository, apply water soluble lubricant
• expose orifice and insert suppository along posterior wall of vagina as far as it will pass (if using applicator 5-7.5cm and push plunger)
• Patient to lie in supine or side-lying position for 10 minutes following administration
• Offer perineal pad

Question 9

Rectal Medications

Answer 9

• Position in left lateral (Sims)
• Provide privacy and apply gloves
• Apply water soluble lubricant to suppository or enema tube
• Inform pt before you begin insertion and instruct to take slow, deep breaths through mouth
• Suppositories placed past internal anal sphincter and against rectal mucosa (10cm in adults 5cm in children and infants)
• After administration, apply gentle pressure and hold buttocks together momentarily
• Ask patient to remain flat or on side for at least 5 min to allow medication to work, hold buttocks together momentarily