Principles and Routes of Medication Administration Flashcards
What are the 6 rights of drug administration?
- Right person
- Right drug
- Right dose
- Right time
- Right route
- Right documentation
What should you know about the drugs you provide? (5)
- Indications
- Contraindications
- Dosage
- Side effects
- Rate of administration
What are environments generally sterilized with? (2)
- Heat
- Chemicals
What tool causes the most accidents in healthcare as a whole?
Inadvertent needle sticks
T or F: We must treat all blood and body fluids as potentially infectious
True
How many hands should you use to recap a needle?
One
What are the 4 routes of drug administration?
- Percutaneous (bypasses digestive tract)
- Pulmonary
- Enteral
- Parenteral
What should you do if a patch is given and BP drastically decreases?
Take the patch off
What is one commonly administered sublingual medication?
Nitroglycerine
How should you instruct the patient to take the pill when given buccally or sublingually?
Instruct patient to let the pill dissolve, do not swallow
3 things that increase transdermal absorption rate
- Thin skin
- Overdose
- Penetrating solvents
What do o.d., o.s., and o.u. mean?
- O.d. = right eye (oculus dexter)
- O.s = left eye (oculus sinister)
- O.u. = both right and left eyes (oculus uterque)
What can eye drops or eye ointment be used to treat?
- Eye pain
- Treating infection
- Decreasing intraocular pressure
- Lubricating eyelid
How long should patient close eyes after ocular medication has been given?
1-2 minutes
Before giving a patient nasal meds, what should you instruct them to do?
Blow their nose and tilt head backwards
What does nasal medication commonly treat? (3)
- Nasal congestion
- Hemorrhage
- Infection
What position should patient lie in when given aural (ear) medication?
In the lateral recumbent position
How should you hold the ear when giving medicine to adults? To children?
Adults: pull ear up and back
Pediatrics: pull hear down and back
How long should patient lie with ear up after medication given?
10 minutes
Nebulizer medication administration
- how much saline do you administer?
- how many LPM is regulator set to?
- how long should patient inhale the medication?
- how long does it take?
- Administer 3-5mL of sterile saline to nebulizer if it is not diluted
- Set regulator at 5-8LPM (DO NOT GO OUTSIDE THIS RANGE)
- Hold medication in for 1-2 seconds before exhaling
- This process typically takes 3-5 minutes
What kind of patient typically uses a metered dose inhaler? (MDH)
Someone with asthma or COPD
Why do elderly people and young children often have spacers in their inhalers?
Because they have a hard time operating their inhalers
How long should one gently shake their metered dose inhaler for?
2-5 seconds
Who are nebulizer medications infective to?
Patients with poor tidal and minute volume because drugs cannot reach the site of action
What are the 4 endotracheal medications?
- Lidocaine
- Epinephrine
- Ventolin
- Naloxone
Special considerations when inserting meds through an endotracheal tube? (2)
- Increase IV dosages 2-2.5 times
- Dilute meds in normal saline to create 10mL of solution
What is the most common route for medication?
Enteral administration
What part of the body can alter the medications effectiveness?
The liver. A dysfunctional liver can alter drug distribution and in extreme cases, metabolize therapeutic medications into harmful substances
What are 3 ways that you can possibly retrieve a drug from the enteral route?
- Induce vomiting
- Remove it from the rectum
- Ask the patient to spit it out
How should the medication in a medicine cup be measured? Why?
It should be measured towards the centre, at its lowest level because the sides of the cup are higher, which form the liquid into a meniscus
How much liquid does a teaspoon normally hold?
5mL. However, the volume of a household teaspoon varies significantly
What is the most accurate means of oral liquid medicine administration?
Through an oral syringe
What is an important step when administering medicine orally? How much liquid should follow?
Check the label to see if the medication should be administered with or without food. 100-250mL of water should be used to wash down the medicine
Indications to use a gastric tube? (5)
- Difficulty swallowing
- Nutritional status is poor
- Drug overdose
- Trauma
- Upper GI bleeding
How much normal saline is used to irrigate a gastric tube?
50-100mL
When inserting meds in a gastric tube, how much warm water should you crush the tablet into?
30mL of WARM water. Then draw the medication into a 30-50mL cone tipped syringe. Do not empty syringe completely into gastric tube
How long should the gastric tube be clamped shut after medication has been given?
30 minutes
What drugs can you give rectally? (4)
- Diazepam (Valium)
- Aspirin
- Sedatives
- Antiemetics
What form are rectal drugs in a typical emergency?
Liquid
How long should you hold buttocks closed after you have given a suppository? Why?
5-10 minutes, to allow for retention and absorption
How far should you insert an enema into the anus?
7.5-10mm
When should you not administer rectal drugs?
In the presence of:
- Diarrhea
- Rectal bleeding
- Hemorrhoids
- Severe anal irritation
What are the typical range of syringe sizes?
From 1mL-100mL and greater
What are the calibrations between small vs. large syringes
Small: calibrated in 0.10mL intervals
Large: calibrated in 1.0mL intervals
What are the two parts that make up a syringe?
- Barrel
- Plunger
Hypodermic needle
- Length
- Gauge ranges
- Parts
- Length: 1-3.5cm
- Gauge ranges from 18-27
- Three parts: hilt, shaft and bevel
- Gauge and diameter are inversely related. The large the gauge, the smaller the diameter
What kind of information can you find on a drug label?
- Name of medication
- Expiration date
- Total dose and concentration
What volume can a glass ampule hold? How do you open it?
A glass ampule can hold 1-5mL. To open, place gauze around the thin neck and snap it off with your thumb
This is the cheapest form of drug packaging
An example of two drugs that can be mixed together in one syringe
Meperidine and Promethazine
Intradermal Injection info
- Into the dermal layer of skin at 10-15 degree angle
- Preferably injected into forearm and upper back
- Look for sites free of superficial blood vessels
- Dosage usually less than 1mL
- 25-27 gauge needle, 1-2.5 cm long
- Insert the needle bevel up and hold skin taut
- Do not rub or massage injection site. This promotes systemic absorption and nullifies the advantage of localized effect
Subcutaneous Injection info
- Inject into subcutaneous layer at a 45 degree angle
- Preferred site: upper arm, thighs, abdomen (places that can easily be pinched)
- Avoid blood vessels, nerves, tendons, tattoos or bruising
- Dosage no more than 1mL
- 24-26 gauge needle, 1-2.5cm long
- Insert needle bevel up into pinched skin (2cm)
What is an air plug?
Approximately 0.1mL of air in the syringe that follows the injection and pushed medication further into the subcutaneous tissue, thus preventing leakage or medication loss
Intramuscular Injection info
- Injection sites: deltoid (2mL), dorsal gluteal (5mL), vastus lateralis (5mL), rectus femoris (5mL)
- 21-23 gauge needle, 1-2.5cm long
- Massage skin afterwards, initiating systemic absorption (unless you have injected heparin or another anticoagulant)
