Routes of Administration

Question 1

oral med types

Answer 1

tablets, capsules, liquids, suspensions, elixirs, lozenges

Question 2

Which is the most comon route of administration for meds?

Answer 2

oral

Question 3

oral med contraindications

Answer 3

• vomiting
• decreased GI motility
• absence of gag relfex
• dysphagia
• decreased LOC

Question 4

pt position for oral med admin

Answer 4

HOB at 90° to help with swallowing

Question 5

administering oral meds with or without food

Answer 5

• administer irritating meds with small amount of food
• do not mix with large amount of food or drink in case pt can’t consume it all
• avoid admin with interacting foods or drinks
• administer as prescribed:
  
  • empty stomach = 30 min to 1 hr AC or 2 hrs PC
  • with food

Question 6

When is it OK to crush, cut, or dilute meds?

Answer 6

• follow manufacturer’s instructions
• break/cut scored tablets only

Question 7

When should liquid forms be administered, and how should they be prepared?

Answer 7

• use liquid whenever possible to facilitate swallowing
• follow directions for dilution and shaking
• to prepare: place med cup on flat surface, pour and measure to base of meniscus

Question 8

advantage of oral meds

Answer 8

• safe
• inexpensive
• easy and convenient

Question 9

disadvantages of oral meds

Answer 9

• highly variable absorption
• inactivation in GI tract or by first-pass effect
• pts must be cooperative and conscious

Question 10

sublingual (SL)

Answer 10

under the tongue

Question 11

buccal

Answer 11

between cheek and gum

Question 12

client ed: sublingual and buccal

Answer 12

• keep med in place until complete absorption
• do not eat or drink while tablet is in place, until completely dissolved

Question 13

types of topical meds

Answer 13

• powders
• sprays
• creams
• oitments
• pastes
• oil- and suspension-based lotions

Question 14

advantages of topical meds

Answer 14

• painless
• limited adverse effects

Question 15

topical med admin

Answer 15

• apply with glove, tongue blade, cotton-tipped applicator
• do not apply with bare hand
• skin: wash with soap and water, pat dry beforehand
• use surgical asepsis to apply to open wounds

Question 16

transdermal

Answer 16

• med in a skin patch
• systemic effects

Question 17

client ed: transdermal meds

Answer 17

• apply patches according to directions and dosage (remove old before applying new, etc.)
• wash with soap and water, dry thoroughly before applying
• place patch on hairless area
• rotate sites to prevent skin irritation

Question 18

eye drop admin steps

Answer 18

• pt upright or supine, head tilted, looking up
• rest dominant hand on forehead
• drop med from 1-2 cm over conjunctival sac
• avoid placing directly on cornea
• have pt close eye gently
• repeat if they blink during instillation
• apply gentle pressure with tissue to nasolacrimal duct for 30-60 sec
• wait at least 5 min between eye meds

Question 19

eye ointment admin

Answer 19

apply thin ribbon to edge of lower eyelid from inner to outer canthus

Question 20

pt position for ear meds

Answer 20

• sitting upright or side-lying
• preferably side-lying for 2-3 min after instillation

Question 21

ear med admin steps

Answer 21

• pull auricle up and out for adults or down and back for children under 3 years
• instill drops from 1 cm above ear canal
• gently apply pressure to tragus unless painful
• if necessary, gently place cotton ball in outermost part of ear canal

Question 22

nose drops med admin

Answer 22

• use medical aseptic technique
• supine
• support head with nondominant hand
• instruct pt to mouth breathe, stay supine, and not blow nose for 5 min after

Question 23

nose spray admin

Answer 23

• use medical aseptic technique
• prime spray if indicated
• insert tip into nare with nozzle pointed away from center of nose
• spray into nose while pt inhales
• instruct pt not to blow nose for several minutes

Question 24

rectal suppository admin

Answer 24

• position client in left lateral or Sims’
• insert suppository just beyond internal sphincter
• instruct pt to lie flat or in left lateral for at least 5 min after, to retain suppository
• absorption times vary with med

Question 25

vaginal suppository or cream admin

Answer 25

• pt supine with knees bent and feet flat, hips closed (modified lithotomy or dorsal recumbent)
• provide perineal care if needed
• lubricate suppository or fill applicator
• insert med along posterior wall or irrigate as indicated
  
  • suppository: 3-4 in
  • creams, jellies, foams: 2-3 in
• wash reusable applicators with soap and water or discard disposables

Question 26

client ed: MDI steps

Answer 26

• remove cap
• shake vigorously 5-6 times
• hold:
  
  • mouthpiece at bottom
  • thumb near mouthpiece
  • index and middle fingers at top
  • about 1-2 in away from mouth or close mouth around opening and point at back of throat
• take deep breath and exhale
• tile head back slightly
• press inhaler and begin slow, deep inhalation (3-5 sec) at the same time
• hold breath 10 sec
• remove inhaler
• resume normal breathing

Question 27

client ed: MDI spacer

Answer 27

• keeps med in device longer, increases amount of med delivered to lungs
• installation:
  
  • remove covers from mouthpieces of inhaler and spacer
  • insert MDI into end of spacer
  • use as with MDI alone, with mouth on spacer mouthpiece

Question 28

client ed: DPI use

Answer 28

• do not shake
• take cover off mouthpiece
• follow directions for prep (turning wheel or loading med pellet)
• exhal completely
• place mouthpiece between lips and inhale deeply through your mouth
• hold breath for 5-10 sec
• remove inhaler
• slowly exhale through pursed lips
• resume normal breathing
• rinse mouth with water or brush teeth if using corticosteroid (reduces risk of fungal infection)

Question 29

client ed: DPI care

Answer 29

• remove canister
• rinse inhaler, cap, spacer once a day with warm running water
• dry completely before use

Question 30

admin rules: NG and gastrostomy tubes

Answer 30

• use liquid meds if available or crush meds if allowed
• dissolve crushed tabs and capsule contents in 15-30 mL sterile water
• do not crush specifically prepared oral meds (extended/time-release, fluid-rilled, enteric-coated)
• do not give SL meds through tube; place under tongue
• give each med separately
• do not mix with enteral feedings

Question 31

admin steps: NG and gastrostomy tubes

Answer 31

• verify tube placement
• use syringe and allow med to flow in by gravity or push with plunger
• flush before and after each med with 15-30 mL of sterile water to prevent clogging
• flush with 15-30 mL warm sterile water after giving all meds