198510_633798471340265000

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Administration

of Medications

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MedicationA substance

administered for thediagnosis, cure,

treatment, relief or prevention of disease.

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Types of Doctor¶s Order:

Standing Order- it is carried out

until the specified period of timeor until it is discontinued by

another order.

Single Order- it is carried out for

one time only.

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Stat Order- it is carried out at

once or immediately.

PRN Order- it is carried out as

the patient requires.

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Principles in AdministeringMedications

1. Observe the ³7 Rights´ of drug

administration.

Right drug

Right Dose

Right time

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Right patient

Right Route

Right Approach

Right Recording

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2. Practice asepsis

3. Nurses who administer

medications are responsible for

their own actions. Question any

order that you consider incorrect.

4. Be knowledgeable about

medications that you administer.

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5. keep narcotics and barbiturates in

locked place.

6. Use only medications that are

clearly labeled containers in.

7. Return liquid that are cloudy or havechanged in color to the pharmacy.

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8. Before administering a medication,

identif y the client correctly.9. Do not leave the medications at the

bedside.

10. If the client vomits after taking oralmedication, report this to the nurse

in charge and/or physician.

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11. Pre-operative medications are usually

discontinued during the post-operativeperiod unless ordered to be continued.

12. When a medication is omitted for any reason, record the fact together with thereason.

13. When a medication error is made,report it immediately to the nurse in

charge/or physician.

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Routes of Drug Administration.

1. Oral Route

Forms: a) solid: tablet, capsule,pill, powder.

b) liquid: syrup,

suspension, emulsion.Enteric coated tablets should not

be crushed before administration.

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Suspensions are never administered

intravenously.If the patient vomits within 20 ±

30mins of taking the drugs, notif y

the physician. Do not readminister the drug without a physicians order.

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2. Sublingual- drug placed under the

tongue, where it dissolves.3. Buccal- medication is held in the

mouth against the mucous

membranes. of the cheek until thedrug dissolves.

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4. Topical

a) Dermatologic- lotions, liniments,ointment, pastes and powders.

b) Ophthalmic- instillations and

irrigations.c) Otic

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d) Nasal

e) Inhalation

f) Vaginal- tablet, cream, jelly,

foam, suppositor y

5. Rectal- (objectionable taste or odor)

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6. Parenteral- administration of

medications by needle.a) Intradermal (ID)- under the

epidermis (into the dermis).

b) subcutaneous (SC)- in thesubcutaneous tissue (also,

hypodermic)

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c) intramuscular (IM)- into the

muscle.d) intravenous (IV)- into a vein.

e) intraarterial- into an arter y.

f) intraosseous- into the bone.

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Intradermal (ID)Intradermal (ID)- indicated for allergy

and tuberculin testing and for vaccination.

> SITES:

- inner lower arm

*Left arm- for tuberculin test

* Right arm- for all other test

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- Upper chest

- Back, beneath the Scapula

What to observe?

- less hair y Needle gauge #

- less pigmented - #25,26,27

- less vascularized Needle length

- less keratinized - 3/8´, 5 /8´,1/2´

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- Angle- 10 to 15 degrees angle, bevel

up- Inject a small amount of drug to form

a wheal or bleb.

- Do not massage the site of injection

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Subcutaneous (SC)Subcutaneous (SC)- drug

administered subcutaneous are asfollows:

= Vaccines, pre-operative

medications, narcotics, insulin,heparin.

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SITES: - outer aspect of the upper arm

- anterior aspect of the thigh

- abdomen

- scapula areas of the upper back.

- upper ventrogluteal anddorsogluteal area.

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Needle angle- 45 degrees angle if

5 /8´ needle

-90 degree angle if ½´ needle

(heparin and insulin)

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Intramuscular (IM)- ordered for thefollowing reasons:

1. Rapid absorption because of rich

blood supply2. Muscles can take a greater volume of

fluid without discomfort ( adult can

tolerate up to 3ml in large DG or VLmuscles)

3. Medications that irritating may safely

be given by intramuscular injection.

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Needle length- 1´ , ½´, 2´, (3´ if obese)

Needle gauge- 20, 21, 22 , 23SITES:

1. Ventogluteal site- uses gluteus

minimus muscle.2. Dorsogluteal site- use gluteus

medius muscle.

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- not to be used for children

<3 yrs. of age unless the childhas been walking for 1 yr.

- avoid hitting the sciatic

nerve

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3. Vastus Lateralis Site- recommended

site of injection for infants.

- located at the middle

third of an anterior lateral aspect of

the thigh..

4. Rectus Femoris Site- anterior aspect

of the thigh.

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5. Deltoid site-

Z-tract injection(variation) = for parenteral iron preparation.

- to seal the drug deep intothe muscle.

- prevent permanent stainingof the skin.

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Intravenous (IV)Intravenous (IV)- direct IV, IV push, IV

infusion.- most rapid route of

absorption of medication.

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198510_633798471340265000

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