Chapter 7Chapter 7

Medication Administration

ObjectivesObjectives

Define all key terms.Explain what supplies are needed for

medication administration.Select the correct needle and syringe for

parenteral injections.Describe the solutions used in IV therapy.Describe blood products.

ObjectivesObjectives

Describe how to administer oral medications safely.

Discuss the methods for administering medications through nasogastric or gastric tubes.

Discuss how to inject IM, SC, and ID medications safely.

Describe how to administer ophthalmic and otic medications correctly.

ObjectivesObjectives

Discuss precautions for the safe administration of inhalation therapy.

Describe how to apply transdermal patches correctly.

Describe how to insert vaginal and rectal medications safely.

Discuss how to prepare the patient for IV therapy.

Nonparenteral SuppliesNonparenteral Supplies

Bottles and unit-dose packagesDroppers Inhalation delivery systemsPatchesSuppositories

SafetySafety

Use correct supplies for route.Do not touch medications with your hands.Dispose of or cleanse droppers after use.Humidify oxygen or room air.Do not cut transdermal patches—apply to

intact skin only.Monitor patient after administration.

Critical ThinkingCritical Thinking

What would happen if a patient used a CPAP machine with a mask for 30 minutes without having added water to the inhaled air?

Parenteral Supplies for Injectable Parenteral Supplies for Injectable MedicationsMedications

Ampules and vialsNeedlesSyringesSafety devicesPrefilled syringes IV supplies IV solutions IV setups

Critical ThinkingCritical Thinking

Why do you think vials are used more than ampules?

SafetySafety

Practice good hand hygiene.Change needle after insertion into

ampules or use filter.Clean site.Use safe needles.Use proper sharps disposal procedure.Monitor patient after injection.

Critical ThinkingCritical Thinking

Why is it dangerous to recap a needle? With so many safety devices available, why do you think there are still so many needle-sticks?

Blood ProductsBlood Products

Whole bloodPacked red cellsPlateletsPolymerized hemoglobin

Critical ThinkingCritical Thinking

Why do physicians prescribe different blood products instead of just giving whole blood?

Administering MedicationsAdministering Medications

Oral medicationsOpthalmic administrationOther types

Oral MedicationsOral Medications

Medications by mouthNasogastric and gastric tube

administration

Ophthalmic AdministrationOphthalmic Administration

DropsOintments

Other AdministrationsOther Administrations

OticNasal Inhalation—inhalers and nebulizersTransdermalVaginalRectal

InjectionsInjections

IntramuscularSubcutaneous Intradermal IV

IntramuscularIntramuscular

Hormones, vaccinations, and pain medications

Needle length 1–1½ inchesGauge 21–23Syringe capacity to 5 ccEnter at 90-degree angle

IM SitesIM Sites

DeltoidDorsoglutealVentroglutealVastus lateralis

Critical ThinkingCritical Thinking

Are the dorsogluteal and ventrogluteal the same site? When would you use each method?

Z-track MethodZ-track Method

Same as regular IM, but displace the skin before and after needle removal

Used for fluids that stain the skin

Subcutaneous InjectionsSubcutaneous Injections

Into fat layer—less blood supply and nerve endings

Can be done by patient at home Sites (usually abdomen, back of upper arm, and

thigh) 45-degree angle Needle length ⅜ inch to ½ inch Gauge 25–31 Syringe capacity 1 mL

Intradermal InjectionsIntradermal Injections

Under epidermis10–15 degree angle25–31 gauge needleNeedle length ⅜ to ½ inchSites (usually forearm)

IV AdministrationIV Administration

IV insertionFlushing indwelling devicesComplications of IV therapyDocumentation

DocumentationDocumentation

Size and type of deviceDate and time insertedSite locationType of solutionName of healthcare provider

inserting/hangingAdditives

Documentation ContinuedDocumentation Continued

Flow rateType of infusion pump usedNumber of attempts at insertionPatient responseComplications, if any, and your

interventionsPatient teaching

Assessment DocumentationAssessment Documentation

Date and timeCondition of siteSite care providedDressing changeSite changeTubing and solution changePatient teaching

SummarySummary

What new piece of information in this chapter were you most interested to learn?

What questions do you still have about the information in this chapter?

Return to Objectives to determine extent of learning.

CreditsCredits

Publisher: Margaret Biblis

Acquisitions Editor: Andy McPhee

Developmental Editor: Yvonne N. Gillam

Production Manager: Samuel A. Rondinelli

Manager, Electronic Development: Kirk Pedrick

Technical Project Manager, EP: Frank Musick

Design Associate, EP: Sandra Glennie

The publisher is not responsible for errors or omission or for consequences from application of information in this presentation, and makes no warranty, expressed or implied, in regards to its content. Any practice described in this presentation should be applied by the reader in accordance with professional standards of care used with regard to the unique circumstances that may apply in each situation.