Fundamentals of nursing fatima

FUNDAMENTALS OF NURSING

MEDICATION ADMINISTRATION

Instructor: Dr. Fatemeh Khoshkhou

Nursing StudentSemester: 1Session 12

www.dr-khoshkhou.com

By end of this session Students will be able:

� Explain the mechanism of the drug

� Understand effective factors on medication function

� Discuss side effects

� Explain medication orders

� Calculate a prescribed medication dose

� Discuses different name of drugs

� Explain the seven rights of medication administration

� Explain different routes of administration

� Describe the importance of safe medication techniques

� How to read medication abbreviation

� Explain the nursing process and medication administration

LEARNING OBJECTIVES:


� Medication are administered to clients to prevent, diagnose, or treat disease and health condition

� As a nurse you need to understand the actions and effects of the medications your client take.

� To safely and accurately administer medications, nurses must have an understanding of pharmacology, pharmacokinetics, human growth and development, human anatomy, pathophysiology, psychology, nutrition and mathematics.

SCIENTIFIC KNOWLEDGE BASE

MEDICATION ADMINISTRATION


Medication administration is an important component of nursing care

MECHANISM

The nurse should know about the mechanism of drugs.� Absorption� Distribution� Metabolism� Excretion

Effective factors on medication function� Growing stages� Weight� Gender� Culture and genetic factors� Mental factors� Environment� Pathology� Timing of administration


SIDE EFFECTS

� Iatrogenic

� Drug allergy(rash, diarrhea, nausea, vomiting, fever)

� Anaphylactic(respiratory distress, broncho-spasm, cardiovascular collapse)

(treatment: epinephrine, bronchodilators)

� Tolerance effect

� Cumulative effect

� Idiosyncratic effect

� Drug interaction



� A medication order is required for any medication to be administered

by a nurse.

� Nurse can take orders from: physician, dentists (see the hospital rules)

� Before carrying out a medication order: � determine that the order is clear, complete, current, legible and appropriate, and

� verify that the order, pharmacy label and/or medication administration record (MAR) are complete.

A complete order includes:

� client name

� date prescribed

� medication name

� strength and dosage

� route

� dose frequency

� why the drug is prescribed (when it is a PRN medication)

� quantity to be dispensed (if appropriate)

� Prescribed signature

MEDICATION ORDERS

TYPES OF ORDERS

� Routine medication orders

� PRN (as needed)

(for controlling of pain)

� Single orders (one-time)

(before operation)

� STAT orders

(anaphylactic shock)


THE NAME OF DRUGS

1-Chemical name

(chemical and molecular instructor)

2-Generic name

(The first factory, from chemical name)

3-Official name (Formal publication)

4-Trade name (The name of specific factory for sale)

For example: acetaminophen, Tylenol, tempra, liquiprin


GENERAL PRINCIPLES AND PRACTICES

OF MEDICATION ADMINISTRATION

� The right medication

� The right dose

� The right time

� The right route

� The right client

� The right documentation

� The right reason

(the nurse must check the drugs 3 times before taking)


ROUTS OF ADMINISTRATION

Drugs inter the body through three general Routes:

1-Enteral

2-Precutaneous

3-Parenteral

The drugs that enter the boy by these routs come in various forms.


ENTERAL

Drugs that enter through the enteral (by the GI tract)

Routs are given in these forms:

1-powders (often mixed with a liquid before administration)

2-pills (powder mixed with sticky substances) (round, solid drug form that must be broken down into solution form in the stomach)

3-Tablets (round, spherical, or oddly shaped forms that dissolve in the stomach, types of tablets include: capsule, lozenge,…)

4-Liquids and suspension

5-Suppositories (drugs mixed with lubricated substances, molded to insert into body cavities such as rectum)


THE ENTERAL ROUTES

1-PO: by mouth

2-Tubal: by nasogastric, gasterostomy, Jejunostomy tube, into the stomach

3-Suppository: by rectum, vagina, urethra

4-Enema: by rectum


PERCUTANEOUS

Through the skin or mucus membranes Include:

� Lotions

� Ointments

� Creams

� Powders


PARENTERAL

They are usually thought of as the “needle” Route.

� Ampules

� Vials


THE PARENTERAL ROUTES

1-IM: Intramuscular (within the muscle)

2- SC, SQ or Subq: subcutaneous(under the dermis

Fatty tissue)

3-ID: Intra-dermal (within the dermis)

4-IV: Intra venous (within the vein)


INTRAMUSCULAR INJECTIONS

Places

� Ventrogloteal

� Dorsogloteal

� Vastus lateralis

� Deltoid



TYPES OF SYRINGES

DORSOGLUTEAL MUSCLE


�This site is not used with infants or children Under 3 years

of age due to underdeveloped Muscle

�Risk of sciatic nerve

�5 cc for injection

�Needle 20-23 and 3.75-7.5 length

�Angle of insertion is 90 degrees

VENTROGLUTEAL MUSCLE


VASTUS LATERALIS MUSCLE


�Is the preferred site for children under 3 years of age

because it is free of nerves and blood vessels.

DELTOID MUSCLE


�The brachial vein and artery and the radial nerve are in this area.

�0.5-2 cc for injection

�Needle 23-25 and 1.5-2.5 length

�Angle of insertion is 90 degrees

INTRADERMAL INJECTIONS

1- for skin test agent

2-vaccine

� Needle 25-26-27 with 0.6-1.5 length

� Small volumes: 0.01-0.1 cc

� Create small bubble like

� Angle of insertion is 15 degrees


SITES OF INTRADERMAL INJECTIONS


SUBCUTANEOUS INJECTIONS

� Insulin and heparin are given by SC route.

� Between the dermis and the muscle layer

� No more than 1 cc or ml

� Angle of insertion is 45 degrees.

� Because is not as richly supplied with blood as the muscles, drug absorption is somewhat slower than with IM injections.

� Sites: outer aspect of upper arms, the abdomen, thighs, scapula.


SITES OF SUBCUTANEOUS INJECTIONS


ADMINISTERING EAR DROPS


�For adults and for children over 3 years old, pull earlobe upward and back to

straighten external auditory

�For children under 3 years old pull earlobe downward and back

ADMINISTERING EYE DROPS


�To apply drops, expose lower

conjunctival Sac by having

patients look upward while gentle

traction is applied to lower eyelid.

ADMINISTERING EYE OINTMENTS


�To apply ointments, expose lower

conjunctival Sac by having

patients look upward while gentle

traction is applied to lower eyelid.

INTRA VENOUS THERAPY


CLINICAL CALCULATIONS


� Conversion system

� Dose calculation

Dose ordered/dose on hand ×Amount on hand=Amount to administer

� Pediatric doses(?)

ABBREVIATION

Bid (twice a day)

Tid (three times daily)

Qid (four times a day)

Qd (every day)

Ac (before meals)

Pc (after meals)

Hs (at bedtime)

� PRN(As needed)

� Stat (immediately)

� IM

� IV

� SC, SQ

� ID

� Syr (syrupus)

� Susp(suspension)

� Supp (suppository)

� Cap


ABBREVIATION

Tab

Amp

Dropp

Gtt

Ml

Cc

Mg

gr

Mg/dl

Od

Os

Ou

Po

NPO

Inhalation

Z reack

Qh (every hours)

Q2h (every two hours)

Q3h (every three hours)



1-Assessment

�History

�History of allergies

�Medication data

�Diet history

�Client’s perceptual or coordination problems

�Client’s current condition

�Client's attitude toward medication use

�Client's knowledge and understanding of medication therapy

2-Nursing Diagnosis

� Anxiety

� Ineffective health maintenance

� Deficient knowledge of medications

� Impaired swallowing

� Ineffective therapeutic regimen management

3-Planning

� Goals and outcomes

� Setting priorities

� Collaborative care

4-Implementation

� Health promotion

� Acute care

5-Evaluation

� Use evaluation measure

� Apply various evaluation measure

NURSING PROCESS AND MEDICATION ADMINISTRATION

REFERENCES

1-Taylor C, Lillis C, LeMone P, Kluwer W. (2007) Fundamentals of Nursing: The Art

and Science of Nursing Care, Health/Lippincott Williams & Wilkins.

2- Perry AG, Potter PA, Stockert P. (2006) Fundamentals Of Nursing - Text And

Clinical Companion Package. Mosby

3- Ladner PK, Delaune SC. (2008)Fundamentals Of Nursing. Delmar Publishers

5-Khoshkhou F. Fundamental of Nursing, Available at: www.dr-khoshkhou.com

6- اصول و فنون پرستاری مليحه سادات -اصول و فنون پرستاری تايلور -اصول پرستاری دوگاسکتاب و مريم عالی خانیموسوی



This lecture is available at:www.dr-khoshkhou.com

Please feel free to contact through my website


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Fundamentals of nursing fatima

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