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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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