med administration 2

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Author:
jword2
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138232
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med administration 2
Updated:
2012-02-29 00:08:09
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nursing
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  1. Routes of Administration—

    Easiest, most common
    Most preferred route
    Oral Route
  2. Routes of Administration—
    Has a slower onset of action and a more prolonged effect than parenteral
    oral route
  3. Oral Route
    Placing the medication under the tongue
    Should NOT be swallowed, chewed
    Ex: Nitroglycerin (NTG)—Pt. should NOT eat, drink, or chew gum until the medication is completely dissolved
    Sublingual (SL)
  4. Oral Route
    Placing solid medication against the mucous membranes against the cheek until dissolved
    Acts locally on the mucosa or systemically as it is swallowed in the saliva
    Buccal
  5. Oral Route-Patient Education

    Alternate cheeks with each dose to avoid irritation
    Do not chew, swallow the medication
    No intake of liquids
    buccal
  6. Occurs when food, fluid, or medication intended for the GI route enters the respiratory tract.
    Always evaluate your patient’s ability to swallow
    Fowler’s position or seated position
    Lateral position (when swallow, gag, and cough reflexes are intact)
    aspiration
  7. if pt has trouble swallowing?
    • May need consult (Speech therapy)
    • Use other routes, (IV, SC) if possible
    • May administer through NG or feeding tube
  8. Routes of Administration—

    Injecting a medication into body tissue
    perenteral
  9. what are the routes for parenteral administration
    • Subcutaneous (SQ)
    • Intramuscular (IM)
    • Intravenous (IV)
    • Intradermal (ID)
  10. injection into tissues just below the skin
    Subcutaneous (SQ)
  11. injection into a muscle
    Intramuscular (IM)
  12. injection into a vein
    Intravenous (IV)
  13. injection into the dermis, just under the epidermis
    Intradermal (ID)
  14. Routes of Administration

    Meds that are applied to the skin, mucous and respiratory membranes
    topical
  15. Routes of Administration—Topical

    holds the medicated ointment to the skin—application of dosage varies (hours to week)
    transdermal disk
  16. Types of Ophthalmic Meds (eye meds)
    • Eye drops
    • Ointments
  17. what are problems older adults have installing eye meds?
    • Hand tremors
    • Poor vision
    • Poor grasping
  18. Avoid instilling any form of eye medication directly onto ?
    the cornea
  19. Avoid touching the eyelids or other eye structures with ?
    droppers or ointment tubes
  20. Use eye medication only for the patient’s
    affected eye
  21. what kind of applications do nasal installations come in
    spray

    drops

    tampons
  22. Caution patients to avoid abuse of nose drops or sprays—
    can lead to rebound nasal congestion
  23. Topical Medication ApplicationEar Instillation
    • Internal ear structures are very sensitive to temperature extremes
    • Use sterile ear drops
    • Do not occlude the ear with the dropper or irrigating syringe
    • Straighten ear canal according to age of patient.
  24. what type of medical applications are used with vaginal instillation?
    Foams, Jellies, Creams, Suppositories
  25. what is the purpose of irrigation
    • Cleanse an area
    • -Instill a medication
    • -Apply hot or cold to injured tissue
  26. Examples of irrigation are
    normal saline, sterile water, antiseptic solutions
  27. if there is a break in the skin or mucosa or a sterile cavity, use?
    aseptic technique
  28. Non-sterile cavity use ?
    clean technique
  29. Irrigation may be required as part of caring for the?
    eye, ear, throat, vagina, or urinary tract.
  30. administration of meds by injection are considered an invasive procedure - always use?
    aseptic technique
  31. types of syringes -

    Require special needles that twist on and “lock” themselves in place
    The design of this syringe prevents accidental removal of the needle
    luer-lock
  32. types of syringes -
    Also may be referred to as “slip tip”
    Requires special needles to slip onto the tip of the syringe
    non-luer-lock
  33. Long thin barrel with preattached thin needle
    Syringe is calibrated in sixteenths of a minim and hundredths of a milliliter
    Capacity is 1 milliliter
    Used primarily for ID
    Can be used for SC
    Tuberculin Syringe
  34. what are the 3 parts of a needle
    • -Hub (fits on tip of syringe)
    • -Shaft (connects to the hub)
    • -Bevel (slanted tip) has narrow slit that quickly closes after removing the needle to prevent leakage of med.
  35. what length needle do you need for IM injection
    1 to 1 1/2 inch
  36. what length needle do you need for SQ (SC) injection
    3/8 to 5/8
  37. what determines what length needle will be used
    • Size of patient
    • Weight
    • Route of administration
  38. needles can vary in lenth from what sizes?
    1/4" to 3"
  39. Selection of gauge dependent upon
    • Patient comfort
    • Viscosity of fluid
    • Speed of administration
  40. ampules only contain how much medication?
    a single dose
  41. when drawing up medication from am ampule, what kind of needle do you use?
    filter needle
  42. single or multi-dose container that has a rubber seal at the top
    vials
  43. Air needs to be injected into a vial before drawing up because it is?
    a closed system
  44. vials can be what types of medications
    liquid or powder
  45. Medications that are unstable in solution are ?
    packaged dry
  46. what specifies the solvent or diluent needed to prepare a desired medication concentration
    the vial label
  47. what are common diluents for vials of medication?
    normal saline

    sterile distilled water
  48. Mixing one med from vial and other from ampule?
    vial first, then ampule
  49. Mixing meds from two vials?
    • Do not contaminate one medication with another
    • Ensure the final dose is accurate
    • Maintain aseptic technique
  50. When preparing U-100 insulin, what kind of syringe do you use?
    use a U-100-unit-scaled syringe.
  51. Always have a second nurse double-check insulin for right?
    drug, dose, etc.
  52. how do you mix two types of insulin in a syringe?
    • roll long acting or cloudy insulin between palm of hands, do not shake
    • put air in long acting

    put air in short acting

    draw short acting

    draw long acting
  53. Prior to administration of an injection, you must know…
    • The volume to be injected
    • Characteristics and viscosity of the med
    • Anatomical structures that underlie the site being injected
  54. Failure to select an injection site in relation to anatomical landmarks will result in
    bone or nerve damage during needle insertion
  55. If you do not aspirate, the med may go directly
    into an artery or vein
  56. Too large of volume of medication causes
    extreme pain and results in local tissue damage
  57. Use a sharp-beveled needle in the smallest suitable length and gauge
    Position the patient so that muscle tension is decreased.
    Select the proper injection site, using anatomical landmarks


    these ways to ?
    minimize discomfort
  58. Divert patient’s attention—talk to the patient
    Insert the needle QUICKLY and SMOOTHLY to minimize tissue pulling
    Hold the syringe steady while the needle remains in tissues
    Inject the medication SLOWLY and STEADY.


    these are ways to?
    minimize discomfort when giving injections
  59. Injection of medication into the loose connective tissue under the dermis
    Has slower absorption rate than IM
    Subcutaneous or SC/SQ
  60. Outer posterior aspect of the upper arms
    Abdomen below the costal margins to the iliac crest 2” in. from the umbilicus
    Anterior aspects of the thighs
    -Recommended site for heparin injections is the abdomen.
    Low molecular weight heparin - right or left side of the abdomen. Give 2” from the umbilicus
    Subcutaneous Sites
  61. Fastest to slowest absorption sites for SC/SQ injections
    abdomen→ arms→ thighs→buttocks
  62. what guage needles are insulin needles
    26 - 31 guage
  63. If you are able to grasp 2 inches of tissue, insert ?

    if you are able to grasp 1 inch then insert needle at ?


    these are for SQ/SC injections
    90 degree angle


    45 degree angle
  64. Provides faster absorption than SC
    IM injection
  65. needle legnths & guages for IM injections
    legnths - 1/2" to 1 1/2"


    guages - 21 to 25
  66. when administering an IM injection, what angle does the needle need to be?
    90 degrees
  67. never give IM injections in sites with ?
    infection or necrosis

    bruising or abrasions

    underlying nerves, bones, major blood vessels
  68. what are the sites for IM injections
    ventrogluteal

    dorsogluteal

    deltoid

    vastus lateralis
  69. Most frequent route of exposure to blood-borne diseases is from
    needle-stick injuries

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