Medication Administration: Routes and Purposes

Medication Administration Overview

• A medication is a substance used for diagnosis, treatment, cure, relief, or prevention of a health problem.
• Medication administration involves preparing, giving, and evaluating drugs.
• The general objective is for students to apply medication administration safely and correctly.
• Specific objectives include enumerating the purpose of medication administration, identifying different routes, and applying procedures correctly.

Purposes of Medication

• Preventing diseases using vaccines.
• Assisting in diagnosis, for example, barium for X-rays.
• Managing disease.
• Providing relief from stress and symptoms.
• Helping to cure diseases.
• Restoring normal body functions.
• Supplying deficient substances.

Medication Routes

• Oral Route: The most common route, where the drug is given through the mouth and absorbed in the gastrointestinal tract.
  • Forms of oral drugs can include tablets, capsules, powders, and syrups.
  • Advantages include being safe, easy to take, self-administered, painless, comfortable, less expensive, and not requiring a sterile technique.
  • Disadvantages include slow absorption, unpleasant taste, nausea, vomiting, potential destruction of some drugs, and food-drug interactions.
  • Oral route can be inappropriate if the client cannot swallow or has reduced GIT mobility.
  • Potential to cause teeth discoloration and gastric mucosa irritation.
  • Risk of aspiration for seriously ill patients.
• Sublingual: Medication is placed under the tongue to dissolve.
• Buccal: Medication is placed between the gum and cheek to dissolve.
• Topical: Applied to the skin.
• Inhalation: Inhaled into the lungs.
• Instillation: Applied to the eyes, ears, or nose.
• Rectal: Administered via the rectum.
• Parenteral: Administered through injection

Oral Medication Administration Procedure

• Assessment: Involves checking the physician's order and preparing a medication card.
  • The five rights include right patient, medication, dose, route, and time.
  • State the medication's action, purpose, side effects, and nursing considerations.
  • Assess contraindications and allergy history.
  • Review physical assessment findings and lab data influencing medication administration.
  • Assess the client's knowledge, learning needs, and ability to prepare medication.
• Preparation:
  • Nurse: Hand washing.
  • Environment: Close doors and windows, prepare medication card, tray, measuring cups, water, spoon, mortar, and paper bag.
  • Preparation involves selecting the proper medication
  • Compare the medication label.
  • Check the expiration date, color, odor, and consistency.
• Implementation:
  • Provide enough water.
  • Stay with the patient until the medication is swallowed.
  • Record fluid intake and output if needed.
  • In the event the patient refuses medication, record this and notify the physician.
  • Check the patient 30 minutes after administration to verify their response.
• Administering Tablets, Pills, and Capsules:
  • Place the prescribed dose in a container without touching it.
  • Administer all medications together.
  • Crush tablets if the patient has difficulty swallowing, but never crush enteric-coated tablets.
  • Place on top of the tongue and offer water.
  • Discard and replace capsules or tablets that fall on the ground.
• Sublingual Administration: Place medication under the tongue. The patient must allow complete dissolving and not swallow or chew.
• Powder Administration: Mix medications with liquids at bedside and give to patients for drinking

Instillation Medication

• Instillation for eye involves dispensing sterile ophthalmic medication into a patient's eye.
  • Eye drops are instilled to treat eye disorders, anesthetize the eye before surgery, or for routine examinations.
  • Steps include cleaning eyelids with saline, tilting the head back, pulling the lower lid down, and instructing the patient to look upward.
  • Allow drops to fall into the conjunctival sac, release the lid, ask the patient to move the eye in a circular motion, and wipe off excess solution.
  • Apply gently pressure to patients nasolacrimal duct with clean tissue for 30 to 60 seconds over each eye.
• Otic Medication is for the ears
  • Administer ear drops at room temperature, as cold drops can cause vertigo, nausea, or dizziness.
  • Avoid forcing solutions into the ear or occluding the ear canal to prevent injury to the eardrum.
  • Clean the external ear canal with a cotton ball.
  • Straighten the ear canal by pulling down and back on the earlobe for children under 3 years old.
  • Straighten the ear canal by pulling up and back on the earlobe for older children/adults.
  • Resting the dominant hand on the patient's head, put the correct number of drops gently toward the wall of the ear canal, not directly into the eardrum.
  • Ask the patient to remain in position for at least one minute and insert cotton loosely into the external canal.
• Intranasal Medication is for the nose.
  • Ask the patient to blow their nose and tilt their head back.
  • Gently press on the tip of the nose to open the nares,
  • Insert the dropper just inside the nostril and administer the correct number of drops.
  • Patients that are receiving nasal spray, must insert the nozzle part into whatever nostril is open.

Topical Skin Medication

• Involves locally applying medication to the skin and mucous membranes.
  • Includes lotions, creams, ointments, powders, and solutions.
  • Topical medications can cause systemic effects if absorbed through the skin.
  • Apply topical medications with gloves or applicators to reduce accidental exposure.
  • Never apply new medication over previously applied medication.
  • Administer gloves, wash affected areas with soap and paper towel or just regularly and allow skin to dry. Afterward, put prescribes medication onto patients gloved hand, cotton or gauze and apply

Inhaled Medication Administration

• Position the patient upright.
• Remove the mouthpiece cap and shake the inhaler.
  • Release one dose of medication into the air if the inhaler is new or hasn’t been used for several days.
• Instruct the patient to exhale fully.
• The patient should either insert Chamber mouth piece in mouth, or if there is not Chamber device, they should just put the device in their mouth.
• Next the Nurse can instruct patient to breath in slowly. After inhalation, instruct patient to hold breath for roughly 10 seconds.
• After finishing, give patient water, rinse inhaler/mouthpeice, and monitor patient.

Nebulizer Medication Administration

• Put medicine in medicine cup
• With either a mouth piece or mask, connect to the medicine cup.
• Attach medicine cup via tubing to compressor.
• Instruct patient to put mouthpeice to either the tip of mouth (mouth piece), or to simply cover the nose and mouth (mask).
• All that medicine is gone

Rectal Suppositories

• Rectal suppository is a form of medication that melts and is absorbed into the rectal mucosa.
• Rectal medications can exert local or systemic effects.
  • Rectal Route are unreliable in terms of medication absorption and distribution.
  • Medications safe, local irrition very rare.
  • Rectal medication are contraindicated in patients with recent surgery on the rectum, bowel or prostate, as well as those with rectal prolapes or bleeding and those with very weak platelet levels.