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Questions and Answers
In the context of percutaneous administration, what is the primary reason for choosing the skin or mucous membranes as the route of delivery?
In the context of percutaneous administration, what is the primary reason for choosing the skin or mucous membranes as the route of delivery?
- To facilitate easy removal of the medication in case of adverse reactions.
- To achieve a rapid onset of action for emergency medications.
- To target localized skin infections without systemic effects.
- To bypass the first-pass metabolism in the liver. (correct)
A patient is prescribed a topical corticosteroid cream for eczema. Which instruction should the nurse emphasize during patient teaching regarding proper application?
A patient is prescribed a topical corticosteroid cream for eczema. Which instruction should the nurse emphasize during patient teaching regarding proper application?
- Apply a thick layer of cream to maximize absorption.
- Apply the cream only to open lesions to promote healing.
- Rub the cream vigorously into the skin until fully absorbed.
- Apply a thin layer of cream and gently pat it onto the affected area. (correct)
When preparing a patient for patch testing, which action is most critical for the nurse to confirm prior to the procedure?
When preparing a patient for patch testing, which action is most critical for the nurse to confirm prior to the procedure?
- Cleansing the area with an antiseptic solution to prevent infection.
- Applying a topical anesthetic to minimize discomfort during patch application.
- Shaving the area where the patch will be applied to ensure proper adhesion.
- Ensuring the patient has not taken antihistamines for at least 5 days. (correct)
A patient is prescribed nitroglycerin ointment for angina. What specific instruction should the nurse provide regarding the application technique to prevent self-exposure?
A patient is prescribed nitroglycerin ointment for angina. What specific instruction should the nurse provide regarding the application technique to prevent self-exposure?
A nurse is teaching a patient about the proper use of transdermal patches. What should the nurse emphasize as the most important reason for rotating application sites?
A nurse is teaching a patient about the proper use of transdermal patches. What should the nurse emphasize as the most important reason for rotating application sites?
A patient is prescribed a sublingual medication. What instruction should the nurse emphasize to ensure optimal absorption?
A patient is prescribed a sublingual medication. What instruction should the nurse emphasize to ensure optimal absorption?
Why do buccal medications tend to have a more systemic effect compared to topical applications?
Why do buccal medications tend to have a more systemic effect compared to topical applications?
When instilling eye drops, what is the rationale behind applying gentle pressure to the inner corner of the eyelid after administration?
When instilling eye drops, what is the rationale behind applying gentle pressure to the inner corner of the eyelid after administration?
A nurse is preparing to administer eardrops to a 15-month-old infant. Which technique is most appropriate for this age group?
A nurse is preparing to administer eardrops to a 15-month-old infant. Which technique is most appropriate for this age group?
A patient is prescribed nasal spray for seasonal allergies. What instruction is most important for the nurse to provide to prevent rebound congestion?
A patient is prescribed nasal spray for seasonal allergies. What instruction is most important for the nurse to provide to prevent rebound congestion?
When administering medications via nebulizer, what should the nurse advise the patient to do to maximize medication delivery?
When administering medications via nebulizer, what should the nurse advise the patient to do to maximize medication delivery?
What is the most critical step for a patient using a metered-dose inhaler (MDI) to ensure optimal medication delivery to the lungs?
What is the most critical step for a patient using a metered-dose inhaler (MDI) to ensure optimal medication delivery to the lungs?
A patient is to self-administer a vaginal suppository. What should the nurse include in the instructions to enhance medication effectiveness?
A patient is to self-administer a vaginal suppository. What should the nurse include in the instructions to enhance medication effectiveness?
A patient with a known allergy to adhesive bandages is prescribed a medication that is available only as a transdermal patch. Which approach is most appropriate for the nurse to take?
A patient with a known allergy to adhesive bandages is prescribed a medication that is available only as a transdermal patch. Which approach is most appropriate for the nurse to take?
When educating a patient on the use of a dry powder inhaler (DPI), what key point should the nurse emphasize regarding the patient's inhalation technique?
When educating a patient on the use of a dry powder inhaler (DPI), what key point should the nurse emphasize regarding the patient's inhalation technique?
A patient is prescribed a topical medication to treat a fungal infection. What instruction to include regarding preventing transmission of the infection?
A patient is prescribed a topical medication to treat a fungal infection. What instruction to include regarding preventing transmission of the infection?
A patient is using a transdermal patch for pain management. Which of the following actions indicates the need for further teaching?
A patient is using a transdermal patch for pain management. Which of the following actions indicates the need for further teaching?
Which instruction is most important for the nurse to give a patient who is using topical corticosteroids long-term?
Which instruction is most important for the nurse to give a patient who is using topical corticosteroids long-term?
A nurse is demonstrating the application of a nitroglycerin ointment. Which action demonstrates correct technique?
A nurse is demonstrating the application of a nitroglycerin ointment. Which action demonstrates correct technique?
When educating a patient on using eye drops for glaucoma, what is the most important point for the nurse to emphasize to promote adherence?
When educating a patient on using eye drops for glaucoma, what is the most important point for the nurse to emphasize to promote adherence?
A patient is prescribed a vaginal cream for a yeast infection. What advice is most important to provide regarding hygiene?
A patient is prescribed a vaginal cream for a yeast infection. What advice is most important to provide regarding hygiene?
The nurse is preparing to administer a topical medication. Which factor requires the nurse to double-check the medication order with the prescribing health care provider?
The nurse is preparing to administer a topical medication. Which factor requires the nurse to double-check the medication order with the prescribing health care provider?
The nurse is providing instruction to the parent of a 6-month-old infant regarding the administration of eardrops to treat an ear infection. Which statement indicates a need for further instruction?
The nurse is providing instruction to the parent of a 6-month-old infant regarding the administration of eardrops to treat an ear infection. Which statement indicates a need for further instruction?
The nurse plans to administer an ophthalmic medication to a client. Which nursing action best reduces the risk of systemic absorption of the medication?
The nurse plans to administer an ophthalmic medication to a client. Which nursing action best reduces the risk of systemic absorption of the medication?
The clinic nurse is providing instructions to a client regarding the use of a nasal spray to treat nasal congestion. Which information should the nurse include in the instructions?
The clinic nurse is providing instructions to a client regarding the use of a nasal spray to treat nasal congestion. Which information should the nurse include in the instructions?
The nurse is educating a client on the safe use of a metered-dose inhaler (MDI). Which statement, if made by the client, indicates a need for further teaching?
The nurse is educating a client on the safe use of a metered-dose inhaler (MDI). Which statement, if made by the client, indicates a need for further teaching?
A nurse is planning to administer a vaginal suppository. Which nursing action is most appropriate?
A nurse is planning to administer a vaginal suppository. Which nursing action is most appropriate?
A nurse is instructing the client with heart failure in the use of nitroglycerin ointment. Which of the following statements indicates an understanding of providing self-care using this topical medication?
A nurse is instructing the client with heart failure in the use of nitroglycerin ointment. Which of the following statements indicates an understanding of providing self-care using this topical medication?
Flashcards
Percutaneous Administration
Percutaneous Administration
Applying medication to skin or mucous membranes for absorption.
Creams
Creams
Non-greasy and can be easily removed using water.
Lotions
Lotions
Designed to soothe the skin.
Ointments
Ointments
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Dressings
Dressings
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Patch Testing
Patch Testing
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Wheal
Wheal
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Transdermal drug delivery
Transdermal drug delivery
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Sublingual tablets
Sublingual tablets
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Buccal tablets
Buccal tablets
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Ophthalmic
Ophthalmic
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Otic
Otic
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Eardrop administration for < 3 years
Eardrop administration for < 3 years
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Eardrop administration for > 3 years
Eardrop administration for > 3 years
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Nebulizer
Nebulizer
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Study Notes
- Percutaneous administration involves applying medications to the skin or mucous membranes for absorption.
- Percutaneous administration includes topical applications like ointments, creams, dressings, lotions, and powders.
- Percutaneous administration includes inhalation of aerosolized liquids or gases and instillation of solutions.
Seven Rights & Patient Teaching
- Always follow the seven rights of drug administration during percutaneous administration.
- Premedication assessment and explanation is required.
- Patient teaching should include the need to wash hands, perform proper application techniques, and detail the frequency of treatment.
- Instruct the patient in any cautions specific to the drug being administered and on adverse effects.
- The patient should know when to contact their healthcare provider.
- Documentation is required, including date, time, drug, dosage, and route, and any patient symptoms, like rash or vesicles.
Types of Medications
- Creams are non-greasy and can be removed with water.
- Lotions contain soothing agents.
- Ointments are oil-based and keep medications in contact with the skin longer.
- Dressings include dry gauze, transparent films, and hydrocolloid options.
- Dressings should be used according to orders.
Protocol for Topical Medications
- Wash hands and put on gloves.
- Position the patient comfortably before starting.
- Clean the area where the medication will be applied.
- Shake lotion bottles to ensure proper suspension.
- Use a tongue blade to remove the desired amount of ointment or cream from the container.
- Shake lotions well until a uniform appearance is obtained.
- Use a tongue blade to remove the desired amount of ointments.
- Powders must be applied to clean and dry skin; shake well to break up clumps.
- Dressings should have the prescribed amount of medication spread directly onto them.
- If using wet dressings, wring them out to prevent dripping.
Nicotine Administration
- Nicotine can be administered transdermally for an antismoking program.
Patch Testing for Allergies
- Patch testing identifies sensitivity to contact materials like soaps, pollen, and dyes.
- Allergens are placed on a patch, which is placed in contact with the back, arms, or thighs.
- The patch is left in place for 48 hours.
- The site should be aired for 15 minutes and read.
- A wheal is the definitive reaction indicating an issue, measured on a scale of 1+ to 4+.
Nitroglycerin ointment application
- Emergency equipment must be available in case of anaphylactic response.
- Wash hands and put on gloves.
- Patient is positioned.
- The area is cleaned.
- Apply the dose-measuring applicator paper.
- Do not rub in the ointment.
- Cover the area with plastic wrap.
Nitroglycerin Ointment
- Follow procedure protocols and don gloves.
- Select a new application site for each dose.
- Measure the dose amount on application paper and spread in a thin layer without rubbing.
- Cover the area with plastic wrap and tape.
- Dispose of gloves and wash hands.
- Educate the patient.
- Document the procedure.
Applying Topical Nitroglycerin
- Squeeze topical nitroglycerin onto an applicator paper and place it on the skin, do not massage.
Transdermal Patches
- Transdermal patches provide a controlled release of medication.
- Wash hands and put on gloves.
- Position the patient.
- Apply the topical disk or patch.
- Application frequency varies depending on the drug and order.
- Wash hands after application.
- Label the disk with the time, date, and nurse initials to avoid confusion with scheduling.
Sublingual and Buccal Tablets
- Sublingual tablets are placed under the tongue.
- Buccal tablets are held in the buccal cavity.
- Both offer rapid absorption and onset of action; action is usually systemic.
Eye Medications
- All medications used for the eye must be labeled ophthalmic and be sterile solutions.
- Inspect the affected eye and clean away any exudate.
- Expose the lower conjunctival sac.
- Approach the eye from below.
- Never touch the eye with the dropper or tube.
- Apply gentle pressure on the inner corner of the eyelid for 1 to 2 minutes after application to prevent systemic absorption.
Administration of Ear Drops Considerations
- All medications used for the ear must be labeled otic.
- Ensure the ear is clear of wax.
- Warm medication to room temperature before application.
- For children younger than 3 years, pull the earlobe downward and back when administering eardrops.
- For patients older than 3 years, pull the earlobe upward and back.
- The patient should remain in position for a few minutes after application to allow for complete absorption.
Ear Drop Placement for 2 year old
- Administer ear drops to a 2 year old by pulling he affected ear down and back.
Ophthalmic Drop Installation
- Minimize the risk of systemic absorption of ophthalmic drops by placing a gloved finger against the inner canthus for 1 to 2 minutes after installation.
Nasal Spray Administration Instructions
- Instruct the patient to blow their nose gently prior to use to clear passages.
- For nose drops, position the patient lying down with head hanging over the edge of the bed/table/etc.
- For nasal spray, the patient should be upright.
- Block one nostril and shake the bottle, then insert the tip into the open nostril.
- Spray while the patient inhales.
Nebulizers and Inhalers
- Prepare the medication, and fully fill the nebulizer.
- The patient exhales through pursed lips and then puts the nebulizer in their mouth, but do not seal completely.
- The patient then inhales.
- Metered-dose and dry powder inhalers all require following the specific instructions on the inhaler itself.
Dry Powder Inhaler Use
- With a dry powder inhaler (DPI), a patient knows it is time to replace the inhaler when they do not notice symptom improvement after using the inhaler.
Vaginal Medication Administration
- Have the patient empty the bladder before administration.
- Wash hands and put on gloves.
- Fill the applicator.
- Place the patient in the lithotomy position, and elevate the hips with a pillow.
- Spread the labia and gently insert the applicator or suppository.
- Remain in position for 5 to 10 minutes after the application.
- Wash the applicator with warm, soapy water after each use.
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