Medication Administration Notes PDF

A medication is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of\... Administration of medications 1. A **medication** is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of diseas...

A medication is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of\... Administration of medications 1. A **medication** is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease. 2. **Pharmacology** is the study of the effect of drugs on living organisms. 3. The written direction for the preparation and administration of a drug is called a **prescription**. 4. Purpose of medication 5. Uses of Drugs 6. It is worth knowing that nurses are responsible for their own actions regardless of the presence of a written order. If a nurse gives an overdose of a drug because it is written by a doctor, the error is accounted to the nurse and not the doctor. The nurse should bear in mind that ALL substances are poisons: there is none that is not a poison. The right dose differentiates a poison from a remedy. 7. **Classification of Medication** 8. **Storage of Medications** Medications are dispensed by the pharmacy to nursing units. Once delivered, proper storage becomes the responsibility of the nurse. All medications must be stored in a cool dry place (usually in cabinets, medicine carts or fridges) 9. **Principles of medication administration** Conduct assessment to ascertain drug action, both desired an side effect. 10. **Medication order** 11. **Types of Medication Orders** 12. **Terminologies and abbreviations used in prescriptions of medications** 1. **Psychological Factors** 2. **Illness and Disease** 3. **Time of Administration** 13. **Safety in Administering medications** 14. **Medication error** Most medication errors occur during the administration stage. 15. **PROCEDURE** A. Enteral Administration 1. Oral Medication 2. Gastric Tube Administration D. **Parenteral Administration of Medications** Parenteral administration of medications is the administration of medications by injection into body tissues. When medications are administered this way, it is an invasive procedure that is performed using aseptic techniques. - Syringes range in sizes from 1 to 60 mL. - A nurse typically uses a syringe ranging from 1 to 3 mL in size for injections (e.g. subcutaneous or intramuscular).  **Routes of parenteral therapies** Intra-dermal Subcutaneous Intramuscular Intra Venous ** Advanced techniques**: -- Epidural -- Intra-thecal -- Intra-osseous -- Intra-peritonial -- Intra-plural -- Intra-arterial **Intradermal Injections** Intramuscular Injections The angle of insertion for an IM injection is 90 degrees. 2 to 5 ml of medication can be admini\...  Ventrogluteal site Injection is given to gluteus medius muscle. Position client in prone or side lying position with the k\... **Subcutaneous Injections**  Kinds of drugs commonly administered: Dorsogluteal site Injection is given to the gluteus maximus muscle. Position the client in prone position. Draw an imagina\... **Intramuscular Injections** The angle of insertion for an IM injection is 90 degrees. 2 to 5 ml of medication can be administered into a larger muscle for an adult. Sites for IM injections are Ventrogluteal Dorsogluteal Vastus Lateralis Deltoid Rectus Femoris  Ventrogluteal site Injection is given to gluteus medius muscle. Position client in prone or side lying position with the knee bent and raised slightly toward the chest. The nurse places the heel of the hand on the client's greater trochanter, with the fingers pointing towards the client head. Rectus Femoris it is used occasionally for IM injections. Situated on the anterior aspect of the thigh. [118. ](https://image.slidesharecdn.com/admintrationofmedications1-copy-181202173921/95/administration-of-medications-118-638.jpg?cb=1543772430) Point the thumb toward the patient's groin and the index finger toward the anterior superior iliac spine; extend the middle finger back along the iliac crest toward the buttock. The index finger, the middle finger, and the iliac crest form a V-shaped triangle; the injection site is the center of the triangle.  For administering in Z-track method pull the overlying skin and subcutaneous tissues approximately 2.5 to 3.5 cm lateral\... [119. ](https://image.slidesharecdn.com/admintrationofmedications1-copy-181202173921/95/administration-of-medications-119-638.jpg?cb=1543772430)Dorsogluteal site Injection is given to the gluteus maximus muscle. Position the client in prone position. Draw an imaginary line to divide the buttocks into 4 equal quadrants. The injection site is upper outer quadrant.  [120. ](https://image.slidesharecdn.com/admintrationofmedications1-copy-181202173921/95/administration-of-medications-120-638.jpg?cb=1543772430)Vastus Lateralis The muscle is located on the anterior lateral aspect of the thigh. Intravenous Administration Needle is injected into the vein. Direct IV or IV push, IV infusion. This is the most rapid r\... The land- mark is established by dividing the area between the greater trochanter of the femur & the lateral femoral into thirds & selecting the middle third. **Deltoid Site** Found on the lateral aspect of the upper arm. Locate the site by placing four fingers across the deltoid muscle, with the top finger along the acromion process. The injection site is then three finger widths below the acromion process.  Complications to observe for during IV therapy:  Infiltration escape of fluid into subcutaneous tissue due to dislodgemen\...  Rectus Femoris it is used occasionally for IM injections. Situated on the anterior aspect of the thigh. **Z-Track Method in Intramuscular Injections** When administering IM injections, the Z-track method be used to minimize local skin irritation by sealing the medication in muscle tissue. The Z-track method has been found to be a less painful technique, and it decreases leakage of irritating medications into the subcutaneous tissue Topical Medication Applications Drugs are applied topically to the skin or mucous membranes, mainly for local action. -- \... For administering in Z-track method pull the overlying skin and subcutaneous tissues approximately 2.5 to 3.5 cm laterally or downward.  Hold the skin in this position until you administer the injection. With the needle at a 90-degree angle to the site administer the medicine. Procedure for Applying Skin Preparations POWDER Make sure the skin surface is dry. Spread apart any skinfolds, and sprinkl\...  **Intravenous Administration** Needle is injected into the vein. Direct IV or IV push, IV infusion. This is the most rapid route of absorption of medications. Angle of insertion is 25 degree. CREAMS, OINTMENTS, PASTES Take the medicine in gloved hands. Spread it evenly over the skin using long strokes in the dire\... For adults, the veins on the arm are: Basilic vein Median cubital vein Dorsal veins Median vein Radial vein Cephalic vein On the foot, the veins are; Great saphenous vein Dorsal plexus Parts of an IV infusion set  **Complications to observe for during IV therapy:** **Infiltration** escape of fluid into subcutaneous tissue due to dislodgement of the needle causing swelling and pain. Gross infiltration may result in nerve compression injury which can result in permanent loss of function of extremity or in case of irritating medications (vesicant), significant tissue loss, permanent disfigurement or loss of function may result. When there is infiltration, the site should be changed. **Phlebitis** is the inflammation of the vein. This may result from mechanical trauma due to the insertion too big a needle (for small vein) or leaving a device in place for a long time. Chemical trauma result s from irritation from solutions or infusing too rapidly. This manifests as pain or burning sensation along the vein. On observation, there may be redness, increased temperature over the course of the vein. The site should be changed and warm compress should be applied. **Circulatory Overload**; the intravascular fluid compartment contains more fluid than normal. This occurs when infusion is too rapid or excess volume is infused. This manifests as dyspnoea, cough, frothy sputum and gurgling sounds on aspiration. ** Embolism;** obstruction of the blood vessels by travelling air emboli or clot of the blood. It is fatal. **Duties of the Nurse during IV Therapy** Explain the need for the IV therapy, what to expect, duration of the therapy, activities permitted during the procedure and observations to be made. Help patient to maintain activities of daily living; bathing and grooming, feeding etc. Observation should be made on the flow rate, patency of the tubing, infusion site, level of fluid in the infusion bag/bottle, patient's comfort and reaction to therapy. Change dressing on the IV line as may be necessary. **Topical Medication Applications** Drugs are applied topically to the skin or mucous membranes, mainly for local action. -- Skin Applications -- Nasal Instillation -- Eye Instillation -- Ear Instillation -- Rectal Instillation -- Vaginal instillation **Skin Applications** Skin applicants are applied using gloves. Before applying medications, clean the skin thoroughly. When applying skin applicants, spread the medication evenly over the involved surface and cover the area well. Topical skin or dermatologic preparations include ointments, pastes, creams, lotions, powders, sprays, and patches. **Procedure for Applying Skin Preparations** **POWDER** Make sure the skin surface is dry. Spread apart any skinfolds, and sprinkle the powder until the area is covered with a fine thin layer of powder. Cover the site with a dressing if ordered. **LOTION** Shake the container before use. Put a little lotion on a small gauze dressing or gauze pad, and apply the lotion to the skin by stroking it evenly in the direction of the hair growth. **CREAMS, OINTMENTS, PASTES** Take the medicine in gloved hands. Spread it evenly over the skin using long strokes in the direction of the hair growth. Apply a sterile dressing if ordered by the physician. **AEROSOL SPRAY** Shake the container well to mix the contents. Hold the spray container at the recommended distance from the area (usually about 15 to 30 cm. Cover the client's face with a towel if the upper chest or neck is to be sprayed. Spray the medication over the specified area. **TRANSDERMAL PATCHES** Select a clean, dry area that is free of hair. Remove the patch from its protective covering, holding it without touching the adhesive edges, and apply it by pressing firmly with the palm of the hand for about 10 seconds. Advise the client to avoid using a heating pad over the area to prevent an increase in circulation and the rate of absorption. Remove the patch at the appropriate time, folding the medicated side to the inside so it is covered. Ear Instillation Administration of medicine drop by drop into ear. Articles Tray Dropper Gloves Medicine **Direct application of liquids- Gargle**  **Gargling** is the act of bubbling a liquid in mouth to reduce the sore throat. The head is tilted back, allowing a mouthful of liquid to sit in the upper throat. Irrigation Some medications are used to irrigate or wash out a body cavity. Commonly used irrigating solutions are steri\... Insertion of drug into body cavity- suppository A suppository is a medicated solid dosage form used in the rectum, vagina and urethra. Vaginal suppositories are called pessaries. Urethra suppositories are called bougies.  Rectal suppository Rectal suppository: Insertion of medications into the rectum in the form of suppositories. Procedure: Give left lateral position, with the upper leg flexed. Expose the buttocks. Wear gloves. Unwrap the suppository and lubricate the suppository. Lubricate the gloved index finger. Procedure Explain procedure to the client. Arrange all articles. Wash hands. Have the client sit or lie with the h\... Encourage the client to relax. Insert the suppository gently into the anal canal, rounded end first along the rectal wall using the gloved index finger. Press the client's buttocks together for a few minutes. Ask the client to remain in the left lateral or supine position for at least 5 minutes to help retain the suppository. **Instillation of drug** Instillation is the administration of liquid form of drug drop by drop. Different drug instillations are; --Nasal Instillation --Eye Instillation --Ear Instillation  Nasal Instillation Administration of medicine drop by drop into nose. Articles -- Tray -- Dropper -- Gloves -- Medicine Perform hand washing. Instruct the patient to clear or blow nose gently. Position the patient. Supine position with head backward. Take the medicine in dropper. Administer the nasal drops. Have patient remain in supine position 5 minutes. Replace the articles and document the procedure. Ear irrigation An ear irrigation is administered to wash the external ear canal to remove secretions or foreign bodies t\...  Eye Instillation Administration of medicine drop by drop into eyes. Articles -- Tray -- Bowl -- Cotton swabs -- Dropper -- Gloves -- Medicine -- Kidney tray Perform hand washing. Position the patient. Ask patient to lie supine or sit back in chair with head slightly hyperextended. Wipe the eyes with cotton balls from inner canthus to outer canthus. Take the medicine. Expose the lower conjunctival sac by placing the thumb or fingers of non-dominant hand on the client's cheekbone just below the eye and gently drawing down the skin on the cheek. Place the emesis basin under the ear to be irrigated. Fill the syringe with solution. Administer the medication drops into conjunctival sac. After instilling drops, ask patient to close eye gently. Replace the articles and document the procedure. **Ear Instillation** Administration of medicine drop by drop into ear. Articles Tray Dropper Gloves Medicine **Procedure:**  Perform hand washing. Place patient in side-lying position. Straighten ear canal by pulling auricle down and back (children younger than 3 years) or upward and outward (children 4 years of age and older and adults). Instill prescribed drops holding dropper 1 cm above ear canal Ask patient to remain in side-lying position 2 to 3 minutes. Replace the articles and document the procedure. **Irrigation** Some medications are used to irrigate or wash out a body cavity. Commonly used irrigating solutions are sterile water, saline, or antiseptic solutions on the eye, ear and bladder. Irrigations cleanse an area. **Eye irrigation** An eye irrigation is administered to wash out the conjunctival sac to remove secretions or foreign bodies or to remove chemicals that may injure the eye. **Articles** Sterile irrigating solution warmed to 37⁰ C (98.6 F) Emesis basin or kidney tray Mackintosh Towel **Procedure** Explain procedure to the client. Arrange all articles. Wash hands. Have the client sit or lie with the head tilted toward the side of the affected eye. Protect the client and the bed with mackintosh. Clean the lids and the lashes with a cotton ball moistened with normal saline or the solution ordered for the irrigation. Wipe from the inner canthus to the outer canthus. Discard the cotton ball after each wipe. Place the emesis basin at the cheek on the side of the affected eye to receive the irrigating solution. Expose the lower conjunctival sac. Hold the irrigator about 2.5cm(1 inch) from the eye. Direct the flow of the solution from the inner canthus to the outer canthus along the conjunctival sac. Irrigate until the solution is clear or all of the solution has been used. Dry the area after the irrigation with cotton balls or a gauze sponge. Offer a towel to the client if the face and neck are wet. Wash hands. Replace all articles and document the procedure. Administration of medications  **Different types of irrigating syringe** Asepto syringe Rubber bulb Piston syringe Pomeroy **Ear irrigation** An ear irrigation is administered to wash the external ear canal to remove secretions or foreign bodies that may obstruct the ear. **Articles** Sterile irrigating solution warmed to 37⁰ C (98.6 F) Disposable gloves Cotton balls Sterile irrigating set (sterile container and irrigating tube or irrigating syringe) Emesis basin or kidney tray Mackintosh Towel **Procedure** Explain procedure to the client. Arrange all articles. Wash hands. Protect the client and the bed with mackintosh. Explain that the client may experience a feeling of fullness, warmth, and, occasionally, discomfort when the fluid comes in contact with the tympanic membrane. Assist the client to a sitting or lying position with head tilted toward the affected ear. Place the emesis basin under the ear to be irrigated. Fill the syringe with solution. Straighten the ear canal. Administer the fluid. Continue instilling the fluid until all the solution is used or until the canal is cleaned. Assist the client to a side-lying position on the affected side for the complete drainage of the fluid. Dry the area after the irrigation with cotton balls or towel. Wash hands. Replace all articles and document the procedure. **Bladder irrigation** Bladder irrigation is done to wash out the bladder and sometimes to apply a medication to the bladder lining. Two method; -- Open method -- Closed method **Closed bladder irrigation** Arrange all articles. Wash hands. Apply clean gloves and cleanse the port with antiseptic swabs. Connect the irrigation tubing to the input port of the three-way catheter. Irrigate the bladder by allowing the irrigating fluid into bladder. Adjust the flow rate. The irrigated fluid back from the bladder is collected in urinary bag. Wash hands. Replace all articles and document the procedure. Administration of medications  **Open bladder irrigation** Arrange all articles. Wash hands. Apply clean gloves and cleanse the port with antiseptic swabs. Disconnect catheter from drainage tubing and place the catheter end in the sterile basin. Place sterile protective cap over end of drainage tubing. Draw the prescribed amount of irrigating solution into the syringe. Insert the tip of the syringe into the catheter opening. Gently and slowly inject the solution into the catheter. Remove the syringe and allow the solution to drain back into the basin. Continue to irrigate the client's bladder until the total amount to be instilled has been injected or when fluid returns are clear. Remove the protective cap from the drainage tube and wipe with antiseptic swab. Reconnect the catheter to drainage tubing. Remove and discard gloves. Perform hand hygiene. Replace all articles and document the procedure. **Inhalation medications** Administration of medications Nebulizers deliver most medications administered through the inhaled route. A nebulizer is used to deliver a fine spray of medication or moisture to a client.  The metered-dose inhaler (MDI) is a pressurized container of medication that can be used by the client to release the medication through a mouthpiece. Administration of medications  Eg: Metric system Household system 1 ml 15 drops 5 ml 1 teaspoon 15 ml 1 tablespoon  Eg: Metric system Apothecary system 1 mg 1/60 grain 60 mg 1 grain 1 g 15 grains 4 g 1 dram 30 g 1 ounce 500 g 1.1 pound \...Converting Measurements Units Conversion within one system Conversion between systems Dosage Calculation Cannula A cannula is a flexible tube that can be inserted into the body. A venous cannula is inserted into a vein, for the\...Pen-like model Size of cannula  DISCLAIMER: THIS MEDICATION IS INTENDED FOR EDUCATIONAL PURPOSES ONLY AND DO NOT REPLACE INDEPENDENT PROFESSIONAL JUDGEMENT. INFORMATION HEREIN PRESENTED ARE TAKEN FROM LITERATURES C\-\-\-\-- UNDER THE REFERENCE SECTION.