Administering Tubal Medication PDF

[email protected] [email protected] [email protected] Administering Tubal Medication Alternative route for administering medications through the nasogastric or...

[email protected] [email protected] [email protected] Administering Tubal Medication Alternative route for administering medications through the nasogastric or gastrostomy tube. Purpose: For client who cannot take anything by mouth (NPO) and have nasogastric tube or gastrostomy tube in place. Nasogastric (NG) tube: Is inserted by way of the nasopharynx and is placed into the client‘s stomach for feeding or to remove gastric secretions. ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ Assessment: 1- Assess type, size, and site of tube. 2- Assess of the nose, mouth. 3- Assess the area around gastrostomy. 4- Specific drug action and expected response. Equipment: - Medication administration record 2023/2024 (MAR). 2023/2024 2023/2024 - Glass of water, juice, or other liquid. - Pill crusher. - Tommy syringe. - Tissue paper. - Plastic cups. Action Rationale 1- Wash hands Reduce the number of micro organisms 2- Gather equipment. 3- Check the medication administration record (MAR) for the drug name, dosage, frequency, route and expiration date. - Check the medication administration 80  [email protected] [email protected] [email protected] record (MAR) 4- Always check with the pharmacist to see if client‘s medications come in a liquid form because these are less likely to cause tube obstruction. 5- Prepare medication Pill crusher Pills: Using a pill crusher, crush each pill one at a time. Dissolve the powder with water or other recommended liquid in a liquid medication cup Liquid: When pouring liquid ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ medications from a multidosebottle, hold the bottle with the label against the palm. Usethe appropriate measuring device when pouring liquids, and read the amount of medication at the bottom of themeniscus 2023/2024 at eye level. Wipe the lip 2023/2024 2023/2024 of the bottle with apaper towel Liquid drug measuring Capsule open capsules and mix the contents with water only with the pharmacist‘s advice 7- Use only warm water for mixing and flushing. Some medications are mixed with other fluids, such as normal saline, in order to maximize dissolution. 8-. Transport medications to the patient‘s bedside carefully, and keep the medications in sight at all times. 9. Identify the patient. Usually, the 81  [email protected] [email protected] [email protected] patient should be identified using two methods. Compare information with the/MAR. a. Check the name and identification on the patient‘s identification band. b. Ask the patient to state his or her name and birth date, based on facility policy. c. If the patient cannot identify him- or herself, verify the patient‘s identification with a staff member who knows ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ the patient for the second source. 10. Assist the patient to the high To prevent aspiration during administration Fowler‘s position, unless contraindicated of the medication 11- Assess tube placement before giving the medication, aspirate all the stomach and measure 2023/2024 the residual volume. 2023/2024 2023/2024 Aspirate all the stomach and measure the residual volume. 12- When administering the To prevents excess air from entering the medication(s): stomach and causing distention - remove the plunger from the syringe to a pinched or linked tube. Pinching or kinking the tube. 82  [email protected] [email protected] [email protected] 13- Pour 15 to 30 ml of water into the syringe barrel to flush the tube before administration of the drug. Put 15 to 30 ml of water into the syringe barrel to flush the tube. 14- Raise or lower the barrel to the syringe to adjust the flow as needed. Pinch or clamp the tubing before all the ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ water is instilled to avoid excess air entering the stomach. 15- Pour liquid or dissolved medication into the syringe barrel and allow to flow by gravity into the enteral tube. 2023/2024 2023/2024 2023/2024 Raise the barrel to the syringe to adjust the flow as needed and Pour liquid or dissolved medication into the syringe barrel 16- If you are giving several medications, administer each one separately and flush with at least 15 to 30 ml of tap water between each medication. 17- When you have finished administering all medications, flush with another 15 to 30 ml of warm water to clear the tube. 83  [email protected] 18- If the tube is connected to [email protected] suction, [email protected] disconnect the suction and keep the tube clamped for 20 to 30 min after giving the medication to enhance absorption. 19- Re gathers equipment and washes hand. 20- documentation: - Name, dosage and route of medication. - Assessment data relevant to purpose of medication. - Any complication. ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ - Signature. 2023/2024 2023/2024 2023/2024 84  [email protected] [email protected] [email protected] Administration of Topical Medication Type and forms of Topical medication: 1- Instilling eye drops. 2- Instilling eye ointment. 3- Administering ear drops. 4- Instilling nose drops. 5- Instilling metered dose inhaler Purpose ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ - To provide slow continuous local absorption of medication. Indication: 1-To provide pupil dilation to facilitate eye examination or therapeutic procedures. 2-To minimize eye injuries, neutralize chemical action. 3- To soften and remove ceriman (ear wax). 4-To promote better breathing, and loosen secretions. Assessment 2023/2024 2023/2024 2023/2024 1 – Assess proper route of medication administration 2-Assess condition of ear, or eye and surrounding area. 3-Determine purpose for eye or ear medication. 4-Assess client ability to cooperate with eye/ ear medication administration. 5-Assess dyspnea, labored breathing, wheezing. 6-Determine possible undesired systemic effects of inhaled agents (nausea, tremor, and tachycardia). 7-Assess clients breath sounds before and after each treatment. Instilling Eye Drops and Ointment Equipment's: 1- Eye medication in ocumeter container or eye ointment 2- Gloves 3- Tissues paper 85  [email protected] [email protected] [email protected] Procedure Steps Ration ale 1. Check with the client and the chart for any - occurrence of adverse known allergies or medical conditions that Prev would contraindicate use of the drug. ents reactions. 2. Check the MAR against the written orders. -Ensures accuracy in identification of themedications. ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ 3. Gather the necessary equipment. -Promotes efficiency. 4. Follow the five rights of drug -Promotes safety. administration. 5. Take the medication to the client‗s roomand -Decreases risk of contamination. place on a clean surface. 6. Check client‗s identification armband. -Accurately identifies client. 2023/2024 2023/2024 2023/2024 7. Explain the procedure to the client; inquire if -Reduces client‗s anxiety and the client wants to instill own eye drops. enhances collaboration; some clients are used to instilling their own eye drops. 8. Wash hands, don nonsterile gloves. -Decreases contact with bodily fluids. 9. If the eye has crust or drainage along the, -To avoids pushing microorganisms gently wash the eye. Always wipe from inner intothe lacrimal duct. canthus to outer. 10. Place client in a supine position with the head slightly hyperextend Instilling Eye drops -Prevents contamination of the bottle 11. Remove cap from eye bottle and placecap cap. on its side. 86  [email protected] 12. Squeeze the prescribed [email protected] amount of -Ensures [email protected] correct dose. medication into the eyedropper. 13. Place a tissue below the lower lid. -Absorbs the medication that flows fromthe eye. 14. With dominant hand, hold eyedropper 1/2 -Reduces risk of dropper‗s touching to3/4 inch above the eyeball; rest hand onclient‗s eyestructure. forehead to stabilize. 15. Place nondominant hand on cheekbone and -Stabilizes hand and prevents expose lower conjunctival sac by pulling on systemic absorption of eye cheek while applying slight pressure to the inner medication. ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ canthus. Figure 1- Press the lower lid down 2023/2024 2023/2024 2023/2024 and have the client look upward while instilling drops into the lower conjunctival sac. 16. Instruct the client to look up, and drop -Reduces stimulation of the blink prescribed number of drops into center of reflex;prevents injury to the cornea. conjunctival sac. 17. Avoid instilling medication directly intothe -Pain fibers in the cornea make it cornea. verysensitive to anything applied to it. 18. If the client blinks and the drops land onthe -Therapeutic effect achieved only if outer lid or eyelash, repeat the procedure. thedrop enters the conjunctival sac. 19. Instruct client to gently close eyes -Distributes solution over conjunctivalsurface. 20. Remove gloves; wash hands. -Reduces the transmission ofmicr 87  [email protected] 21. Record on the MAR the route,[email protected] site (which [email protected] documentation that eye), and time administered. the medicationwas given. Instilling Eye Ointment 22. Repeat steps 1–10. 23. Lower lid: -Reduces stimulation of the blink reflex, and keeps cornea out of way of With nondominant hand, gently separate medication. client‗s eyelids with thumb and finger, and Ensures that drug is applied to entire grasp lower lid near margin immediately lid. below the lashes; exert pressure downward over the bony prominence of the cheek. ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ Instruct the client to look up. Apply eye ointment along inside edge of the Figure 1- Separate client‗s eyelids entire lower eyelid, from inner to outer with thumb and finger. Apply eye ointment along inside edge of the entire lower eyelid. 24. Upper lid:  Keeps cornea out of way ofmedi 2023/2024 2023/2024 2023/2024 Instruct client to look down. Ensures medication applied to entirelength of lid. With nondominant hand, gently grasp client‗s lashes near center of upper lid withthumb and index finger, and draw lid up and away from eyeball. Squeeze ointment along upper lid starting at inner canthus. 25. Repeat steps 19–21. 88  [email protected] [email protected] [email protected] Instilling Ear Medication Equipment -Medication administration record (MAR) - Medication. -Cotton-tipped applicator. - Gloves. -Cotton balls. Steps Rationale 1. Check with client and chart for any known Prevents the occurrence ofhype allergies. 2. Check the MAR against the health care Ensures accuracy in practitioner‗s written orders. identification of themedication. 3. Wash your hands. Reduces the transfer of microorganisms. ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ 4. Calculate the dose. Ensures the administration of the correctdose. 5. Use the identification armband to properly Ensures correct client. identify the client. 6. Explain the procedure to the client. Enhances cooperation. 2023/2024 2023/2024 2023/2024 7. Place the client in a side-lying position Facilitates the administration of with the affected ear facing up. the medication. 8. Don non sterile gloves. Decreases contact with body fluid. 9. Straighten the ear canal by pulling the Opens the canal and pinna down and back for children or upward facilitates introduction of and outward for adults. medication. A- Straighten the ear canal by pulling the pinna down and 89  [email protected] [email protected] [email protected] back for children. B-Straighten the ear canal by pulling the pinna upward and outward for adults. 10. Instill the drops into the ear canal by holding the dropper at least 1/2 inch above ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ the ear canal C-Instill the drops into the ear canal by holding the dropper at 2023/2024 2023/2024 least 1/2 inch above the ear canal 2023/2024 11. Ask the client to maintain the position for Allows for distribution of the 2 to3 minutes. medication. 12. Place a cotton ball on the outermost part Prevents the medication from of the canal. escapingduring sitting or standing position. 13. Wash hands. Reduces microorganisms. 14. Document the drug, number of drops, time 90  [email protected] [email protected] [email protected] Administering Nasal Drops Equipment: 1- Medication bottle 2-Dropper 3-Tissue paper Procedure: Steps Rationale 1-Compare the medication record with physician order 2- Gather necessary equipment 3-Remove medication from medication cart 4-Compare the label on medication -This is safety check to ensure that ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ container to the medication record medication is for eye instillation 5-Check identity band ,and ask client to statename and birth day 6-Perform hand hygiene 7- Take equipment to client room and bed number against medication record 2023/2024 2023/2024 2023/2024 8-Place client in sitting position with head tilted back or in supine position with head tilted back over pillow. Positioning a Client for Nose Drop Instillation 9-Fill dropper with prescribed amount of medication. 10-Place dropper just inside the naris and instill correct medication dosage.repeat procedure in other naris 91  [email protected] [email protected] 11-Instruct client not to sneeze or blow [email protected] client not to sneeze or blow nose and keep head tilted back for 5 minute nose and keep head tilted back for 5 minute 12-Check to see that client is comfortable 12-Check to see that client is before leaving room comfortablebefore leaving room 13-Perform hand hygiene 13-Perform hand hygiene 14-Return medication to appropriate storage 14-Return medication to appropriate area storagearea ‫ﻋﺒﺪﺍﻟﻠﻪ ﻋﻨﺘﺮ ﻣﺤﻤﺪ ﺍﻟﺪﻳﺐ‬ 2023/2024 2023/2024 2023/2024 92