Download PowerPoint Chapter 10

Chapter 10
Preparing and Administering Medications
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
1
Learning Objectives



Compare dosage forms for drugs given by
the enteral route
Outline procedures for giving medications
enterally, parenterally, and percutaneously
List processes to prevent transmission of
human immunodeficiency virus (HIV) and
other blood-borne pathogens
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
2
Enteral Medications




Medications given directly into the GI tract
Oral; Box 10-1 Oral Medication Forms
Nasogastric or PEG
Rectal
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
3
Oral Administration





Asepsis
Steps to administer: Procedure 10-1
Getting ready
Preparing the medication
Administering the medication
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
4
Oral Administration (cont.)


Solid form
Liquids
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
5
Nasogastric Administration



Appropriate patients
PEG tube
Medication forms:


Liquids
Pills: crushed, add water
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
6
Procedure for Administering
Nasogastric Medications






Aspirate stomach contents
Listen for gurgling sounds in the stomach
Listen for breath sounds
Put medication into the tubing
Instill medications via gravity
Add water to tube following medication
administration
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
7
Rectal Administration




Getting ready
Preparing the medication
Administering the medication
Concluding
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
8
Parenteral Medications



“Into the skin”
Routes
Reasons for parenteral administration
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
9
Standard Precautions



Protect health care workers
Centers for Disease Control (CDC)
Sharps container for disposal of needles
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
10
Parenteral Administration





“Into the skin”
Routes for administration
Parenteral rationale/Advantages
Disadvantages
Costs
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
11
Basic Equipment



Syringes: Figure 10-2
Types of syringes: Figure 10-3
Volume of medication: mL or m
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
12
Parts of a Syringe
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
13
Needles





Needles: gauge
Hub
Specialized needles
Guide for needle selection: Table 10-1
Needleless system: Figure 10-6
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
14
Parts of the needle
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
15
Needles: Gauges
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
16
Question 1
The Z-track method is used to give
medicines:
1.
2.
3.
4.
Orally.
That should be absorbed slowly.
That are irritating or may stain the skin.
Rectally.
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
17
Question 2
____________ are gelatin containers that
hold powder or liquid medicine.
1.
2.
3.
4.
Capsules
Elixirs
Emulsions
Suspensions
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
18
Learning Objectives


Outline procedures for giving medications
enterally, parenterally, and percutaneously
Identify anatomy landmarks used for giving
parenteral medications
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
19
Procedure for Preparing and
Administering Parenteral Medications





Procedure for medication administration:
Procedure 10-3
Determine site for administration
Use of equipment
Package
Medication characteristics
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
20
Forms of Parenteral Medications




Vials: Figure 10-7
Ampules: Figure 10-8
Mix-O-Vial: Figure 10-9
Single or Multidose vials
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
21
Vial
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
22
Ampules
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
23
Forms of Parenteral Medications
(cont.)





Combining drugs in one syringe
Mixing insulin
Prefilled syringes
IV solutions
Secondary or “piggyback”
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
24
Administering Intradermal
Injections




Uses
Skin anatomy and needle angle: Figure
10-12
Bleb
Equipment and technique
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
25
Intradermal Injections
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
26
Administering Subcutaneous
Medications





2 mL into the loose connective tissue
Slow onset, longer duration
Placement: Figure 10-14
Sites: Figure 10-15
Technique
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
27
Subcutaneous Injections
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
28
Administering Intramuscular
Medications





Location
Absorption
Equipment
Sites: Box 10-3
Technique
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
29
Intramuscular Injections
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
30
Question 3
The _____ muscle is a common injection site
for adults, because it is _____.
1.
2.
3.
4.
deltoid; easily reached
dorsogluteal; relatively free from nerves and
major blood vessels
vastus lateralis; less painful
ventrogluteal; near the abdomen
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
31
Administering Intravenous
Medications






Onset and absorption
Dosing and scheduling considerations
Equipment
Sites: Figures 10-18 (adult) and 10-19
(children)
Venipuncture and intravenous infusion
Procedure 10-4
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
32
Intravenous sites in adults
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
33
Intravenous sites in children
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
34
Modifications in Technique for
Specific Situations





Adding medication by syringe to an infusion
Adding medication to a plastic bag or an IV
bottle
Adding medication to a volume control
Adding medication by piggyback infusion
Administration of medication when there is
only an intermittent infusion device
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
35
Intravenous Infusion Rates







Monitoring infusion rates
Calculating infusion rates
Infusion pumps; syringe infusion pumps
Infusion controllers and volumetric pumps
Implantable pumps
Venous access device
Common problems with intravenous
infusions
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
36
Percutaneous Medications



Absorption: mucous membranes or the skin
Absorption and application
Inhalation
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
37
Percutaneous Administration



Factors affecting transdermal application
Skin condition
Methods of administration
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
38
Procedures for Administering
Percutaneous Medications


Applied to the area requiring treatment
Common Forms: Box 10-4
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
39
Administering Topical
Medications







Clean skin before application
Gloves
Lotions
Ointments
Excess medication
Dressings
Patient Education – Home Care
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
40
Administering Medications to
Mucous Membranes








Absorption
Sublingual
Buccal
Vaginal
Ear drops: child and adult
Eye
Nose
Respiratory
Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
41