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3- Parenteral Medication To administer parenteral medications, nurses use injectable equipment which syringes have three parts; the tip, the barrel and the plunger. Syringe The needle contains three parts: 1) hub. 2) Shaft. 3) Bevel. 1 4- Administering Subcutaneous injection Purposes: 1- To provide a medication the client required 2- To allow slower absorption of a medication compared with either the intramuscular or intravenous route. Equipment: - Tray - Galipot containing alcohol swabs - 1 cc syringe - Needle 3 inch, 24 or 25 gauge - prescribed medication (vial or ampules) - Disposable container - Blade or file - Medication sheet Procedure: 1- Wash hands 2- Check the doctor's order 3- Check the patient's and his medication sheet 4- Check the type of drug, the time and the site to give 5- Explain to the patient what you plan to do 6- Wash hands before preparing the injection 7- Maintain aseptic technique throughout the procedure 8- Prepare the medication in the syringe and keep ready for use 9- Identify the patient 10- Screen the bed. 11- Position the patient 12- Find the injection site and clean it with an alcohol swab, using a spiral motion. 13- Hold trie syringe upright and check the dosage, comparing it with the dosage on the medication card 2 14- Remove the sheath, it side on a clean surface, expel air from the syringe 15- Pinch a cushion of tissue at the injection site; insert the needle about binch at 30 to 45° angle, depending on the amount of tissue at the site. 16- Retract the plunger slightly if blood appears in the syringe indicating that "you have entered a blood vessel, withdraw the needle, change the needle and inject in another site, if blood does not appear press the plunger slowly and steadily, injecting the medication. 17- Place a second alcohol swab at the injection site and withdraw the needle quickly, apply pressure and gently massage for a few seconds. 18- Place the sterile sheath over the used needle, and discard it 19- Signs the medication card on the time you gave the medication 20- Return all equipment in its place 21- Return patient to a comfortable position. 3 4 5 3- Administering Intramuscular Injection Purpose: To provide a medication the client requires. Equipment: - Tray - Alcohol swab - 5 cc syringe - Needle 1-2 inch 21-22 gauge - Ampule - Vial - Disposable container - Blade or file - Medication sheet Procedure: 1- Wash your hands 2- Explain to the patient what you plan to do and the purpose of each medication 3- Prepare the equipment 4- Check the dosage from the medication card 5- Maintain aseptic technique throughout the procedure 6- Prepare the medicine in the syringe and keep ready for use 7- Identifies the right patient 8- Screen the bed 9- Position the patient either on his side, or prone position. 10- Fines*they injection’ site' and clean it with an alcohol swat), spiral Motion (Assess for lumps, redness. Echymosis and muscle size) using a 11- Hold* the syringes upright and tap the barrel gently to consolidate the air Bubbles expel the air bubbles and check. Accurate volumes, after insuring proper dosage add 0.2ml to 0.3ml air in the barrel. 12- Spread the skin and underlying tissue tautly at the injection site and insert the needle at a 90° degree angle at the proper site with a quick thrust. 6 13- Retract the plunger slightly if blood appears in the syringe withdraw the needle change the needle and inject in another site. If blood does not appear press the plunger slowly and steadily, injecting the medication. 14- Quickly withdraw the needle, apply pressure to the site, massage gently for a few seconds. 15- Place the sterile sheath over the used needle, and discards the needle you use properly. 16- Sings the medication card on the time you gave the medication. 17- Return all equipment in its place 18- Return patients to a comfortable 7 Administration of rectal medication Purposes: 1- To avoid irritation of trie upper gastrointestinal tract in client who encounter this problem. 2- To released the drug at a slow but steady rate. Procedure: 1- Check doctor's order 2- Prepare equipment 3- Explain the procedure to the patient 4- Screen bed 5- Prepare the patient on his left side extended his left leg and extension his right leg 6- Wash hands 7- Wear disposable gloves 8- Open the suppositories 9- Insert it inside the anus [Figure-561 10- Check that it is inserted in the internal and external 11- Remove the gloves, discard in appropriate place 12- Record on the patient's chart that medication was given 13- Return the equipment used in its place 8 Vials and ampules: - A vial is a small glass bottle with a sealed rubber cap. - Ampule is a glass container usually designed to hold a single dose of a drug. - Ampule file: is used when ampule is not scored. Intervention: Check the medication order. Check the label of ampule. Follow the three check of administrating medication: Before it taken from the shelf. Before with drawing the medication. And after placing it back on the shelf. Flick the upper stem of the ampule several times. Partially file the neck of the ampule. Place piece of sterile gauze between your thumb and ampule and break off top. Dispose of the top of the ampule in the sharp container. Draw medication by place ampule on flat surface. 9 Administration of ophthalmic instillation: Purpose: To provid eye medication to client requires ( antibiotic). Assessment Allergy. Appearance of eye, exudates, erythema, swelling. Ithching. Burning, blurred vision. Willingness to cooperate. Equipment: Disposable gloves. Sterile sponge or gauze. Medication Eye dressing. Intervention: Check the doctor order Hand washing Check the medication. Prepare the client identification. Explain procedure to the patient. Assist the client for comfortable position. Use sterile cotton balls to cleen and moist eye from inner to outer canthus. 10 Instruct the client to lock up to the ceiling and give the client dry sterile absorbent sponge. Expose the lower conjctival sac by placing the thumb or figers of your non dominant hand on the client cheekbone. Approach the eye from the side and instill thr correct number of drops onto outer third and hold the dropper 1 – 2cm above the sac. Instruct the patient to close eye lid but nit squeeze them. Clean eyelid as needed. Apply an eye pad if needed. Return equipment. Hand washing. Documentation the relevant data. 11