Download Pharmacology and the Nursing Process, 4th ed. Lilley/Harrington

Chapter 9
Photo Atlas of Drug Administration
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Preparing for Drug Administration
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Check the “Six Rights”
Standard Precautions: Perform hand hygiene!
Double-check if unsure about anything
Check for drug allergies
Prepare drugs for one patient at a time
Check label three times
Use verified medication record
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Preparing for Drug Administration
(cont’d)
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Check expiration dates
Check for compatibility
Check patient’s identification
Give medications on time
Explain medications to the patient
Open medications at the bedside
Document medications given before going to the next
patient
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Administering Enteral Drugs
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Oral medications
Sublingual or buccal medications
Orally disintegrating medications
Liquid medications
Oral medications to infants and children
Drugs given through a nasogastric or gastrostomy tube
Rectal drugs
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Classroom Response Question
The nurse’s instructions to a patient who is to take an orally
disintegrating tablet would include which statement?
A. “Place the tablet on the tongue, and let it dissolve
there.”
B. “After it starts dissolving, chew the medication.”
C. “Place the tablet on your tongue, and then take a sip of
water.”
D. “This tablet will take a few minutes to fully dissolve.”
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Parenteral Drugs
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Never recap a used needle!
May recap an unused needle with the “scoop
method”
Prevention of needlesticks
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“Needleless” systems
Filter needles
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Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Parenteral Drugs (cont’d)
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Removing medications from ampules
Removing medications from vials
Safe disposal of used needles and syringes
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Injections
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Needle angles for various injections
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Intramuscular (IM)
Subcutaneous (subcut)
Intradermal (ID)
Air-lock technique
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Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Injection Techniques
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Intradermal injections
Subcutaneous injections
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Insulin administration
Heparin administration
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Insulin Syringes
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Always use an insulin syringe to administer
insulin
Types of insulin syringes
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100-unit syringe (U 100)
50-unit syringe (U 50)
Patient self-administration of insulin
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Classroom Response Question
A patient is ordered to receive two different types of insulin.
The nurse will
A. draw each insulin into an insulin syringe and administer
two injections.
B. draw the cloudy insulin into the insulin syringe first then
the clear insulin into the same syringe.
C. call the prescriber to question the order.
D. draw the clear insulin into the insulin syringe then the
cloudy insulin into the same syringe.
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Intramuscular Injections
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Sites
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Ventrogluteal site (preferred)
Vastus lateralis site
Deltoid site
Dorsogluteal site (not recommended)
Z-track technique
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Classroom Response Question
A patient is to receive a 0.5-mL injection of iron dextran,
which can be very irritating to the body’s tissues. The
proper technique for administration of this drug would be
a(n)
A.
B.
C.
D.
IM injection using the Z-track technique.
IM injection into the deltoid muscle.
subcutaneous injection into the abdomen.
intradermal injection into the forearm.
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Classroom Response Question
Which is the safest site for administration of an
intramuscular injection to an adult?
A.
B.
C.
D.
Deltoid
Dorsogluteal
Vastus lateralis
Ventrogluteal
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Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Intravenous Medications
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Needleless systems
Compatibility issues
Expiration dates
Infusion of intravenous piggyback (IVPB)
medications
Labeling intravenous (IV) infusion bags when
adding medications
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Intravenous Medications (cont’d)
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Adding medications to a primary infusion bag
IVPB medications (secondary line)
IV push medications (bolus)
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Through an IV lock
Through an existing IV infusion
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Intravenous Medications (cont’d)
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Volume-controlled administration set
Using electronic infusion pumps
Patient-controlled analgesia (PCA) pumps
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Topical Drugs
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Eye medications
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Drops
Ointments
Eardrops
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Adults
Infant or child younger than 3 years of age
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Classroom Response Question
When administering eye drops, where will the nurse place
the drop?
A.
B.
C.
D.
On the pupil
On the sclera
In the conjunctival sac
In the inner canthus
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Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Topical Drugs (cont’d)
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Inhaled drugs
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Metered-dose inhalers (MDIs)
Dry powder inhalers
Small-volume nebulizers
Administering medications to the skin
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Lotions, creams, ointments, powders
Transdermal patches
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Topical Drugs (cont’d)
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Nasal drugs
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Drops
Spray
Vaginal medications
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Creams, foams, gels
Suppositories
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