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Administration

of

Medications

Medication
A

substance
administered for the
diagnosis, cure,
treatment, relief or
prevention of disease.

Types of Doctors Order:


Standing Order- it is carried out
until the specified period of time
or until it is discontinued by
another order.
Single Order- it is carried out for
one time only.

Stat Order- it is carried out at


once or immediately.
PRN Order- it is carried out as
the patient requires.

Principles in Administering
Medications
1.

Observe the 7 Rights of drug


administration.
Right drug
Right Dose
Right time

Right

patient
Right Route
Right Approach
Right Recording

2. Practice asepsis
3. Nurses who administer
medications are responsible for
their own actions. Question any
order that you consider incorrect.
4. Be knowledgeable about
medications that you administer.

5. keep narcotics and barbiturates in


locked place.
6. Use only medications that are
clearly labeled containers in.
7. Return liquid that are cloudy or have
changed in color to the pharmacy.

8. Before administering a medication,


identify the client correctly.
9. Do not leave the medications at the
bedside.
10. If the client vomits after taking oral
medication, report this to the nurse
in charge and/or physician.

11. Pre-operative medications are usually


discontinued during the post-operative
period unless ordered to be continued.
12. When a medication is omitted for any
reason, record the fact together with the
reason.
13. When a medication error is made,
report it immediately to the nurse in
charge/or physician.

Routes of Drug Administration.


1.

Oral Route
Forms: a) solid: tablet, capsule,
pill, powder.
b) liquid: syrup,
suspension, emulsion.
Enteric coated tablets should not
be crushed before administration.

Suspensions are never administered


intravenously.
If the patient vomits within 20
30mins of taking the drugs, notify
the physician. Do not readminister
the drug without a physicians order.

2. Sublingual- drug placed under the


tongue, where it dissolves.
3. Buccal- medication is held in the
mouth against the mucous
membranes. of the cheek until the
drug dissolves.

4. Topical
a) Dermatologic- lotions, liniments,
ointment, pastes and powders.
b) Ophthalmic- instillations and
irrigations.
c) Otic

d) Nasal
e) Inhalation
f) Vaginal- tablet, cream, jelly,
foam, suppository
5. Rectal- (objectionable taste or odor)

6. Parenteral- administration of
medications by needle.
a) Intradermal (ID)- under the
epidermis (into the dermis).
b) subcutaneous (SC)- in the
subcutaneous tissue (also,
hypodermic)

c) intramuscular (IM)- into the


muscle.
d) intravenous (IV)- into a vein.
e) intraarterial- into an artery.
f) intraosseous- into the bone.

Intradermal (ID)
Intradermal (ID)- indicated for allergy
and tuberculin testing and for
vaccination.
> SITES:
- inner lower arm
*Left arm- for tuberculin test
* Right arm- for all other test

Upper chest
- Back, beneath the Scapula
What to observe?
- less hairy
Needle gauge #
- less pigmented
- #25,26,27
- less vascularized
Needle length
- less keratinized
- 3/8, 5/8,1/2
-

Angle- 10 to 15 degrees angle, bevel


up
Inject a small amount of drug to form
a wheal or bleb.
Do not massage the site of injection

Subcutaneous (SC)
Subcutaneous (SC)- drug
administered subcutaneous are as
follows:
= Vaccines, pre-operative
medications, narcotics, insulin,
heparin.

SITES: - outer aspect of the upper arm


- anterior aspect of the thigh
- abdomen
- scapula areas of the upper
back.
- upper ventrogluteal and
dorsogluteal area.

Needle angle- 45 degrees angle if


5/8 needle
-90 degree angle if needle
(heparin and insulin)

Intramuscular (IM)- ordered for the


following reasons:
1.

2.

3.

Rapid absorption because of rich


blood supply
Muscles can take a greater volume of
fluid without discomfort ( adult can
tolerate up to 3ml in large DG or VL
muscles)
Medications that irritating may safely
be given by intramuscular injection.

Needle length- 1 , , 2, (3 if obese)


Needle gauge- 20, 21, 22 , 23
SITES:
1. Ventogluteal site- uses gluteus
minimus muscle.
2. Dorsogluteal site- use gluteus
medius muscle.

- not to be used for children


<3 yrs. of age unless the child
has been walking for 1 yr.
- avoid hitting the sciatic
nerve

3. Vastus Lateralis Site- recommended


site of injection for infants.
- located at the middle
third of an anterior lateral aspect of
the thigh..
4. Rectus Femoris Site- anterior aspect
of the thigh.

5. Deltoid siteZ-tract injection(variation) = for


parenteral iron preparation.
- to seal the drug deep into
the muscle.
- prevent permanent staining
of the skin.

Intravenous (IV)
Intravenous (IV)- direct IV, IV push, IV
infusion.
- most rapid route of
absorption of medication.