Photo Atlas of Drug Administration

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Presentation transcript:

Photo Atlas of Drug Administration Chapter 9 Photo Atlas of Drug Administration Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Preparing for Drug Administration 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 Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Preparing for Drug Administration (cont’d) 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.

Administering Enteral Drugs 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 Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Classroom Response Question The nurse’s instructions to a patient who is to take an orally disintegrating tablet would include which statement? “Place the tablet on the tongue, and let it dissolve there.” “After it starts dissolving, chew the medication.” “Place the tablet on your tongue, and then take a sip of water.” “This tablet will take a few minutes to fully dissolve.” Correct answer: A Rationale: Orally disintegrating medications, either in tablet or medicated strip form, dissolve in the mouth without water in about a minute. These medications are placed on the tongue, not under the tongue, as in the sublingual route. The patient must be instructed to allow the medication to dissolve on the tongue and not to chew or swallow the medication. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Parenteral Drugs Never recap a used needle! May recap an unused needle with the “scoop method” Prevention of needlesticks “Needleless” systems Filter needles Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Parenteral Drugs (cont’d) Removing medications from ampules Removing medications from vials Safe disposal of used needles and syringes Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Injections Needle angles for various injections Intramuscular (IM) Subcutaneous (subcut) Intradermal (ID) Air-lock technique Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Injection Techniques Intradermal injections Subcutaneous injections Insulin administration Heparin administration Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Insulin Syringes Always use an insulin syringe to administer insulin Types of insulin syringes 100-unit syringe (U 100) 50-unit syringe (U 50) Patient self-administration of insulin Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Classroom Response Question A patient is ordered to receive two different types of insulin. The nurse will draw each insulin into an insulin syringe and administer two injections. draw the cloudy insulin into the insulin syringe first then the clear insulin into the same syringe. call the prescriber to question the order. draw the clear insulin into the insulin syringe then the cloudy insulin into the same syringe. Correct answer: D Rationale: When two different types of insulin are ordered for a patient, the same syringe is used. The clear insulin is drawn up into the syringe first followed by the cloudy insulin. There is no need to administer two separate injections. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Intramuscular Injections Sites Ventrogluteal site (preferred) Vastus lateralis site Deltoid site Dorsogluteal site (not recommended) Z-track technique Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

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) IM injection using the Z-track technique. IM injection into the deltoid muscle. subcutaneous injection into the abdomen. intradermal injection into the forearm. Correct answer: A Rationale: The Z-track method is used for administration of irritating substances. This technique forms a “Z-track” in the tissue that prevents the irritating medication from leaking through the more sensitive subcutaneous tissue. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.

Classroom Response Question Which is the safest site for administration of an intramuscular injection to an adult? Deltoid Dorsogluteal Vastus lateralis Ventrogluteal Correct answer: D Rationale: The ventrogluteal site is considered the safest of all sites because the muscle is deep and away from major blood vessels. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Intravenous Medications Needleless systems Compatibility issues Expiration dates Infusion of intravenous piggyback (IVPB) medications Labeling intravenous (IV) infusion bags when adding medications Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Intravenous Medications (cont’d) Adding medications to a primary infusion bag IVPB medications (secondary line) IV push medications (bolus) Through an IV lock Through an existing IV infusion Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Intravenous Medications (cont’d) Volume-controlled administration set Using electronic infusion pumps Patient-controlled analgesia (PCA) pumps Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Topical Drugs Eye medications Drops Ointments Eardrops Adults Infant or child younger than 3 years of age Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Classroom Response Question When administering eye drops, where will the nurse place the drop? On the pupil On the sclera In the conjunctival sac In the inner canthus Correct answer: C Rationale: To avoid trauma to the eye and systemic absorption, the eye drop should be placed in the conjunctival sac. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Topical Drugs (cont’d) Inhaled drugs Metered-dose inhalers (MDIs) Dry powder inhalers Small-volume nebulizers Administering medications to the skin Lotions, creams, ointments, powders Transdermal patches Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Topical Drugs (cont’d) Nasal drugs Drops Spray Vaginal medications Creams, foams, gels Suppositories Copyright © 2014 by Mosby, an imprint of Elsevier Inc.