1. 1 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Assisting with Medications Chapter 35

2. 2 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Safety in Drug Administration  Safety precautions in the management of medication administration should be consistently applied.  MA must clearly understand the medication, dose, strength, and route of administration for the drug ordered by the physician.  A drug should not be given until the MA knows the purpose, potential side effects, precautions, and recommended dose.  Patients have the right to refuse medication.

3. 3 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Seven Rights of Drug Administration  Right patient  Right drug  Right dose  Right route of administration  Right time  Right technique  Right documentation

4. 4 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Drug Label Checks EACH TIME a medication is dispensed, the MA MUST do the three label checks. Compare the physician’s written order with the label: 1.When removing the drug from the storage site 2.Just before dispensing the medication from the container 3.When replacing the container or before discarding it

5. 5 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Patient’s Environment  Allergy injections should not be given unless a physician is present.  Make sure emergency medications are accessible to counteract adverse reactions that might occur.

6. 6 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Needle Parts  Bevel—angled tip of a needle  Gauge—diameter or lumen size of a needle  The larger the gauge number, the smaller the diameter of the needle  Smallest gauges are 27 to 28 for ID injections  Gauges 25 to 26 for SC injections  Gauges 20 to 23 for IM—viscous drugs and deeper injections Needle Length -IM: 1 to 3 inches; length depends on the muscle being used and patient size

7. 7 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Syringes  Parts of syringe—barrel, calibrated scale, plunger, tip  3-cc syringe—calibrated with cc or ml  Tuberculin syringe—holds 1 ml  Insulin syringe—calibrated in units, 50 U or 100 U  The appropriate syringe is determined by the type of medication and the amount of drug.  Specialty syringe units, such as the Nova Pen and the EpiPen, are designed for quick administration of certain medications in public or in an emergency.

8. 8 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Parts of the Syringe

9. 9 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Retractable Needle Cover

10. 10 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Anaphylactic Signs and Symptoms  Hypotension resulting from systemic vasodilation  Urticaria  Dyspnea caused by bronchoconstriction  Vomiting and diarrhea

11. 11 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. EpiPen  Automatic injector systems that contain a dose of epinephrine  Carried as a safety precaution by individuals who have anaphylactic reactions to allergens such as bee stings or certain types of foods

12. 12 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. EpiPen Injection  EpiPen can be injected through clothing.  Firmly press tip of injector on outer aspect of thigh and hold in place for 10 seconds.  Remove EpiPen and massage to promote absorption.  Notify physician or go to ER for follow up.  Periodically check unit expiration date.  Store in a readily available location.

13. 13 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Intramuscular Injections  Based on patient size, choose needle long enough to reach muscle.  Angle of insertion 90 degrees.  IM sites include the deltoid, vastus lateralis, gluteus medius, and ventrogluteal muscles.  Muscular site used for three reasons:  Irritating drug for SC tissues  Requires more rapid absorption  Large volume of medication needed

14. 14 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Intramuscular Injection

15. 15 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Intramuscular Injection Sites

16. 16 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Deltoid Site  Muscular cap of shoulder located at top of upper arm.  Injection site located 2 fingerbreadths below the acromial process.  Avoid the acromion and humerus.  Can hold up to 2 cc of medication.  Acceptable site for adults and older children.  Should not be used if the muscle is small or underdeveloped.  Small arm: 25-gauge, 5/8-inch needle  Average arm: 23-gauge, 1-inch needle

17. 17 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Deltoid Site

18. 18 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. IM Injections-Deltoid

19. 19 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Patient Education  The more the patient knows and understands about how to take the medication and why it is prescribed, the greater the chances that the drug treatment will be successful.  Patient education is absolutely crucial to the correct administration of medication at home.

20. 20 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. Patient Education  The patient should understand:  Purpose of the drug  Time, frequency, and amount of the dose  Storage requirements  Typical side effects  Take medicine as prescribed  Discard all expired drugs  Keep medicine away from light, heat, air, moisture  Do not combine different drugs in the same container

21. 21 Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved. THE END