1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 33 Topical and Inhalant Medications

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Topical Route Introduction Cutaneous applications –Inunction application –Transdermal applications oSkin patches oDrug paste

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pathway for Absorption From a Transdermal Skin Patch

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Topical Route (cont’d) Ophthalmic applications Otic applications Nasal applications Sublingual and buccal applications Vaginal applications Rectal applications

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? The conjunctiva lines the inner eyelids and the anterior surface of the sclera.

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. The mucous membrane of the eyes, called the conjunctiva, lines the inner eyelids and the anterior surface of the sclera.

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? When instilling ear medication in a young child, the nurse pulls the ear up and back.

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. When instilling ear medication in a young child, the nurse pulls the ear down and back. For an adult, the nurse pulls the ear up and back.

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Instilling Eye Medications (Refer to Skill 33-1 in the textbook.)

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Administering Nasal Medications (Refer to Skill 33-2 in the textbook.)

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Administering Medications Vaginally Vaginal Applicator

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Administering Medications Vaginally Vaginal Applicator Insertion

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? In a sublingual application, medication is introduced into the bloodstream by dissolving or mixing medication in water and ingesting thereafter.

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. In a sublingual application, the drug is placed under the tongue and is left to dissolve slowly and become absorbed by the rich blood supply in the area.

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Inhalant Route Advantage of administering drugs via the inhalant route Definition of aerosol and its purpose in administering medication

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Inhalant Route (cont’d) Definition of inhalers –Turbo-inhaler –Metered-dose inhaler –Definition of a spacer and its advantage

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Drug residue accumulates only in the mouthpiece of faulty inhalers.

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Drug residue may accumulate in the mouthpiece of all inhalers, so the client should rinse the mouthpiece in warm water after use.

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Parts of an Inhaler

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Using a Metered-Dose Inhaler

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Spacer and Inhaler

22. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Implications Nursing diagnoses –Deficient knowledge –Ineffective therapeutic regimen management –Impaired gas exchange –Impaired skin integrity –Impaired tissue integrity

23. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Ineffective Breathing Patterns

24. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Consideration Instilling eye medications in older adults Complex eye medication regimes in older adults Precautions when administering eye medications in older adults Physical problems associated with administering drugs or relief in older adults Educating older adults in complicated inhalant route administration processes