Medication Administration

• Medication preparation and administration

  • Medication
  • Preparation
  • Administration
• Within the US and Philippines, laws have been enacted to control the development and administration of drugs
• Food and Drug Administration (FDA)


  The agency responsible for licensing, monitoring and regulation of cosmetics, drugs, foods, household hazardous products, medical devices, vaccine and related products for safety, efficacy and quality in the PH
• RA no. 9711 otherwise known as "The Food and Drug Administration Act of 2009" requires that labels be accurate and that all drugs be tested for harmful effects
• Controlled substances


  Kept in a locked drawer, cupboard, medication cart, or computer controlled dispensing system in hospitals
• Another aspect of nursing practice governed by law is the use of controlled/regulated drugs
• 10 Rights of Medication Administration

  • Right Medication
  • Right Dose
  • Right Time
  • Right Route
  • Right Client
  • Right Client Education
  • Right Documentation
  • Right to Refuse
  • Right Assessment
  • Right Evaluation
• Principles of Medication Administration

  • Practice asepsis
  • Nurse who administers the medication is responsible for their own action
  • Be knowledgeable about the medication that you administer
  • Keep the narcotics in locked place
  • Use only medications that are in clearly labeled containers
  • Return liquid that is cloudy in color to the pharmacy
  • Before administering medication, identify the client correctly
  • Do not leave the medication at the bedside
  • If the client vomits after taking the medication report this to the nurse in charge physician
  • When a medications is omitted for any reasons, record the fact together with the reason
  • When the medication error is made, report it immediately to the nurse in charge or physician
• Nurses need to know how nursing practice acts in their areas define and limit their functions, and be able to recognize the limits of their own knowledge and skill
• Under the law, nurses are responsible for their own actions regardless of whether there is a written order
• Nurses should question any order that appears unreasonable and refuse to give the medication until the order is clarified
• Advantages of Oral Administration


  • The easiest and most desirable way to administer medication
  • Most convenient
  • Safe does not break skin barrier
  • Usually less expensive
• Disadvantages of Oral Administration


  • Inappropriate if client cannot swallow
  • Inappropriate for client with nausea and vomiting
  • Drug may have unpleasant taste
  • Drug may discolor teeth
  • Drug may be aspirated by seriously ill patient
• Drug Forms for Oral Administration

  • Solid - tablet, capsule, pill, powder
  • Liquid - syrup, suspension, emulsion, elixir
• Never crush enteric-coated or sustained-release tablets
• Sublingual Administration


  A drug that is placed under the tongue where it dissolves
• Advantages of Sublingual Administration

  • Same as oral
  • Drug rapidly absorbed in the blood stream
• Disadvantages of Sublingual Administration

  • If swallowed, drug may be inactivated by gastric juices
  • Drug must remain under the tongue until dissolved and absorbed
• Buccal Administration


  A medication is held in the mouth against the mucous membranes of the cheek until the drug dissolves

  
• Advantages of Buccal Administration

  • Same as oral
  • Drug can be administration for local effect
  • Ensures greater potency because drug directly enters the blood and bypass the liver

  
• Disadvantages of Buccal Administration

  • If swallowed, drug may be inactivated by gastric juices
• Nasogastric tube


  Inserted by way of nasopharynx and placed into stomach
• Gastrostomy tube


  Surgically placed directly into the client's stomach and provides route for medication and nutrition
• Types of Topical Administration

  • Percutaneous - applied to intact skin
  • Transdermal patch - administers sustained action medications via multilayered films containing drug and an adhesive layer
  • Dermatologic preparations - applied to skin
  • Instillations and irrigation - applied to body cavities/ orifices
  • Inhalations - administered into the respiratory tract by nebulizer
• Parenteral Administration


  • Intradermal (ID)
  • Subcutaneously
  • Intramuscularly (IM)
  • Intravenous
• Syringe


  Tip - connect with the needle, Barrel - outside part, on which the scales are pointed, Plunger - which fits inside the barrel

  
• Needles


  Made of stainless steel and most are disposable
• Parenteral Medication Supplies


  • Ampules - glass container usually designed to hold syringe dose of drug
  • Vials - small glass bottle with a sealed rubber cap
  • Prefilled syringes

  
• Intradermal injection


  Administered in the dermal layer of skin beneath epidermis
• Subcutaneous injections


  Administered in the outer aspect of upper arms and anterior aspect of thighs
• Intramuscular injection


  Absorbed quickly than subcutaneous, sites include ventrogluteal, vastuslateralis, deltoid, and rectus femoris
• Ophthalmic medication


  Administer to the eye using irrigation / installation
• Otic administration


  Installation or irrigation of the external auditory canal
• Nasal administration


  Nasal installations (nose drops and sprays) usually instilled for the astringent effect to shrink/swollen mucous membrane and facilitate drainage
• Rectal administration


  Inserting medication into the rectum in the form of suppositories
• Vaginal administration


  Inserting medication into the vagina in the form of suppositories