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• Medication


  A substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease
• Prescription


  Written direction for the preparation and administration of a drug
• Pharmacology


  The study of the effect of drugs on living organisms
• Specific parts of all drug orders and prescriptions


  • Person's full name
  • Date
  • Drug name (brand & generic)
  • Route of administration
  • Dose
  • Frequency
  • Duration of order
  • Doctor's signature
• Standing order


  Carried out until the specified period of time or until it is discontinued by another order
• Single order


  Carried out for one time only
• Stat order


  Carried out at once or immediately
• PRN order


  Carried out as the patient requires
• Types of doctor's orders


  • Observe the "12 rights" of the drug administration
  • Practice asepsis
  • Nurses who administer medications are responsible for their actions. Question any order that you consider incorrect
  • Be knowledgeable about the medications that you administer
  • Keep narcotics and barbiturates in a locked place
• Principles in administering medications


  • Use only medications that are clearly labeled in containers
  • Return liquids that are cloudy or have changed in color to the pharmacy
  • Before administering a medication, identify the client correctly
  • Do not leave the medications at the bedside
  • If the client vomits after taking oral medication, report this to the nurse in charge and/or physician
• 12 rights of drug administration


  • Right client
  • Right drug
  • Right dose
  • Right route
  • Right time
  • Right assessment
  • Right motivation/approach
  • Right of the client to refuse
  • Right of the client to educate
  • Right evaluation
  • Right documentation
  • Right drug preparation
• Oral route forms


  • Solid: tablet, capsule, pill, powder
  • Liquid: syrup, suspension, emulsion
• Enteric-coated tablets should not be crushed before administration
• Suspensions are never administered intravenously. If the patient vomits within 20 – 30 minutes of taking the drugs, notify the physician. Do not re-administer the drug without a physician's order
• Oral routes


  • Sublingual
  • Buccal
• Topical routes


  • Dermatologic - lotions, liniments, ointment, pastes and powders
  • Ophthalmic- instillations and irrigations
  • Otic
  • Nasal
  • Inhalation
  • Vaginal - tablet, cream, jelly, foam, suppository
  • Rectal - suppository
• Parenteral routes


  • Intradermal (ID)
  • Subcutaneous (SC)
  • Intramuscular (IM)
  • Intravenous (IV)
  • Intraarterial
  • Intraosseous
• Ampoule drug preparation


  1. Tap the top of the ampoule

  2. Use gauze or an alcohol swab to protect your fingers

  3. Break the neck of the ampoule away from your body

  4. Use a filter needle if available

  5. Insert your needle into the solution

  6. Invert the ampoule (or leave on the surface)

  7. With your needle in the solution, pull back on the plunger to the appropriate dose
• Vial drug preparation


  1. Remove the metal or plastic protective covering

  2. Swab the top with an alcohol swab

  3. Fill the syringe with air equivalent to the amount you want to withdraw from the vial

  4. Insert the needle into the center of the rubber stopper

  5. Instill the air from the syringe

  6. Invert the vial

  7. Pull back on the plunger to the desired amount

  8. Make sure the needle tip is in the fluid

  9. Remove the needle/syringe from the vial once the desired amount is reached

  10. Use the "scoop" technique to recap the needle

  11. Change the needle before administration
• Intradermal (ID) injection


  Administered into the dermis just below the epidermis, have the longest absorption time of all parenteral routes because there are fewer blood vessels and no muscle tissue, used for sensitivity testing because the patient's reaction is easy to visualize, and the degree of reaction can be assessed
• Intradermal (ID) injection technique


  The angle of administration is 5 to 15 degrees, use your nondominant hand to spread the skin taut over the injection site, a bleb (small blister) should appear under the skin indicating the medication has been correctly placed in the dermis

  
• Subcutaneous (SQ) injection


  Administered into the adipose tissue layer called "subcutis" below the dermis, medications injected into the subcutaneous layer are absorbed at a slow and steady rate
• Subcutaneous (SQ) injection technique


  A 45- or 90-degree angle is used, a 90-degree angle is used for normal-sized adult patients or obese patients, and a 45-degree angle is used for patients who are thin or have less adipose tissue at the injection site

  
• Intramuscular (IM) injection


  Used to place medication in muscle tissue, muscle has an abundant blood supply that allows medications to be absorbed faster than the subcutaneous route
• Intramuscular (IM) injection technique


  Stabilize skin with nondominant hand, insert the needle quickly at a 90-degree angle, aspirate for blood if needed, inject the medication slowly if no blood, discard and prepare again if there's blood, remove the needle at the same angle, cover with sterile gauze and band-aid if necessary

  
• Intramuscular (IM) injection sites


  • Ventrogluteal
  • Vastus lateralis
  • Deltoid
• 1. track method for IM injections


  Prevents the medication from leaking into the subcutaneous tissue, allows the medication to stay in the muscles, and can minimize irritation
• Liquid measurement conversions


  1. Express 5mg in micrograms: 5 mg = 5 x 1000 = 5000 mcg

  2. Express 0.5g to mg: 0.5 g = 0.5 x 1000 = 500 mg

  3. Express 300ml in liters: 300 ml = 300 / 1000 = 0.3 L
• Liquid and solid measurement conversions


  • 500 g to kg
  • 56 mg to g
  • 3.2 L to mL
  • 700 mL to L
  • 200 cc to mL
• Drug dosage calculation


  Required when the amount of medication ordered (or desired) is different from what is available on hand for the nurse to administer
• Drug dosage calculations based on body weight


  Required when the dosage ordered and administered is dependent on the weight of the patient
• IV fluid computation


  1. For a 66-year-old patient on warfarin (Coumadin) therapy with a 5 mg tablet, the nurse should instruct the patient to take 1.5 tablets daily to achieve the ordered 7.5 mg/day dosage

  2. For a patient with an order for dextrose in water 1,000 mL to be infused over 24 hours with tubing that has a drop factor of 60, the appropriate drip rate is 41-42 gtts/min

  3. For a patient with an order for an IVPB of ranitidine (Zantac) 50 mg in 50 mL D5W to be administered over 30 minutes with tubing that has a drip factor of 15, the appropriate drip rate is 25 gtts/min
• Hygiene


  Conditions and practices that help to maintain health and prevent the spread of diseases
• Hygiene


  • Practice related to lifestyle, cleanliness, health and medicine
  • Series of practices performed to preserve health
  • Plays an important role in preventing the spread of infectious diseases in a variety of settings
• Hygiene activities and practices can protect health and prevent disease
• Hygiene practices vary widely among groups and people
• It is important to respect differences in patient hygiene practices and provide care and information in non-judgemental manner
• Culture


  • Cleanliness is highly valued in North American culture, with many North Americans bathing or showering once or twice a day, whereas some other cultures bathe only once a week
  • Some cultures believe that bathing requires privacy, whereas others practice communal bathing
  • Body odor is considered offensive in some cultures but normal in others
• Socio-economic


  • A person's socioeconomic class and financial resources often define the hygiene options available to that person
  • Some people may have limited finances to buy soap, shampoo, shaving cream and deodorant
  • Homeless people may have no or limited access to water and soap
• Spiritual practices


  • May include ceremonial washings and purifications such as before prayer, eating
  • In the Jewish tradition, ritual baths are required for women after childbirth and menstruation
  • In some religion of Nepal, contact with a deceased person may make a person unclean