chapter 9 photo atlas of drug administration copyright © 2014 by mosby, an imprint of elsevier inc

Chapter 9

Photo Atlas of Drug Administration

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

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

Preparing for Drug Administration

2Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

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

Preparing for Drug Administration (cont’d)


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

Administering Enteral Drugs


Classroom Response Question

The nurse’s instructions to a patient who is to take an orally disintegrating tablet would include which statement?

A. “Place the tablet on the tongue, and let it dissolve there.”

B. “After it starts dissolving, chew the medication.”

C. “Place the tablet on your tongue, and then take a sip of water.”

D. “This tablet will take a few minutes to fully dissolve.”


Never recap a used needle! May recap an unused needle with the “scoop

method” Prevention of needlesticks

“Needleless” systems Filter needles

Parenteral Drugs


Removing medications from ampules Removing medications from vials Safe disposal of used needles and syringes

Parenteral Drugs (cont’d)


Needle angles for various injections Intramuscular (IM) Subcutaneous (subcut) Intradermal (ID)

Air-lock technique

Injections


Intradermal injections Subcutaneous injections

Insulin administration Heparin administration

Injection Techniques


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

Insulin Syringes


A patient is ordered to receive two different types of insulin. The nurse will

A.draw each insulin into an insulin syringe and administer two injections.

B.draw the cloudy insulin into the insulin syringe first then the clear insulin into the same syringe.

C.call the prescriber to question the order.

D.draw the clear insulin into the insulin syringe then the cloudy insulin into the same syringe.



Sites Ventrogluteal site (preferred) Vastus lateralis site Deltoid site Dorsogluteal site (not recommended)

Z-track technique

Intramuscular Injections



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)

A. IM injection using the Z-track technique.

B. IM injection into the deltoid muscle.

C. subcutaneous injection into the abdomen.

D. intradermal injection into the forearm.



Which is the safest site for administration of an intramuscular injection to an adult?

A. Deltoid

B. Dorsogluteal

C. Vastus lateralis

D. Ventrogluteal


Needleless systems Compatibility issues Expiration dates Infusion of intravenous piggyback (IVPB)

medications Labeling intravenous (IV) infusion bags when

adding medications

Intravenous Medications


Adding medications to a primary infusion bag IVPB medications (secondary line) IV push medications (bolus)

Through an IV lock Through an existing IV infusion

Intravenous Medications (cont’d)


Volume-controlled administration set Using electronic infusion pumps Patient-controlled analgesia (PCA) pumps

Intravenous Medications (cont’d)


Eye medications Drops Ointments

Eardrops Adults Infant or child younger than 3 years of age

Topical Drugs


When administering eye drops, where will the nurse place the drop?

A.On the pupil

B.On the sclera

C.In the conjunctival sac

D.In the inner canthus



Inhaled drugs Metered-dose inhalers (MDIs) Dry powder inhalers Small-volume nebulizers

Administering medications to the skin Lotions, creams, ointments, powders Transdermal patches

Topical Drugs (cont’d)


Nasal drugs Drops Spray

Vaginal medications Creams, foams, gels Suppositories

Topical Drugs (cont’d)


chapter 9 photo atlas of drug administration copyright © 2014 by mosby, an imprint of elsevier inc

Documents

imprint of elsevier

cloudy insulin

clear insulin

buccal medications

patient open medications

different types of insulin

oral medications sublingual

bedside document medications