1 / 194

Chapter 12

Chapter 12. Administering Medication. Basic Knowledge about Medication Administration. 1. Oral Administration. 2. Parenteral Administration. 3. Inhalation Administration. Medication Anaphylaxis Test. Topical Administration. 4. 5. 6. Contents. Section 1.

clare-delgado
Download Presentation

Chapter 12

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 12 Administering Medication

  2. Basic Knowledge about Medication Administration 1 Oral Administration 2 Parenteral Administration 3 Inhalation Administration Medication Anaphylaxis Test Topical Administration 4 5 6 Contents

  3. Section 1 Basic Knowledge about Medication Administration

  4. Contents • Drug Forms, Distribution System and Medication Storage • Principles of Administering Medications • Routes of Administration • Times and Time of Administration • Contributing Factors of Drug Actions

  5. Aerosol spray Aqueous solution Aqueous suspension Capsule Enteric-coated tablet Extended/ sustained release Extract Glycerite Liniment Lotion Ointment Paste Pill Powder/granule Suppository Syrup Tablet Tincture Transdermal disk or patch Troche (lozenge) Drug Forms

  6. Four kinds • oral medications • external medications • for injection • new preparations

  7. Distribution System • Stock Supply System • Unit-dose System • Computer-controlled Dispensing System

  8. Store medication • Cabinet • bright and ventilative, avoiding direct shine and keep clean, tidy and dry. • Placement of medications • Store separately according to their different routes (oral, injection, or topical), toxicity or untoxicity • Expensive drugs, narcotics and virulent toxicants must be taken charge of by a special nurse who should lock the cabinet and have the key always with her. • On every shift

  9. Label the container of medications clearly • blue strip labels oral medications, • Red strip labels external medications, • and black strip labels virulent toxicants. • Label the container with name, concentration and dose of drugs • If the labels are soiled or illegible, discontinue using the medications

  10. Check the medications carefully • Store the medications properly according to their different nature. • Medications which tend to volatilize, deliquesce, or effloresce should be kept in airtight bottles, e.g., ethanol, iodine, sugar-coat tablets.

  11. Medications that will be oxidized if exposed to air and be denatured if exposed to light should be kept in airtight colored bottles. Cover the container with shade paper box if necessary and store it in the shady and cool area, e.g., Vitamine C 氨茶碱 盐酸肾上腺素

  12. Biologic products and antibiotics that will be destroyed and decomposed if exposed to heat should be kept in the dry, and shady and cool area (about 20℃) or in refrigerator (about 2～10℃) according to their natures and requirements of storage, e.g., an antitoxic serum, vaccine, placental globin, penicillin skin test solution.

  13. Medications should be used designedly according to valid periods in case of invalidation, e.g., antibiotics and insulin. • Store the inflammable and explosive medications in airtight bottle and place in the shady and cool area separately and keep them away from fire and electric appliances.

  14. Principles of Administering Medications • Correct Transcription and Communication of Orders • Use the Guidelines of Three Checks and Seven Rights to Ensure Safe Drug Administration • Administer medication safely and accurately • Observe the client’s response to the medication after administration

  15. Three Checks • the check before operation • the check during operation • the check after operation

  16. Seven Rights • the right name of the client • right bed number of the client • right name of the medication • right concentration • right dose • right route • right time. • Quality valid

  17. Routes of Administration • Oral Routes • Oral administration • Sublingual Administration • Buccal Administration • Parenteral Routes • Intradermal (ID) • Subcutaneous (SQ) • Intramuscular(IM) • Intravenous( IV) • Skin and Mucous Membrane Route • Inhalation Route the intrathecal or intraspinal, intraosseous, intrapleural, intraarterial, intraarticular, and intracardiac, routes Topical administration

  18. Skin and Mucous Membrane Route • 1.Direct application of liquid or ointment (e.g., eye drops, gargling, swabbing the throat) • 2.Insertion of drug into a body cavity (e.g., placing a suppository in rectum or vagina or inserting medicated packing into vagina) • 3.Instillation of fluid into body cavity (e.g., ear drops, nose drops, or bladder and rectal instillation [fluid is retained]) • 4.Irrigation of body cavity (e.g., flushing eye, ear, vagina, bladder, or rectum with medicated fluid [fluid is not retained]) • 5.Spraying (e.g., instillation into nose and throat)

  19. Declining sequence of absorption • Inhalation Route＞Sublingual route＞rectal route＞intramuscular injection＞subcutaneous injection＞ oral administration＞skin route

  20. Times and Time of Administration

  21. Contributing Factors of Drug Actions • ADDITIVE • ANTAGONISTIC • DISPLACEMENT • INCOMPATABILITY • INTERFERENCE • SYNERGISTIC • Factors about The Drug Itself • Drug Dose Response • Drug Forms • Routes, time and interval of Administration • Drug interactions • Factors about The Body • Physiological Factors • Age and Weight • Sex • Pathological Factors • Psychological and Behavioral Factors

  22. Section 2 Oral Administration

  23. ORAL MEDICATIONS • Most common route • Convenient • Least expensive • Most meds available in this form • Easy to counteract overdose or toxicity

  24. Indications • Clients who are able to swallow solid and liquid

  25. Contraindications • 1.Clients with impaired swallowing function • 2.Unconscious clients • 3.clients who refuse to take medications orally • 4.clients with vomiting or/and nausea • 5.clients with gastric or intestinal suction • 6.clients with bowel inflammation or reduced peristalsis • 7.clients with recent GI surgery

  26. DIFFERENT FORMS • Capsules • Tablets • Elixirs • Emulsions • Lozenges • Suspensions • Syrups

  27. NASOGASTRIC ADMINISTRATION • For patients who cannot swallow • NG tubes • Similar to oral administration

  28. Skills _Equipment • Medication cards, sheets, or records Medication cart or tray • Medication cups, measuring cup, drop tube Drinking straws • Pill-crushing or pillating device(研钵) • Kettle with warm water • Paper towels See disk

  29. Procedure Medication preparation 1．Wash hands, wear mouth mask and assemble the equipment 2．Follow the three checks and seven rights principle. 3．Prepare medications with appropriate method based on different forms of medication . Fetching meds from bottles.

  30. Fetching Method Solid（tablet/capsule）with spoon pediatric、 NG tubes or Gastric bleeding, pill-crushing device such as a mortar or pestle or grind pills Pouring liquid meds with measuring cup ＜1ml，with Drop tub

  31. Administering medication 1．Wash hands. TakeMedication cards, sheets, or records Medication cart or tray to bedside. 2．Offer medications and warm water 3. Assist clients with critical illness or pediatric clients. For NG, grind meds. 4．Teach clients the effects and cautions of meds 4．Clean the cup See disk

  32. Guidelines followed when administering oral medications • 1.Always administer a drug with warm boiled water of 40~60℃ instead of with tea. • 2.Medications that erode teeth such as acid and chalybeate should be sucked with a sucker and then rinse to protect teeth. • 3.Never chew, crush or break sustained release tablets, enteric-coated tablets and capsules

  33. 4.Place lozenges under the tongue or between buccal membrane and teeth dissolved slowly rather than allow clients to chew or swallow. • 5.Generally, stomachic medications are appropriately taken before meal, while those irritating gastric membrane taken after meal. Hypnotics is properly taken before sleep and parasiticides taken in limosis or half limosis.

  34. 6.Antibiotics and sulfonamide should be taken at certain interval to ensure effective drug blood concentration. • 7.Avoid giving fluids immediately after a client swallows medication such as syrup that exerts local medicating effects on the oral mucosa

  35. 8. Allow the client to drink more water after sulfonamide is taken to prevent the crystal which the drug produces when excreted through kidney with the less urine volume to block the nephridium. • 9. Observe the heart rate and rhythm closely when cardiotonic is taken. If the heart rate is lower than 60 times per minute or arrhythmia occurs, discontinue to use the drug and inform the physicist.

  36. Section 3 Parenteral Administration

  37. Parenteral Administration • Concept • the process that injects a certain volume of sterile solution and/or biological products into human body by using sterile syringe • Purpose • to prevent, diagnose and cure disease.

  38. Characteristics • Appropriate for clients unable to take meds orally • Rapid absorption • Difficult to Counteract Adverse Reaction • Invasive procedure, be performed using aseptic techniques

  39. Contents • Principles of Injections • Equipment • Draw medication • Common Injection Methods

  40. Principles of Injections • Apply Sterile Technique Strictly • Carry out Check Principles Strictly • Perform Disinfection and Seclusion Policy • Appropriate Syringe and Needle • Appropriate Injection Site • Prepare and Administer Temporarily • Eject Air thoroughly • Note Blood Return • Insert Needle at Appropriate Angle and Depth • Give No-Pain Injection

  41. Apply Sterile Technique Strictly • Preparation of nurses • Sterilize the local skin over injection site as required • Maintain sterility of equipment

  42. Carrying out Check Principles Strictly • three checks and seven rights • inspect the package of medication and sterile equipment

  43. Perform Disinfection and Seclusion Policy • every client individually uses one series of equipment • All of used equipments are disposed according to the disinfection and seclusion policy

  44. Appropriate Syringe and Needle • Consider route of injection • Other factors • dosage, viscosity, irritation of medication, and the age, height, and weight of the client, the site of injection • check the package and the expiration date • check whether the needle is sharp, without crooks, and is tightly connected with tip of syringe

  45. Appropriate Injection Site • away from nerves, bones, and blood vessels • free of inflammation, bruises, itches, edema, nodules and scars • change the site for each injection • When intravenously injecting, a distal site first, proximal site later.

  46. Prepare and Administer Temporarily • The medication solution is prepared and dispensed when administered • To prevent from the lower effect or contamination

  47. Eject Air thoroughly • If not, arouse air embolism

  48. Note Blood Return • administering by SQ(皮下)，ID, or IM, no blood return appears • By IV or IA, blood return appears

More Related