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This chapter covers the key terms, supplies, and techniques involved in medication administration, including oral medications, injections, parenteral administrations, and IV therapy. It also discusses safety precautions and documentation requirements.
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Chapter 7 Medication Administration
Objectives Define all key terms. Explain what supplies are needed for medication administration. Select the correct needle and syringe for parenteral injections. Describe the solutions used in IV therapy. Describe blood products.
Objectives Describe how to administer oral medications safely. Discuss the methods for administering medications through nasogastric or gastric tubes. Discuss how to inject IM, SC, and ID medications safely. Describe how to administer ophthalmic and otic medications correctly.
Objectives Discuss precautions for the safe administration of inhalation therapy. Describe how to apply transdermal patches correctly. Describe how to insert vaginal and rectal medications safely. Discuss how to prepare the patient for IV therapy.
Nonparenteral Supplies Bottles and unit-dose packages Droppers Inhalation delivery systems Patches Suppositories
Safety Use correct supplies for route. Do not touch medications with your hands. Dispose of or cleanse droppers after use. Humidify oxygen or room air. Do not cut transdermal patches—apply to intact skin only. Monitor patient after administration.
Critical Thinking What would happen if a patient used a CPAP machine with a mask for 30 minutes without having added water to the inhaled air?
Parenteral Supplies for Injectable Medications Ampules and vials Needles Syringes Safety devices Prefilled syringes IV supplies IV solutions IV setups
Critical Thinking Why do you think vials are used more than ampules?
Safety Practice good hand hygiene. Change needle after insertion into ampules or use filter. Clean site. Use safe needles. Use proper sharps disposal procedure. Monitor patient after injection.
Critical Thinking Why is it dangerous to recap a needle? With so many safety devices available, why do you think there are still so many needle-sticks?
Blood Products Whole blood Packed red cells Platelets Polymerized hemoglobin
Critical Thinking Why do physicians prescribe different blood products instead of just giving whole blood?
Administering Medications • Oral medications • Opthalmic administration • Other types
Oral Medications Medications by mouth Nasogastric and gastric tube administration
Ophthalmic Administration Drops Ointments
Other Administrations Otic Nasal Inhalation—inhalers and nebulizers Transdermal Vaginal Rectal
Injections • Intramuscular • Subcutaneous • Intradermal • IV
Intramuscular Hormones, vaccinations, and pain medications Needle length 1–1½ inches Gauge 21–23 Syringe capacity to 5 cc Enter at 90-degree angle
IM Sites Deltoid Dorsogluteal Ventrogluteal Vastus lateralis
Critical Thinking Are the dorsogluteal and ventrogluteal the same site? When would you use each method?
Z-track Method Same as regular IM, but displace the skin before and after needle removal Used for fluids that stain the skin
Subcutaneous Injections Into fat layer—less blood supply and nerve endings Can be done by patient at home Sites (usually abdomen, back of upper arm, and thigh) 45-degree angle Needle length ⅜ inch to ½ inch Gauge 25–31 Syringe capacity 1 mL
Intradermal Injections Under epidermis 10–15 degree angle 25–31 gauge needle Needle length ⅜ to ½ inch Sites (usually forearm)
IV Administration IV insertion Flushing indwelling devices Complications of IV therapy Documentation
Documentation Size and type of device Date and time inserted Site location Type of solution Name of healthcare provider inserting/hanging Additives
Documentation Continued Flow rate Type of infusion pump used Number of attempts at insertion Patient response Complications, if any, and your interventions Patient teaching
Assessment Documentation Date and time Condition of site Site care provided Dressing change Site change Tubing and solution change Patient teaching
Summary • What new piece of information in this chapter were you most interested to learn? • What questions do you still have about the information in this chapter? • Return to Objectives to determine extent of learning.
