NURS3804 Chapter 10: Drug Administration Overview

How are eyes drops administered?

- gently pull down the skin below the eye to expose the conjunctival sac

- apply drops to the middle third of the sac without touching the eye with the dropper

- apply gentle pressure over the lacrimal duct after administration

How is eye ointment administered?

- gently pull down the skin below the eye to expose the conjunctival sac

- squeeze a 1/4 inch wide strip of ointment into the conjunctival sac from inner canthus to outer canthus

- instruct patient to close eyelid for 2-3 minutes

- tell patient that their vision may be blurry for a short time

How are ear drops administered to children under 3 years of age?

- straighten the external ear canal by pulling the ear down and back

- squeeze ear drops into the ear without touching the dropper on the skin

How are ear drops administered to adults and children over 3 years of age?

- straighten the external ear canal by pulling the ear up and back

- squeeze ear drops into the ear without touching the dropper on the skin

How are nasal drops/sprays administered?

- instruct patient to blow their nose

- drops: tilt the patient's head back to insert drops and have them remain in this position for 5 minutes

- sprays: tilt head forward and insert spray

How is medication administered via an inhaler?

- remove cap and shake inhaler

- instruct patient to breathe out all the way

- press down on the inhaler as the patient breathes in

- instruct patient to hold their breath for 10 seconds and then slowly breathe out

How is medication administered via feeding tubes?

- verify tube placement

- elevate head of bed

- double check that the medication can be crushed

- flush the tube

- administer one drug at a time

- flush the tube

How is a rectal suppository administered?

- position patient in modified left lateral recumbent (Sim's)

- remove foil and apply lubricant to suppository

- insert past the internal anal sphincter

- instruct patient to lie on their back or on one side for 30 minutes after insertion

How is a vaginal suppository administered?

- gently insert the applicator into the vagina

- press the applicator's plunger

- remove the applicator from the vagina

Which routes are considered parenteral?

- ID

- SQ

- IM

- IV

What degree angle should be used to administer an intradermal (ID) injection?

10-15

What degree angle should be used to administer a subcutaneous (SQ) injection?

45-90

What degree angle should be used to administer an intramuscular (IM) injection?

90

Where are subcutaneous (SQ) injection sites?

- outer surface of upper arm

- top of thighs

- abdomen at least 2 inches to the side of the umbilicus

- lower back

What gauge and length needle is typically used for subcutaneous injections?

- 25 to 27 gauge

- 3/8 to 5/8 inches long

What is the typical dose for a subcutaneous (SQ) injection?

0.5 to 1 mL

What are intramuscular (IM) injection sites?

- deltoid

- ventrogluteal

- vastus lateralis

What is the Z-track method?

- for IM injections

- use nondominant hand to pull skin laterally and hold it in position while giving injection

- wait 10 seconds and then withdraw the needle

- release skin immediately after withdrawing needle to seal off the injection site

What gauge and length needle is typically used for ventrogluteal IM injections?

- 18 to 25 gauge

- 5/8 to 1 and 1/2 inch long

What is the typical dose for an injection into the deltoid?

0.5 to 1 mL

What gauge and length needle is typically used for deltoid IM injections?

- 23 to 25 gauge

- 5/8 to 1 and 1/2 inch long

What are risks associated with the injection into the deltoid?

can cause injury due to location of blood vessels and nerves

What is the preferred intramuscular (IM) site for young children?

vastus lateralis

What is the typical dose for an injection into the vastus lateralis of an infant?

0.5 mL (1 mL max)

What is the typical dose for an injection into the vastus lateralis of a pediatric patient?

1 mL

What is the typical dose for an injection into the vastus lateralis of an adult patient?

1 to 1.5 mL (2 mL max)

What is the preferred intramuscular (IM) injection site?

ventrogluteal