Final Exam: Med Admin

Fundamentals of Nursing

What are the 7 RIGHTS of med admin?

Right patient

Right drug

Right dose

Right frequency/timing

Right route

Right indication

Right documentation

Requirements to waste a High Alert medication

Must waste in med system with another RN to witness

Requirements specific to controlled substances

Double-locked storage system

All administered doses must be documented in special system

Packaged with each dose separate

What should you do before administering oral meds?

Assess pts ability to swallow

Oral med admin

With full glass of water
Must observe patient consuming and swallowing medication

Which oral meds can you NOT crush or cut?

Long-acting, enteric-coated, sublingual, or unscored

Buccal Med Admin

Placed between cheek and gums; must fully dissolve before drinking/eating

Sublingual med admin

Tablet placed under tongue, must fully dissolve before drinking/eating

Enteral med admin

Placed into GI tract via port (feeding or medications)

What must be done before administering a topical medication?

Remove old patch/medication, clean site, and wear gloves

Where can you apply topical medications?

Clean, intact, non-irritated skin
AVOID hairy areas

How to administer optic irrigation meds?

Have pt look up, drop into conjunctival site without touching applicator to eye

How to administer otic irrigation meds?

½ inch above the ear canal

What should you do before administering otic medications?

Pull pinna up and back for adults, and down/back for children

What should you do after administering otic irrigation?

Massage the tragus and instruct pt to remain on side for 15 minutes

What should you assess before administering nasal medication?

Nasal patency and obstructions. Occlude one nostril at a time and assess for clearancee

How to administer nasal medications?

Occlude one nostril and instruct pt to inhale while inserting medication. Repeat on other side as needed

What should you do after administering nasal medications?

Instruct patient to remain in position for 1-5 minutes
Avoid blowing nose for 10 minutes

What position is best for administering vaginal medications?

Dorsal recumbent

What position is best for administering rectal medications?

Sims position

What should you do after administering rectal medication?

Hold position for 5-10 minutes, clench buttocks

Where to administer rectal medications

Past the internal sphincter (1-2 inches)

Intradermal injection angle

5-15 degrees, just under epidermis

Intradermal syringe volume

0.05-0.1 mL

Intradermal needle size

25-27 gauge

Intradermal needle length

½ - 5/8 inch

What are intradermal injections used for?

TB or allergy testing

Subcutaneous angle insertion

45 - 90 degrees

Subcutaneous syringe volume

½ - 1 mL

Subcutaneous needle size

pre-attached needle, 28-31 gauge

Subcutaneous needle length

¼ - 5/8 inch

Sites for subcutaneous injections

Stomach, fatty portion of outer thighs or upper arms

Subcutaneous injection uses

Insulin admin

Intramuscular injection sites

Deltoid: upper arm

Ventrogluteal: Lateral portion of glutues

Vastus Lateralis: Superior portion of thigh

IM syringe volume

1-3 mL

Where can I give a 1 mL injection (IM)?

Deltoid

Where should I give a 3mL injection?

Vastus lateralis or ventrogluteal

IM needle size

21-25 gauge

IM needle length

1-2 inches

Uses for IM injection

Immunizations, general med admin

IM angle of insertion

90 degree dart