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Drug Administration - Chapter 10: Comprehensive Study Notes

Forms and Routes of Drug Administration (1 of 4)

  • Tablets and capsules: Most common drug forms

  • Liquids: Elixirs, emulsions, suspensions

  • Transdermals: Medication stored in patch placed on skin

  • Topicals: Application; Contamination risks

Forms and Routes of Drug Administration (2 of 4)

  • Instillations: Eyedrops; Eye ointment; Eardrops; Nose drops; Nasal sprays

Forms and Routes of Drug Administration (3 of 4)

  • Inhalations: Metered-dose inhalers; Spacers

  • Nasogastric and gastrostomy tubes: Check tube placement; Elevate head of bed; Make sure drug can be crushed

Forms and Routes of Drug Administration (4 of 4)

  • Suppositories: Rectal suppositories – Place patient in Sims position; Place past internal anal sphincter

  • Vaginal medications: Suppositories, foams, jellies, creams

Parenteral Medications (1 of 2)

  • Parenteral medications: Administered via injection

  • Intradermal

  • Subcutaneous

  • Preferred Intramuscular Injection Sites: Ventrogluteal; Deltoid; Vastus lateralis

Parenteral Medications (2 of 2)

  • Z-track technique

  • Intravenous

  • Action

  • Sites

  • Equipment

  • Technique

Nursing Implications for Parenteral Medication Administration

  • Sites

  • Equipment

  • Technique

Clinical Judgment: Overview of Medication Administration (1 of 2)

  • Concept: Caring interventions

  • Recognize cues: Determine patient’s level of consciousness, risk for aspiration, and ability to take medications

  • Obtain drug history including drug allergies

  • Analyze cues and prioritize hypothesis: Injury, acute pain, decreased mobility

  • Generate solutions: Identify strategies to promote adherence to drug regimen

Clinical Judgment: Overview of Medication Administration (2 of 2)

  • Take action:

    • Check drug label three times, check expiration date, and apply rights of medication administration

    • Be certain of drug calculations; verify dose with another RN, licensed personnel, or pharmacy as necessary

    • Avoid contact with topical and inhalation preparations by wearing gloves

    • Discard needles and syringes in a sharps container

  • Evaluate outcomes

Developmental Needs of a Pediatric Patient

  • Stranger anxiety

  • Hospitalization, illness, or injury viewed as punishment

  • Fear of procedure

  • Safety

Practice Question #1 (1 of 2)

  • An 18-year-old has an external ear infection to be treated with eardrops. Which of the following should the nurse correctly instruct the patient in placing the angle the ear during medication administration?

    • Down and back

    • Up and out

    • Down and forward

    • Up and forward

Practice Question #1 (2 of 2)

  • Answer: B. Up and out

Practice Question #2 (1 of 2)

  • A nurse is planning to administer an intradermal injection to a patient. Which represents the appropriate technique for this route?

    • 21-gauge needle at 33 degrees

    • 20-gauge needle at 90 degrees

    • 23-gauge needle at 45 degrees

    • 26-gauge needle at 15 degrees

Practice Question #2 (2 of 2)

  • Answer: D. $26\text{-gauge}$ needle at $15^\circ$

Practice Question #3 (1 of 2)

  • Which statement about transdermal drugs is true?

    • Transdermal drugs are preferred because they exert only a local effect.

    • Transdermal drugs provide more consistent blood levels than oral and injection forms.

    • For maximum effectiveness, transdermal patches should be reapplied to the same location when reapplied.

    • For maximum effectiveness, the skin should not be cleansed with soap once it has been exposed to a transdermal drug.

Practice Question #3 (2 of 2)

  • Answer: B. Transdermal drugs provide more consistent blood levels than oral and injection forms.

Practice Question #4 (1 of 2)

  • The Z-track method is the preferred method of administration for which drug?

    • Vitamin B12

    • Iron dextran

    • Penicillin

    • Morphine

Practice Question #4 (2 of 2)

  • Rationale: B. Iron dextran