Fundamentals of nursing fatima

FUNDAMENTALS OF NURSING
MEDICATION ADMINISTRATION
Instructor: Dr. Fatemeh Khoshkhou
Nursing Student
Semester: 1
Session 12

www.dr-khoshkhou.com
By end of this session Students will be able:
Explain the mechanism of the drug
Understand effective factors on medication function
Discuss side effects
Explain medication orders
Calculate a prescribed medication dose
Discuses different name of drugs
Explain the seven rights of medication administration
Explain different routes of administration
Describe the importance of safe medication techniques
How to read medication abbreviation
Explain the nursing process and medication administration
LEARNING OBJECTIVES:

Medication are administered to clients to prevent, diagnose, or treat
disease and health condition
As a nurse you need to understand the actions and effects of the
medications your client take.
To safely and accurately administer medications, nurses must have an
understanding of pharmacology, pharmacokinetics, human growth
and development, human anatomy, pathophysiology, psychology,
nutrition and mathematics.
SCIENTIFIC KNOWLEDGE BASE

MEDICATION ADMINISTRATION
Medication administration is an important component of nursing care

MECHANISM
The nurse should know about the mechanism of drugs.
Absorption
Distribution
Metabolism
Excretion
Effective factors on medication function
Growing stages
Weight
Gender
Culture and genetic factors
Mental factors
Environment
Pathology
Timing of administration

SIDE EFFECTS
Iatrogenic
Drug allergy
(rash, diarrhea, nausea, vomiting, fever)
Anaphylactic
(respiratory distress, broncho-spasm, cardiovascular collapse)
(treatment: epinephrine, bronchodilators)
Tolerance effect
Cumulative effect
Idiosyncratic effect
Drug interaction

A medication order is required for any medication to be administered
by a nurse.
Nurse can take orders from: physician, dentists (see the hospital rules)
Before carrying out a medication order:
determine that the order is clear, complete, current, legible and appropriate, and
verify that the order, pharmacy label and/or medication administration record (MAR) are complete.
A complete order includes:
client name
date prescribed
medication name
strength and dosage
route
dose frequency
why the drug is prescribed (when it is a PRN medication)
quantity to be dispensed (if appropriate)
Prescribed signature
MEDICATION ORDERS

TYPES OF ORDERS
Routine medication orders
PRN (as needed)
(for controlling of pain)
Single orders (one-time)
(before operation)
STAT orders
(anaphylactic shock)

THE NAME OF DRUGS
1-Chemical name
(chemical and molecular instructor)
2-Generic name
(The first factory, from chemical name)
3-Official name (Formal publication)
4-Trade name (The name of specific factory for sale)
For example: acetaminophen, Tylenol, tempra, liquiprin

GENERAL PRINCIPLES AND PRACTICES
OF MEDICATION ADMINISTRATION
The right medication
The right dose
The right time
The right route
The right client
The right documentation
The right reason
(the nurse must check the drugs 3 times before taking)

ROUTS OF ADMINISTRATION
Drugs inter the body through three general Routes:
1-Enteral
2-Precutaneous
3-Parenteral
The drugs that enter the boy by these routs come in various forms.

ENTERAL
Drugs that enter through the enteral (by the GI tract)
Routs are given in these forms:
1-powders (often mixed with a liquid before administration)
2-pills (powder mixed with sticky substances) (round, solid drug form that must be
broken down into solution form in the stomach)
3-Tablets (round, spherical, or oddly shaped forms that dissolve in the stomach, types
of tablets include: capsule, lozenge,…)
4-Liquids and suspension
5-Suppositories (drugs mixed with lubricated substances, molded to insert into body
cavities such as rectum)

THE ENTERAL ROUTES
1-PO: by mouth
2-Tubal: by nasogastric, gasterostomy, Jejunostomy tube, into the stomach
3-Suppository: by rectum, vagina, urethra
4-Enema: by rectum

PERCUTANEOUS
Through the skin or mucus membranes Include:
Lotions
Ointments
Creams
Powders

PARENTERAL
They are usually thought of as the “needle” Route.
Ampules
Vials

THE PARENTERAL ROUTES
1-IM: Intramuscular (within the muscle)
2- SC, SQ or Subq: subcutaneous(under the dermis
Fatty tissue)
3-ID: Intra-dermal (within the dermis)
4-IV: Intra venous (within the vein)

INTRAMUSCULAR INJECTIONS
Places
Ventrogloteal
Dorsogloteal
Vastus lateralis
Deltoid

TYPES OF SYRINGES

DORSOGLUTEAL MUSCLE
This site is not used with infants or children Under 3 years
of age due to underdeveloped Muscle
Risk of sciatic nerve
5 cc for injection
Needle 20-23 and 3.75-7.5 length
Angle of insertion is 90 degrees

VENTROGLUTEAL MUSCLE

VASTUS LATERALIS MUSCLE
Is the preferred site for children under 3 years of age
because it is free of nerves and blood vessels.

DELTOID MUSCLE
The brachial vein and artery and the radial nerve are in this area.
0.5-2 cc for injection
Needle 23-25 and 1.5-2.5 length

INTRADERMAL INJECTIONS
1- for skin test agent
2-vaccine
Needle 25-26-27 with 0.6-1.5 length
Small volumes: 0.01-0.1 cc
Create small bubble like

SITES OF INTRADERMAL INJECTIONS

SUBCUTANEOUS INJECTIONS
Insulin and heparin are given by SC route.
Between the dermis and the muscle layer
No more than 1 cc or ml
Angle of insertion is 45 degrees.
Because is not as richly supplied with blood as the muscles, drug absorption is
somewhat slower than with IM injections.
Sites: outer aspect of upper arms, the abdomen, thighs, scapula.

SITES OF SUBCUTANEOUS INJECTIONS

ADMINISTERING EAR DROPS
For adults and for children over 3 years old, pull earlobe upward and back to
straighten external auditory
For children under 3 years old pull earlobe downward and back

ADMINISTERING EYE DROPS
To apply drops, expose lower
conjunctival Sac by having
patients look upward while gentle
traction is applied to lower eyelid.

ADMINISTERING EYE OINTMENTS
To apply ointments, expose lower
conjunctival Sac by having
patients look upward while gentle
traction is applied to lower eyelid.

INTRA VENOUS THERAPY

CLINICAL CALCULATIONS
Conversion system
Dose calculation
Dose ordered/dose on hand × Amount on hand=Amount to administer
Pediatric doses(?)

ABBREVIATION
Bid (twice a day)
Tid (three times daily)
Qid (four times a day)
Qd (every day)
Ac (before meals)
Pc (after meals)
Hs (at bedtime)
PRN(As needed)
Stat (immediately)
IM
IV
SC, SQ
ID
Syr (syrupus)
Susp(suspension)
Supp (suppository)
Cap

ABBREVIATION
Tab
Amp
Dropp
Gtt
Ml
Cc
Mg
gr
Mg/dl
Od
Os
Ou
Po
NPO
Inhalation
Z reack
Qh (every hours)
Q2h (every two hours)
Q3h (every three hours)

1-Assessment
History
History of allergies
Medication data
Diet history
Client’s perceptual or coordination problems
Client’s current condition
Client's attitude toward medication use
Client's knowledge and understanding of medication therapy
2-Nursing Diagnosis
Anxiety
Ineffective health maintenance
Deficient knowledge of medications
Impaired swallowing
Ineffective therapeutic regimen management
3-Planning
Goals and outcomes
Setting priorities
Collaborative care
4-Implementation
Health promotion
Acute care
5-Evaluation
Use evaluation measure
Apply various evaluation measure
NURSING PROCESS AND MEDICATION ADMINISTRATION

REFERENCES
1-Taylor C, Lillis C, LeMone P, Kluwer W. (2007) Fundamentals of Nursing: The Art
and Science of Nursing Care, Health/Lippincott Williams & Wilkins.
2- Perry AG, Potter PA, Stockert P. (2006) Fundamentals Of Nursing - Text And
Clinical Companion Package. Mosby
3- Ladner PK, Delaune SC. (2008)Fundamentals Of Nursing. Delmar Publishers
5-Khoshkhou F. Fundamental of Nursing, Available at: www.dr-khoshkhou.com
6- ‫کتاب‬‫دوگاس‬ ‫پرستاری‬ ‫اصول‬-‫تايلور‬ ‫پرستاری‬ ‫فنون‬ ‫و‬ ‫اصول‬-‫سادات‬ ‫مليحه‬ ‫پرستاری‬ ‫فنون‬ ‫و‬ ‫اصول‬
‫موسوی‬‫خانی‬ ‫عالی‬ ‫مريم‬ ‫و‬

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Fundamentals of nursing fatima

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