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Medication Administration

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Presentation on theme: "Medication Administration"— Presentation transcript:

1 Medication Administration

2 Automated Medication Administration Equipment
Pyxis SureMed MedServe

3 Essential Components of a Medication Order
Client’s Name Medical Record Number, Room/Bed # Date & time of order Name of Medication Dosage of Medication Route Frequency of administration MD’s signature

4 Six “Rights” of Medication Administration
Right Patient (check name band, ask client their name) Right Medication Right Dose Right Route Right Time (frequency) Right Documentation * Client’s also have the right to refuse (say no) to medication

5 The Nurse’s Responsibility for Medication Administration
Assess whether the client can tolerate the meds Administer meds accurately & timely Monitor for side-effects Know contraindications Client teaching Practice the “Six Rights”(stressed in clinical) Evaluation (effectiveness & client response)

6 Types of Oral Medications
Tablets Capsules Sublingual Buccal Elixirs Enteric Coated

7 Precise & Safe Medication Administration

8 Rectal Medications Provide for privacy Explain procedure to client
Place client in Sim’s position Apply clean gloves Lubricate tip, round end inserted first Encourage client to relax , deep breathe Insert past sphincter, towards umbilicus Have client remain on side at least five mins. (hold buttocks together etc.)

9 Rectal Medication Administration

10 Ophthalmic Medications
Place HOB down or low Fowler’s Provide Kleenex for client Have client look towards ceiling Instill meds in conjunctiva (if gtts) If ointment, apply ribbon from inner to outer canthus Know od, os, ou routes

11 Topical & Inhalation Medications
Ointments (absorbed via mucous membranes, skin) Inserted (vaginal) Instilled (ear/nose gtts) Lotions Sprays (nasal) Pastes (absorbed through skin) Inhalation (nebulized treatments, MDI)

12 Topical Ointments

13 Otic Medications

14 MDI Medications

15 Medications via NGT/EFT
Determine whether med comes in elixir form Crush all except for EC meds and mix with water or other liquid medications Stop feedings, clamp tube, apply syringe, unclamp tube, flush tube with approx. 30cc water Clamp tube, remove syringe, pull plunger from barrel, reattach barrel, pour meds through barrel Add water as necessary to keep things flowing smoothly After all meds have been given, flush with 30cc water, clamp tube, remove syringe, start feedings


17 Documentation Always record:
Date, time & your initials or signature, title (R. Otten, SN,CSUF ) Medication, route (site) and actual time given Reason why med was omitted (ie. refused) Client’s response to the medication

18 Medication Administration Records (MARs)

19 Nursing Considerations for Injection Sites
Assess for adequate tissue & muscle availability/client body wt. Assess where previous injections have been administered Assess client restrictions Assess for quantity & quality of medication to be administered

20 Parts of a Needle & Syringe
Barrel Plunger Tip Needle: Bevel Shaft Hub

21 Types of Syringes

22 Tips of Syringes Luer-Lok Non Luer-Lok

23 Pre-Filled Systems

24 Assembling the Device

25 Scoop Method

26 Safety Devices

27 Needless Systems

28 Three Types of Injections
Intradermal - Injected into dermal skin layers (Allergy tests, PPDs, etc.) Subcutaneous - Injected into subcutaneous tissues (Heparin, Insulin) Intramuscular - Injected into deep muscles (narcotic analgesics, iron)

29 Intradermal Injections
Given in small doses (i.e.. 0.1cc) Common sites include: RFA, LFA Use 1cc syringe with gauge needle, 1/4 - 5/8 inch long Administer with needle at 5-15 degree angle with bevel of needle up Check for “bleb” or “wheal” Document site in medication book/nurses’ notes

30 Intradermal Injections

31 Subcutaneous Injections
Given in doses of 0.5cc cc Common sites include: deltoid, abdomen Deltoid landmarks: Find Acromium Process and go 4 to 6 finger-lengths below Rotate sites to minimize tissue damage Use Insulin/TB syringe for these meds For other SQ meds use 1-3 cc syringe, 25-27 gauge needle, 3/8-5/8 inch length Insert needle degrees

32 Deltoid Injections

33 Vastus Lateralis Injections
Site well-developed in both adults & children, lacks major blood vessels/nerves Landmark: Find Greater Trochanter & Knee, divide thigh up into three equal quadrants with hand, middle 1/3 is the site for injection (lateral aspect). Good for clients with position restrictions

34 Intramuscular Injections

35 Vastus Lateralis

36 Dorsogluteal Injections
Rarely used due to Sciatic nerve risk Less accessible than other sites (i.e. requires side-lying or turned further) Landmark: Find Greater Trochanter & Iliac Crest, draw quadrants and administer in upper two quadrants

37 Dorsogluteal Injections

38 What other site is used for IMs?

39 Ventrogluteal Good for deep injections
Away from blood vessels and nerves Z-track Thick, viscous meds Antibiotics Large volume Irritating

40 What if…… when giving an IM injection, the aspirate comes back with blood. What is the correct procedure and why?

41 Preparing NPH & Regular Insulin
Swab tops of both vials Inject desired units of air into NPH vial, remove needle and then inject desired units of air into Regular vial Invert Regular vial and withdraw desired units of insulin (no bubbles) Insert needle into NPH vial, invert and withdraw desired units of insulin

42 Regular & NPH Insulins

43 Mixing Insulins NPH Insulin Regular Insulin

44 Remember !!! If an IM injection requires the administration of > 3cc of medication, divide the medication up into two equal doses and administer in different sites.

45 Remember !!! Always double-check Insulin & Heparin amounts/doses with another licensed person (RN/LVN/INSTRUCTOR)

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