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Medication Administration. Automated Medication Administration Equipment. Pyxis SureMed MedServe. 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

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Presentation Transcript
essential components of a medication order
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
six rights of medication administration
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

the nurse s responsibility for medication administration
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)
types of oral medications
Types of Oral Medications
  • Tablets
  • Capsules
  • Sublingual
  • Buccal
  • Elixirs
  • Enteric Coated
rectal medications
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.)
ophthalmic medications
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
topical inhalation medications
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)
medications via ngt eft
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
documentation
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
nursing considerations for injection sites
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
parts of a needle syringe
Parts of a Needle & Syringe

Syringe:

  • Barrel
  • Plunger
  • Tip

Needle:

  • Bevel
  • Shaft
  • Hub
tips of syringes
Tips of Syringes

Luer-Lok

Non Luer-Lok

slide28

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)

slide29

Intradermal Injections

  • Given in small doses (i.e.. 0.1cc)
  • Common sites include: RFA, LFA
  • Use 1cc syringe with 26-27 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
subcutaneous injections
Subcutaneous Injections
  • Given in doses of 0.5cc - 1.5 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 45-90 degrees
slide33

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
dorsogluteal injections
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
ventrogluteal
Ventrogluteal
  • Good for deep injections
  • Away from blood vessels and nerves
  • Z-track
  • Thick, viscous meds
  • Antibiotics
  • Large volume
  • Irritating
what if
What if……

when giving an IM injection, the aspirate comes back with blood.

  • What is the correct procedure and why?
preparing nph regular insulin
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
mixing insulins
Mixing Insulins

NPH

Insulin

Regular Insulin

remember
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.

remember45
Remember !!!

Always double-check Insulin & Heparin amounts/doses with another licensed person

(RN/LVN/INSTRUCTOR)

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