- Demonstrate the techniques required to administer rectal suppositories
2.squeeze dollop of lubricant onto paper towel.
3. Remove foil paper from suppository.
4. Moisten suppository tip with warm water or used lubricant to facilitate insertion.
5. Don’t clean gloves and inspect anal area for hemorrhoids.
6. Instruct client to bear down to identify anal opening and insert the suppository about1 ½ inches into rectal canal beyond the anal sphincter.
7. Instruct client to lie quietly for 15 minutes while medicine was absorbed.
- Demonstrate the techniques utilized to administer a disposable enema.
2. Provide for patient privacy position the patient on the left side, and drape to avoid unnecessary exposure.
3. Put on gloves, remove protective covering from the rectal tube, and lubricate.
4. Insert the lubricated rectal tube into the rectum and insert the solution by compressing the plastic container.
5. Replace the used container in its o original package for disposal.
6. Encourage the patient to hold the solution for about 30 minutes before defecating.
7. Assist the patient to a sitting position on the bedpan or to the bathroom as orders permit.
8. Tell the patient NOT to flush the toilet until you return and can see the results of the enema. Instruct the patient regarding the location of the
Call light in case assistance is needed.
- Demonstrate the techniques in preparing medication for the following;
1. Move solution from neck to body of ampule by tapping stem sharply or holding neck of ampule between thumb and forefinger and flicking wrist.
2. Grasp stem of ampule between thumb and forefinger of one hand and frasp body of ampule with other hand. Using pad, break stem away from
Self. (If ampule was not scored, partially file neck of ampule.)
3. Set ampule upright.
4. Use a special filter needle to withdraw solution.
5. Remove needle guard and insert needle into ampule without touching sides of ampule neck.
6. If needle is sufficiently long, withdraw medication with ampule in withdraw appropriate amount of medication.
7. Return ampule to an upright position and withdraw syringe.
8. Tap syringe barrel below bubbles to dislodge air bubbles.
9. Eject air with syringe in an upright position. If amount of solution was overdrawn, invert syringe and remove excess solution into nearby recep-
Tacle.
10. Cover needle guard.
- Demonstrate the techniques jin preparing medication for the following
1. Remove vial cap.
2. Open alcohol wipe, and cleanse rubber top of vial.
3. Tighten needle on syringe. Remove needle guard.
4. Pull back on plunger to fill syringe with an amount of air equal to amount of solution to be withdrawn.
5. Insert needle into upright vial.
6. Touch only syringe barrel an plunger tip.
7. Expell air bubbles from syringe by tapping the side of syringe sharply with finger below air bubble.
8. Recheck amount of liquid in syringe.
9. Turn vial to upright position and remove needle.
10 Replace needle guard.
11 Recheck liquid label and dosage against medication record and calculation.
12 Replace or dispose of liquid vial.
- . Demonstrate the techniques in preparing medication for the following;
1. Prepare both vials by removing cap and cleansing tops with separate alcohol wipes.
2. Draw air into syringe equal to amount of solution to be removed from second vial. Do not withdraw medication at this time.
3. Draw air into syringe equal to amount of solution to be removed from first vial and injected it into first vial.
4. Invert first vial and withdraw ordered amount of medication without removing syringe.
5. Expel all air bubbles from syringe.
6. Recheck amount of solution and remove syringe from vial.
7. Insert needle into second vial, invert, and withdraw exact amount of solution ordered.
- For two insulin solutions
2. Wipe top of insulin bottles with alcohol.
3. Take needle guard off and placed on tray.
4. Pull plunger of syringe down to desired total units of insulin.
5. Insert needle and inject prescribed amount of air into bottle A (cloudy) insulin. Do not touch insulin solution with the needle.
6. Inject air into insulin bottle B and withdraw medication.
7. Withdraw needle from bottle and expel all air bubbles.
8. Invert bottle A and insert needle.
9. Pull back on plunger to obtain exact prescribed amount of intermediate or long-acting insulin.
10. Replace needle guard.
- Demonstrate the techniques used to administer a medication via the intradermal route.
2. Cleanse area with antimicrobial wipe using circular motion outward from site and allowed to dry.
3. Remove needle guard. Grasp client’s dorsal forearm to gently pull skin taut on ventral forearm.
4. Hold syringe almost parallel to skin, insert needle at 15 degree angle with bevel facing up, about 1/8 inch. Needle point should be visible
Under skin. Do not aspirate.
5. Inject medication slowly, observing for a wheel (bilster) formation and blanching at the site.
6. Withdraw needle at same angle as inserted. Pat area gently with a dry guaze pad but Do not massage.
7. Activate needle safety feature and discard syringe unit in puncture-proof container.
8. Mark injection site with pen for future assessment.
- Demonstrate the techniques used to administer a medication via the subcutaneous route.
2. Cleanse area with antimicrobial wipe, using circular motion from inside outward.
3. Remove needle guard.
4. Use thumb and forefinger and gently grasp loose area (“pinch and inch”) of fatty tissue on appropriate site.
5. Insert needle at a 45 or 90 degree angle.
6. Continue to hold tissue and aspirate by pulling back on plunger with thumb of dominant hand. If no blood appeared, administer injection
If blood appeared, withdraw the needle, activate safety feature and discard, then prepare a new injection. For heparin and insulin, Do not
Aspirate.
7. Inject medcation slowly.
8. Wait 10 seconds, then withdraw needle quickly and activate needle safety feature.
- . Demonstrate the techniques used to administer a medication via the intramuscular route.
2. Cleanse area with antimicrobial wipes using circular motion from inside outward.
3. Spread skin taut between thumb and forefinger.
4. Insert needle at 90 degree angle to the muscle, using a quick darting motion.
5.Stabilize syringe by holding needle hub before aspirating. Pull back on plunger and if blood returned, discard syringe and prepare a new
Injection.
6. Withdraw needle quickly, and massage area with an alcohol wipe.
7. Activate needle safety feature.
8. Dispose of syringe/needle unit in puncture-proof container.
- Demonstrate the Z-track method on intramuscular injection.
1. Cleanse site with antimicrobial wipe.
2. Pull skin 1 to 1 ½ inch laterally away from injection site.
3. Maintaining displacement, insert needle at a 90 degree angle.
4. Aspirate by pulling back on plunger to see if needle was in blood vessel. If so, discard an prepare new injection.
5. Inject medication and wait 10 seconds, keeping skin taut.
6. Withdraw needle and release retracted skin.
7. Apply light pressure with antimicrobial swabs. Do not massage.
8. Activate needle safety measure.
9. Discard equipment in appropriate area.
- Locate the landmarks of the following sites for intramuscular injection.
Handbreadth below the greater trichinae and one handbreadth above the knee. It is generally the preferred site for IM injections in infants
Because it has the largest muscle mass for that age group.
2. Rectus femoris muscle- The rectus femoris muscle lies just medial to the vastus lateralis muscle but does not cross the midline of the anterior
Thigh. The injection site is located in the same manner as the vastus lateralis muscle.
- . Locate the landmarks of the following sites for intramuscular injection.
Palm of the hand on the lateral portion of the greater trichinae, the index finger on the anterior superior iliac spine, and the middle finger
Extended to the iliac crest of the ilium.
2. Dorsogluteol muscle- To use this injection site the patioen must be placed in a prone position on a flat table surface. The site is identified
By drawing an imaginary line from the posterior superior iliac spine to the greater trichinae of the femur. The injection should be given
At any point between the imaginary straight line and below the curve of the iliac crest (hip bone). The syringe should be held perpendicular
To the flat table surface with the needle directed on a straight back-to-front course.
PART 2
1. Identity and differentiate the topical forms of medication used on the skin (cream, lotion, ointment)
1. Cream- semisolid emulsions containing medicinal agents for external applications, the cream base is non-greasy and water-soluble
Commonly used as moisturizing agents.
2. Ointment- are semisolid preparations is an oily base such as lanolin or petrolatum- for prolonged contact with the skin, can be applied
Directly to the skin or mucous membrane usually water-insoluble.
3. Lotion- are usually aqueous preparations that contain suspended materials, commonly used as soothing agents for skin protection,
To relieve rashes and itching, as cleansing agent, a stringent agents, must be gently but firm patted on the skin instead of rubbing
To prevent increased circulation and itching.
2. Identify the sites and demonstrate the techniques used when the following are prescribed;
Sublingual tablet and buccal tablet
Sublingual tablet are designed to be placed under the tongue for dissolution and absorption through the vast network of blood vessels in this
Area. Buccal tablets are designed to be held in the buccal cavity (between the cheek and molar teeth) for absorption from the blood vessels
Of the cheek.
Techniques;
1. Wash hand, assemble equipment, 6R, privacy, explanation, positioning
2. Put on a glove place the medication under the tongue (sublingual) or between the upper molar teeth and the cheek (buccal)
3. Ask the patient not to swallow the tablet
4. Ask the patient to hold the saliva until the tablet is dissolved.
5. Do not administer water.
3. Identify the sites and demonstrate the techniques used when the following are prescribed;
Eye drops- Medications for use in the eye are labeled ophthalmic.the site is have the patient look upward over your head.
Techniques;
1. Drop the specified number of drops into the conjunctival sac. Never drop directly onto the eyeball.
2. After instilling the drops, apply gentle pressure, using a cotton ball or clean tissue, to the inner corner of the eyelid on the bone for approxi-
mately 1 to 2 minutes. This prevents the medication from entering the canal, where it would be absorbed in the vascular mucosa of the
nose and produce systemic effects. It also ensures an adequate concentration of medication in the eye.
3. When more than one type of eye drop is ordered for the same eye, wait 1 to 5 minutes between instillation of the different medications.
Use only the droper provided by the manufacturer. Apply a sterile dressing as ordered.
Otic drops
Ear drops are a solution containing a medication used for the treatment of localized infection or inflammation of the ear. Medicatons for use
In the ear are labeled otic.
Techniques;
1. Wash hand, assemble equipment, 6R, privacy, explanation.
2. Positioning: affected ear is directed upward.
3. Put on gloves.
4. Assess the ear canal for wax accumulation, irrigate if necessary.
5. Warm the medication to room temperature, shake well, and draw up into the dropper.
4. Identify and describe oral dose forms of medication;
Capsules- capsules are small cylindrical gelatin containers that hold dry powder or liquid medicinal agents. They are available in a variety
Sizes and are a convenient way of administering drugs that have an unpleasant odor or taste.
Tablets- tablets are dried, powdered drugs compressed into small disks, variety in shape, size and weight. Tablets can be molded, compressed,
Chewable and effervescent.
Elixirs- are clear liquids made up of drugs dissolved in alcohol and water, used primarily when the drug will not dissolve in water alone, flavoring
Agents are often added to improve taste.
5. Identify and describe oral dose forms of medications
1. Emulsion- emulsions used to mask bitter tastes and provide better solubility to certain drugs they are dispersions of small droplets of water
In oil or oil in water A suspension of fat particles in a watery base (intralipid IV fat solution) the dispersion is maintained by
Emulsifying agents such as sodium lauryl sulfate, gelatin, or acacia.
2. Suspension- suspension are liquid dose forms that contain solid, fine, undisclosed, insoluble drug particles dispersed in a liquid base particles
Settle to the bottom after prolonged standing should be shaken well to ensure thorough mixing.
3.syrup- syrups contain medicinal agents dissolved in a concentrated solution of sucrose , used to mask the bitter taste of a drug and
Commonly used in pediatric medicines.
6. Identify and describe common receptacles used to administer oral medications.
1. Souffle cup- souffle cup is a small paper or plastic cup used to transport solid medication (capsule/tablet) to avoid contamination.
2. Medicine cup- is a glass or plastic container with three scale;-
Apothecary
Metric
Household to measure liquid medications
Used syringe for doses smaller then 1 tsp; tuberculin syringe for volumes less than 1cc.
3. Medicine dropper- used to administer eye drops, ear drops, and pediatric medications
4. Teaspoon- used to administer liquid medications.
5. Oral syringe- used to measure liquid medications accurately.
7.Demonstrate the measuring techniques for the following
1. Measuring with a medicine cup-
1oz 2 tbs 30 ml
1/2oz 1 tbs 15ml
1/4oz 1tsp 5ml
Techniques-
1. Hold the bottle of liquid so that the label is in the palm of the hand. This prevents the contents from smearing the label during pouring.
2. Examine the medicine cup and locate the exact place where the measured volume should be measured, placed your fingernail at this level.
3. While holding the medicine cup straight at eye level, pour the prescribed volume.
4. Read the volume accurately at the level of the meniscus.
5. Compare the information on the medication card against the label on the stock bottle and the quantity of drug placed in the cup.
6. Recheck the five rights of the medication order.
7. Return the five rights of the medication order.
8. Return the medication container to the shelf of the cabinet.
9. Place the patients medication cup on the medication tray with the medication card.
10 Proceed to the patients bedside when all medications are assembled for administration.
2. Measuring with an oral syringe-
Method 1- with a large-bore needle attached to the syringe, draw up the prescribed volume of medication. The needle is not necessary if the
Bottle opening is large enough to receive the syringe.
Method 2- Using the cup and method 1, pour the amount of medication needed into a medicine cup, then use a syringe to measure the
Prescribed volume.
1. Compare the information on the medication card against the label on the stock bottle and the quantity of drug placed in the syringe.
2. Recheck the five rights of the medication order.
3. Return the medication container to the shelf of the cabinet.
4. Place the patients medication syringe on the medication tray with medication card directly under the syringe.
5. Proceed to the patients bedside when all medications are assembled for administration.
8. Demonstrate the measuring techniques for the following
1. Removing medications directly from a bottle
1. Identity and differentiate the topical forms of medication used on the skin (cream, lotion, ointment)
1. Cream- semisolid emulsions containing medicinal agents for external applications, the cream base is non-greasy and water-soluble
Commonly used as moisturizing agents.
2. Ointment- are semisolid preparations is an oily base such as lanolin or petrolatum- for prolonged contact with the skin, can be applied
Directly to the skin or mucous membrane usually water-insoluble.
3. Lotion- are usually aqueous preparations that contain suspended materials, commonly used as soothing agents for skin protection,
To relieve rashes and itching, as cleansing agent, a stringent agents, must be gently but firm patted on the skin instead of rubbing
To prevent increased circulation and itching.
2. Identify the sites and demonstrate the techniques used when the following are prescribed;
Sublingual tablet and buccal tablet
Sublingual tablet are designed to be placed under the tongue for dissolution and absorption through the vast network of blood vessels in this
Area. Buccal tablets are designed to be held in the buccal cavity (between the cheek and molar teeth) for absorption from the blood vessels
Of the cheek.
Techniques;
1. Wash hand, assemble equipment, 6R, privacy, explanation, positioning
2. Put on a glove place the medication under the tongue (sublingual) or between the upper molar teeth and the cheek (buccal)
3. Ask the patient not to swallow the tablet
4. Ask the patient to hold the saliva until the tablet is dissolved.
5. Do not administer water.
3. Identify the sites and demonstrate the techniques used when the following are prescribed;
Eye drops- Medications for use in the eye are labeled ophthalmic.the site is have the patient look upward over your head.
Techniques;
1. Drop the specified number of drops into the conjunctival sac. Never drop directly onto the eyeball.
2. After instilling the drops, apply gentle pressure, using a cotton ball or clean tissue, to the inner corner of the eyelid on the bone for approxi-
mately 1 to 2 minutes. This prevents the medication from entering the canal, where it would be absorbed in the vascular mucosa of the
nose and produce systemic effects. It also ensures an adequate concentration of medication in the eye.
3. When more than one type of eye drop is ordered for the same eye, wait 1 to 5 minutes between instillation of the different medications.
Use only the droper provided by the manufacturer. Apply a sterile dressing as ordered.
Otic drops
Ear drops are a solution containing a medication used for the treatment of localized infection or inflammation of the ear. Medicatons for use
In the ear are labeled otic.
Techniques;
1. Wash hand, assemble equipment, 6R, privacy, explanation.
2. Positioning: affected ear is directed upward.
3. Put on gloves.
4. Assess the ear canal for wax accumulation, irrigate if necessary.
5. Warm the medication to room temperature, shake well, and draw up into the dropper.
4. Identify and describe oral dose forms of medication;
Capsules- capsules are small cylindrical gelatin containers that hold dry powder or liquid medicinal agents. They are available in a variety
Sizes and are a convenient way of administering drugs that have an unpleasant odor or taste.
Tablets- tablets are dried, powdered drugs compressed into small disks, variety in shape, size and weight. Tablets can be molded, compressed,
Chewable and effervescent.
Elixirs- are clear liquids made up of drugs dissolved in alcohol and water, used primarily when the drug will not dissolve in water alone, flavoring
Agents are often added to improve taste.
5. Identify and describe oral dose forms of medications
1. Emulsion- emulsions used to mask bitter tastes and provide better solubility to certain drugs they are dispersions of small droplets of water
In oil or oil in water A suspension of fat particles in a watery base (intralipid IV fat solution) the dispersion is maintained by
Emulsifying agents such as sodium lauryl sulfate, gelatin, or acacia.
2. Suspension- suspension are liquid dose forms that contain solid, fine, undisclosed, insoluble drug particles dispersed in a liquid base particles
Settle to the bottom after prolonged standing should be shaken well to ensure thorough mixing.
3.syrup- syrups contain medicinal agents dissolved in a concentrated solution of sucrose , used to mask the bitter taste of a drug and
Commonly used in pediatric medicines.
6. Identify and describe common receptacles used to administer oral medications.
1. Souffle cup- souffle cup is a small paper or plastic cup used to transport solid medication (capsule/tablet) to avoid contamination.
2. Medicine cup- is a glass or plastic container with three scale;-
Apothecary
Metric
Household to measure liquid medications
Used syringe for doses smaller then 1 tsp; tuberculin syringe for volumes less than 1cc.
3. Medicine dropper- used to administer eye drops, ear drops, and pediatric medications
4. Teaspoon- used to administer liquid medications.
5. Oral syringe- used to measure liquid medications accurately.
7.Demonstrate the measuring techniques for the following
1. Measuring with a medicine cup-
1oz 2 tbs 30 ml
1/2oz 1 tbs 15ml
1/4oz 1tsp 5ml
Techniques-
1. Hold the bottle of liquid so that the label is in the palm of the hand. This prevents the contents from smearing the label during pouring.
2. Examine the medicine cup and locate the exact place where the measured volume should be measured, placed your fingernail at this level.
3. While holding the medicine cup straight at eye level, pour the prescribed volume.
4. Read the volume accurately at the level of the meniscus.
5. Compare the information on the medication card against the label on the stock bottle and the quantity of drug placed in the cup.
6. Recheck the five rights of the medication order.
7. Return the five rights of the medication order.
8. Return the medication container to the shelf of the cabinet.
9. Place the patients medication cup on the medication tray with the medication card.
10 Proceed to the patients bedside when all medications are assembled for administration.
2. Measuring with an oral syringe-
Method 1- with a large-bore needle attached to the syringe, draw up the prescribed volume of medication. The needle is not necessary if the
Bottle opening is large enough to receive the syringe.
Method 2- Using the cup and method 1, pour the amount of medication needed into a medicine cup, then use a syringe to measure the
Prescribed volume.
1. Compare the information on the medication card against the label on the stock bottle and the quantity of drug placed in the syringe.
2. Recheck the five rights of the medication order.
3. Return the medication container to the shelf of the cabinet.
4. Place the patients medication syringe on the medication tray with medication card directly under the syringe.
5. Proceed to the patients bedside when all medications are assembled for administration.
8. Demonstrate the measuring techniques for the following
1. Removing medications directly from a bottle
9. Demonstrate the methods used to confirm the correct placement of the NGT
Demonstrate the techniques and precautions necessary when administering medications via a nasogastric tube (NGT)
1. Sit the patient upright and confirm the location of the NGT before administering any liquid x-ray verification, ph and color testing, ausultatory
Method.
2. Clamp the tubing and attach the bulb syringe.
3. Pour prescribed medication into syringe.
4. Unclamp tubing allowing the medication to flow through tube by gravity.
5. Flush tube with 15-30 ml water after medication.
6. Clump tubing and secure end in place.
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