Routes of Medication Administration

Supine with head tilted back

How should a patient be positioned when administering nasal drops?

sitting upright with head slightly hyperextended

How should patient be positioned when administering nasal spray?

side-lying position

If a patient needs to take an oral medication but is unable to sit, place the patient in a ___________-__________ ______________.

irrigate; pancrelipase tablets

If an NG tube becomes blocked, what is the first attempt you should make to un-block it? What if that doesn't work?

spacer

Patients who have problems coordinating proper use of MDI's a ______ device should be used.

Intradermal

Routes of Medication Administration Classified as a type of injection used for administering local anesthetics as well as testing the skin. -typically placed in the upper back or the inner forearm

Subcutaneous injection

Routes of Medication Administration: Medicine is deposited in the fatty tissue of the skin to allow a much slower absorption rate.

Intramuscular Injections

Routes of Medication Administration: Medicine is injected deep into muscle tissue -deltoid -vastus lateralis -ventrogluteal

Sublingual

Routes of Medication Administration: Administered under the patients tongue. -absorbed through mucus membranes for rapid effect

Vaginal

Routes of Medication Administration: Comes in the forms of jellies, foams, creams and suppositories. -treats infections, relieves discomfort and restores pH level to maintain normal flora

Oral

Routes of Medication Administration: Considered to be the easiest route for medication administration -Should not be given to a patient who is NPO

Nasogastric

Routes of Medication Administration: Describes administration of medicine through a tube that goes to the stomach.

Topical

Routes of Medication Administration: Includes lotions, creams, ointments patches and pastes. -produce a local effect (transdermal patches are actually systemic ie. nitroglycerin)

Otic

Routes of Medication Administration: Instilled directly into the ear.

Buccal

Routes of Medication Administration: Placed between upper and lower molars and the patients cheek. -absorbed through mucus membranes for rapid effect

Nasal

Routes of Medication Administration: Used commonly to relieve congestion of the nasal cavity or to moisten mucous membranes

Rectal

Routes of Medication Administration: Used to provide local effect to the gastrointestinal mucosa or sometimes can be used for a systemic affect such as relieving nasuesa

Inhaled

Routes of Medication Administration: Used to treat symptoms and disorders of the respiratory tract.

Opthalmic Medication

Routes of Medication Administration: includes- drops ointments intaocular disks always considered to be serile

1ml/sec

How fast should you dispense IM injections once you have penetrated the patients vascular muscle?

False; keep head elevated for 1 hour

After administering NG meds, place patient in a flat position for 1 hour.

supine

After patient receives a vaginal medication, patient should remain in the __________ position for at least 10 minutes to make sure medicine is absorbed

45-90; 90 degree

At what angle should a SubQ medication be administered in an average patient? For an obese patient?

90 degree

At what angle should an IM injection be inserted?

aspirate

Before administering nasogastric medicine _______ gastric contents to observe color, ph and appearance of contents.

swallowing

Before administering oral medication, assess patient for problems with __________.

pharmacist

Before crushing or cutting meds, it's a good practice to check first with a _________ or consult your drug guide.

high fowlers

For nasogastric medicine administrations, what position should the patient be placed in?

pinna

Pulling the _____ up and back helps with instilling medication via the otic route

syringe

To improve accuracy of liquid medication, use a dosage _______.

True

True or False The most common form of inhaled medication is a metered dose inhaler (MDI) and it is important that the patient is taught to depress the inhaler while inhaling.

False; patient should take medicine even if menstruating

True or False Vaginal medications should be stopped if patient is actively menstruating, and resumed immediately afterward.

False; never massage

True or False: After administering an IM injection, place a cotton ball or gauze directly on the site and massage gently.

True

True or False: Because liquid medication isn't always available, sometimes it is necessary to crush a medicine and dissolve it in a facility approved fluid. (Nasogastric Route)

False; outtermost

True or False: Before administering an otic medication, used a cotton tipped applicator to remove drainage or build-up to the innermost part of the ear to make sure medication is completely absorbed.

True

True or False: Before administering nasal medication, have patient gently blow nose to ensure medication absorption.

False: Inner to outer

True or False: Before instilling and opthalmic medication, gently wipe away drainage or discharge starting from the outer canthus toward the inner canthus.

True

True or False: Children sometimes will have difficulty keeping a suppository in place, it is appropriate when necessary to hold the buttocks together for 5 to 10 minutes to make sure it is melted and absorbed through the mucousal tissue.

True

True or False: Cutting pills, while sometimes necessary, should be avoided if possible

True

True or False: Due to age-related physiological changes, geriatric patients are at a higher risk for toxicity when receiving oral medication.

False; rotate to prevent damage to tissue

True or False: It is important to always rotate the location of an IM injection (when receiving regularly) to make sure medication is absorbed the same way every time.

True

True or False: It is important when pouring liquid medication to measure the medication at the base of the meniscus rather than the edges.

False: could cause cornea damage

True or False: Opthalmic medication should always be administered to the center of the eye.

True

True or False: The "Z" technique consists of displacing patients skin with non-dominant hand approximately 1-1 1/2 inches at the site of injection and releasing immediately after removing the needle.

False; disrupts distribution of active drug

True or False: To make administration of rectal medication more comfortable for the patient, it is appropriate to cut the suppository in half.

True

True or False: Warming otic meds to room temperature prevents nausea and dizziness.

True

True or False: When administering an intradermal injection, pull the skin taught and insert the needle at a 5 to 15 degree angle with the bevel facing up.

True

True or False: When administering opthalmic medications, place thumb on patients cheekbone and gently pull down the eyelid avoiding touching the eyeball directly or the tip of the medicine bottle.

False; causes meds to be absorbed too rapidly

True or False: When applying an ointment such as nitroglycerin, gently massage ointment into the skin.

False: use cutting device

True or False: When cutting a scored tablet, use gloved hands to break the tablet in half manually.

accidental exposure

Wearing gloves during topical medication administration protects the nurse from ______ _________.

rectal surgery or bleeding

What are 2 situations where rectal medications would not be considered appropriate?

Injection site, age, and size of the patient

What are some factors that determine the max volume, length and gauge of a needle used in an IM injection?

blanching, wheal formation

What are some things to look for that indicate an intradermal injection was administered correctly?

bleeding or no wheel formation

What are some things to look for that indicate an intradermal medication was administered incorrectly

diameter

What does the gauge of the needle refer to?

Younger than age 3

What group should never receive a deltoid injection?

Liquid

What is considered the easiest route of medication administration for pediatric patients?

rebound effect

What is the term used to describe inflammation of mucus membranes after prolonged use of nasal medications?

medical

What kind of asepsis should be used if patients skin is considered intact, while administering topical medications?

surgical

What kind of asepsis should be used if patients skin is not intact, while administering topical medications?

quick, darting

What kind of motion should be used when administering an IM injection?

intradermal

What kind of needle is this used for? 3/8-5/8 inch needle 25-27 gauge inserted at a 5 to 15 degree angle

subQ

What kind of needle is this used for? 3/8-5/8 inch needle 25-30 gauge inserted at a 45-90 degree angle

intramuscular

What kind of needle is this used for? 5/8-1 1/2 inch needle 18-25 gauge inserted at a 90 degree angle

sharps container

What should be observed before administering any type of of injection to assure safe disposal of the used needle?

"Z" technique

What technique is used of IM injections to ensure medication does not leak into subcutaneous tissue?

one-handed scoop

What technique should you use to recap a clean needle?

gargle warm water

When a patient is taking steroids as an inhalant, what can be done to prevent the development of thrush?

True

When administering a subcutaneous medication, gently pinch the tissue from the underlying muscle; your needle should be about half the width of the skin fold.

Conjunctival sac

When administering opthalmic medications, medicine should be placed in the _________ ___________.

before; after

When cutting or crushing a pill, remember to clean the mortar and pestle or cutting device ______ and ______ use.

Inflammation, bony prominence, lesions

When preparing to give an intramuscular injection, besides determining adequate muscle tissue, what things should you observe about the patient?

deltoid

Where is this patient receiving their IM injection? The nurse inserts the needle 1-2 inches below the acromion process above the axillary line. The midline of the lateral aspect of the arm

vastus lateralis

Where is this patient receiving their IM injection? The nurse inserts the needle one hand space below the greater trochanter and one had space below the knee. In the anterolateral aspect of leg.

ventrogluteal

Where is this patient recieving their IM injection? The nurse places her hand on the greater trocanter and points her thumb toward the patients abdomen. Then using her index finger, extends it so that her index is pointing to the anterior supperior iliac spine. Lastly she spreads her other fingers along the iliac crest and inserts the needle in the "V" created by her index and 3rd finger.

False; stop feeding for 30 mins. provide meds. flush tube and resume feeding after an hour.

While administering nasogastric medication to a patient receiving continuous feeding, mix medications with the feeding solution.

rotate

While administering topical medications, ________ the placement of the medication to prevent skin irritation.

to prevent overdose

Why is it important to remove a transdermal patch before applying a new one?

nasal corner

With patients who refuse to open their eyes while administering opthalmic medication, place the drops on the _________ ___________ . (where eyelids meet).