Pharmacology: Alternative Methods for Drug Administration
How far do you need to insert the rectal suppository?
-3 inches or 7-8 centimeters
How far do you need to insert the vaginal suppository applicator?
-3-4 inches or 8-10 centimeters
Metered-Dose Inhaler with Spacer Instructions
-Similar to an MDI with the following additions: 1.) Start to inhale as soon as the canister is depressed. 2.)Check that the valve opens and closes with each breath. 3.) Wash spacer as directed by manufacturer.
Can a patient administer a vaginal medication herself?
-YES
What can the patient receiving a vaginal suppository use to prevent soiling of clothing?
-a light pad in her underwear
What is the suggested time to administer a vaginal drug?
-at bedtime
Commonly Used Areas for Transdermal Patches
-chest -abdomen -arms -thighs
How should the patient turn their head for the nasal drops to reach the ethmoidal and sphenoidal sinuses?
-lean forward bringing their head toward the knees
Purpose of Rectal Medications
-relieve vomiting when the client is unable to take oral medication -relieve pain or anxiety -promote defecation -administer drugs that could be destroyed by digestive enzymes
Steroid Inhalers Patient Teaching
-rinsing and gargling are necessary to remove residual steroid medications, thus preventing a sore throat or final overgrowth and infection
Purpose of Ear Medications
-soften and loosen ear wax in the ear canal -anesthetic effect -immobilize insects in the ear canal -treat infection such as fungal infections
Purpose of Transdermal Patches
-the patch is applied to the skin for slow, systemic absorption, usually over 24 hours. -avoids the gastrointestinal problems associated with some oral medications -provides a more consistent drug level in the patients blood
Metered-Dose Inhaler Instructions
1.) Insert the medication canister into the plastic holder. 2.)Shake the inhaler well before using. Remove the cap from the mouthpiece. 3.) Instruct the patient to breathe out through the mouth, expelling air. Place the mouthpiece into the patient's mouth, holding the inhaler upright. 4.) Instruct the patient to keep their lips securely around the mouthpiece and inhale. While the patient is inhaling push the top of the medication canister once. 5.) Instruct the patient to hold their breath for a few seconds. (remove the mouthpiece and tell the patient to exhale slowly) 6.) Cleanse the mouthpiece.
Ear Drops Administration Instructions
1.) Instruct the patient lie on the unaffected side or to sit upright with his or hear head tilted toward unaffected side. 2.) Straighten the external ear canal. 3.) Instill the prescribed number of drops. Avoid contaminating the dropper. 4.) Instruct the patient to remain in this position for 2 to 5 minutes to prevent the medication from leaking out of the ear.
Pharyngeal Mouthwash Instructions
1.) Instruct the patient sit upright. 2.) Instruct the patient to swish the solution around the mouth, but NOT swallow the solution, and then to spit it into an emesis basin or sink.
Eye Drops Administration Instructions
1.) Instruct the patient to lie or sit with his or her head tilted back. 2.) Instruct the patient to look up toward the ceiling and away from the dropper. Pull down the lower lid of the affected eye. Place the number of drops prescribed into the lower conjunctival sac. 3.) Press gently on the medial nasolacrimal canthus with a tissue to prevent systemic drug absorption. 4.) If the other eye is affected, repeat the procedure in the other eye. 5.) Instruct the patient to blink once or twice and then to keep his or her eye closed for several minutes.
Eye Ointment Administration Instructions
1.) Instruct the patient to lie or sit with his or her head tilted back. 2.) Pull down the lower lid to expose the conjunctival sac of the affected eye. 3.) Squeeze a strip of ointment about 1/4 inch long onto the conjunctival sac. 4.) If the other eye is affected, repeat the procedure. 5.) Instruct the patient to close his or her eyes for 2 to 3 minutes.
Pharyngeal Lozenge Instructions
1.) Instruct the patient to sit upright. 2.) Instruct the patient to place the lozenge into his or her mouth and suck until it is fully dissolved. 3.) The lozenge should NOT be chewed or swallowed whole.
Pharyngeal Spray Administration Instructions
1.) Instruct the patient to sit upright. 2.) Place a tongue blade over the patient's tongue to improve visualization of the mouth and to prevent the tongue from becoming numb if an anesthetic is being administered. 3.) Hold the spray pump nozzle outside the patient's mouth, and direct the spray to the back of the throat.
Nasal Drops Administration Instructions
1.) Instruct the patient to sit with his or her head tilted back. 2.) Insert the dropper into the nostril without touching the nasal membrane. 3.) Instill the number of drops prescribed. 4.) Instruct the patient to keep his or her head tilted back for 5 minutes and to breathe through the mouth. 5.) Cleanse the dropper.
Nasal Spray Administration Instructions
1.) Instruct the patient to sit with his or her head tilted slightly back or slightly forward, according to the directions on the spray container. 2.) Insert the tip of the container into one nostril and occlude the other nostril. 3.) Instruct the patient to inhale as you squeeze the drug spray container. Repeat with the same nostril or other nostril if ordered. 4.) Encourage the patient to keep his or her head tilted back for several minutes to promote absorption of the medication. 5.) Drink plenty of fluids after using a steroid nasal spray to avoid microbial overgrowth.
Vaginal Suppository, Cream, and Ointment Administration Instructions
1.) Place the patient in the lithotomy position. 2.) Place the vaginal suppository at the tip of the applicator or connect the top o the vaginal cream/ointment tube with the tip of the applicator and squeeze the tube to fill the applicator. 3.) Lubricate the applicator with WATER-SOLUBLE lubricant if necessary. 4.) Insert applicator downward first, then upward and backward. 5.) Instruct patient to remain lying down for 5-15 minutes after the application. 6.) Instruct the patient to avoid using tampons after insertion of the vaginal medication.
Rectal Suppositories Administration Instructions
1.) Place the patient on his or her left side in Sims position. 2.) Expose the anus by lifting the upper portion of the buttock. (check that the anus/rectum is not full of stool) 3.) Lightly lubricate the suppository with water-soluble lubricant, and insert the narrow (pointed) end of the suppository into the anus, past the anal sphincter and into the rectum. 4.) Instruct the patient to remain in a supine or left lateral Sims position for 5 to 10 minutes.
Transdermal Patch Instructions
1.) Wear gloves to remove existing patch if present, then cleanse and dry the area of skin where the new patch will be applied. 2.) Label the patch with date, time, and nurse's initials. 3.) Remove the transparent cover inside of the patch. Do NOT touch the inside of the patch. 4.) Apply the patch to the chosen area with the dull plastic side up. 5.) Document location transdermal patch on medication administration record or chart.
How do you prevent contamination while applying eye drops?
DO NOT touch the end of the dropper on the eye or eyelashes.
When can the nose be blown after nasal spray use?
Not until the head is upright.
How do you straighten the external ear canal in a child?
Pull the auricle of the ear down and back until age 3.
How do you straighten the external ear canal in an adult?
Pull the auricle. of the ear up and back.
What might the patient expect after eye ointment is applied?
blurred vision for a short time
What areas do you avoid when applying a transdermal patch?
areas with hair
What is the nasolacrimal canthus?
corner of the eye closest to the nose
How should the patient turn their head for the nasal drops to reach the frontal and maxillary sinuses?
side to side
When to administer a second dose of an inhaled medication?
wait 1 to 2 minutes after the first
What do you do if you are administering two or more different types of eye drops?
wait 5 minutes between medications
