Oral
How do you administer a sublingual tablet?
Under the tongue. Let it dissolve completely under the tongue. Do not swallow the tablet whole.
What supplies do you need to administer ear or eye drops?
Medication, tissues, gloves. Possibly a washcloth for eye drops.
What length and size needle would be needed for subQ or ID injections?
3/8 inch - 1/2 inch
26-27 guage needle
What assessments are needed prior to administering an IM injection?
When giving an antibiotic?
Assess the site. Avoid any site that is bruised, tender, hard, swollen, inflamed, or scarred. Allergies. 11 rights. Preferred arm or leg.
Allergies!
What assessments are needed prior to administering a transdermal patch?
Skin assessment (wounds, rashes, broken skin), presence of body hair, remove previous patch if still applied. Knowledge of medication. Allergies. 11 rights.
Allergies, swallowing ability, 11 rights, knowledge of medication, vital signs and pain (if applicable).
What position do you place a patient in for:
Ear drops? Adults vs children.
Eye drops?
Ear drops: Turn your head to the side opposite the one where you are administering the medication. To administer to adults, pull the pinna up and back. To administer to adults, pull the pinna down and back.
Eye drops: Tilt the head back with the eye lids open.
What assessments are required prior to administering:
SubQ injection:
ID injection:
SubQ injection: last injection site, skin assessment
Why do we rotate sites?
ID injection: skin assessment, previous reaction to medication being given
Where would you administer a 1mL injection?
Where would you administer a 3 mL injection?
Best site for children?
Deltoid
Ventrogluteal
Vastus lateralis
How do you prepare the skin prior to administering a patch?
Alcohol wipe or soap and water. May need to shave area if excess hair is present.
How do you administer crushed tablets?
One at a time in applesauce or pudding. Add applesauce to medicine cup, not medicine to the applesauce cup.
What should the nurse do if the eye dropper touches the patient's lid or lashes?
Dispose of the medication bottle and request a new bottle from the pharmacy. The bottle is now contaminated.
What needle angle would you use for:
SubQ injection?
ID injection?
SubQ: 45-90 degrees
Why would it differ?
ID: 10-15 degrees
What size needle and length will you choose for:
Vastus lateralis?
Deltoid in adults?
Deltoid in children?
Ventrogluteal?
VL: 5/8 to 1.5 inches
Adults:1-1.5 inches
Children: 5/8 to 1 inch
VG: 1-1.5 inches
Adult gauge: 20-25g
Pediatric gauge: 23-28g
Considerations when administering a transdermal patch?
Remove old patch by folding sticky side together and disposing of by policy. Rotate patch sites. Name/date/time on a piece of tape near the medication patch. Change patch at same time every day.
What type of medications cannot be crushed?
Extended release tablets, immediate release tablets, capsules, gel capsules.
What should the nurse do after administering:
Eye drops?
Ear drops?
Eye drops: place gentle pressure on the inner cathus to prevent medication getting into the tear duct. Do not vigorously wipe eyes.
Ear drops: Keep side lying for 5-20 minutes to allow medication to absorb.
What are you looking for after giving a intradermal injection?
How long after administering TB test would you wait to reassess for reaction?
A wheal. Means that medication has entered the dermis.
48-72 hours post administration.
How do you administer an IM injection?
What angle do you use to administer an IM injection?
Clean area and allow to dry for 5-20 seconds. Pull skin taut to stretch the adipose tissue tight to allow needle to get into muscle. May use the Z track method.
90 degree angle.
If applying a transdermal patch for pain, what assessment is needed prior to administering patch?
Pain scale.
How do you administer liquid oral medication?
In a bottle:
In a syringe:
In a bottle: pour into a medicine cup and measure mLs at eye level.
In a syringe: Pull up ordered medication in oral syringe or verify mLs sent from the pharmacy.
Let the patient choose if possible how they would like to take the medication. What option would you choose for children?
What interventions/assessments should be completed prior to administering:
Eye drops:
Ear drops:
Eye drops: Assessment of eye drainage, infection, or redness. Clean eye from inner to outer if needed.
Ear drops: Warm medication in hand prior to administering to prevent dizziness and nausea. Assess for ear drainage and cleaniness.
Nurse is administering insulin subQ. What assessments are needed before and after administration?
Blood sugar. Did the patient eat? Signs of hypoglycemia.
How long do you wait to remove the needle from an IM injection?
10 seconds. Allows medication to get into muscle and not escape through the needle track.
*You should do this for subQ injections as well.
Where can a nurse apply a transdermal patch?
Depends on medication and manufacturers recommendations.
Fentanyl: chest, back, flank, and upper arm
Nitroglycerin: chest is preferable, have to shave hair, need a break from medication q12 hours to prevent tolerance.