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Foundation (2) NUR 211
Dr/ Magda Bayoumi
Dr/ Magda Bayoumi
Medication Adminstration 28/10/2012
Medication: is substances administered for diagnosis, cure, treatment, or relief of symptom or for prevention of disease. Prescription: the written direction for the preparation and administration of a drug. Generic name: is given before a drug become official Official name: is the name under which it is listed in one of the official publications Chemical name: is the name by which a chemist knows it; this name describes the constituents of the drug precisely. Trademark or brand name: is the name given by the drug manufacturer.
Dr/ Magda Bayoumi
Medication Adminstration 28/10/2012
Effects of drugs:
Therapeutic effect: of a drug, also referred to as the desired effect, is the primary effect intended, that is, the reason the drug prescribed (e.g; the therapeutic effect of morphine sulfate is analgesia . A side effect, or secondary effect, of the drug is one that is unintended. Side effects are usually predictable and may be either harmless or potentially harmful. (e.g; digitalis increase the strength of myocardial contractions (desired effect) but it can have the side effect on inducing nausea and vomiting. Some side effects are tolerated for the drug's therapeutic effect; more severe side effects, also called adverse effects, may justify the discontenting of a drug Drug toxicity: deleterious effects of a drug on an organism or tissue) results from over dosage, ingestion of a drug intended for external use, and buildup of the drug in the blood because of impaired metabolism or excretion (cumulative effect). Some toxic effects are apparent immediately; some are not apparent for weeks or months (toxic effect is respiratory depression due to the cumulative effect of morphine sulfate in the body. A drug allergy: is an immunologic reaction to a drug, when a client is the first exposed to foreign substance (antigen), the body may react by producing antibodies. A client can react to drug as to an antigen and thus develop symptoms of an allergic reaction. Anaphylactic reaction usually occurs immediately after the administration of the drug, his response can be fatal if the symptoms are not noticed immediately and treatment is not obtained promptly. The earliest symptoms are acute shortness of breath, acute hypotension, and tachycardia. Drug tolerance exists in a person who has usually low physiologic response to a drug and how requires increases in the dosage to maintain a given therapeutic effect A cumulative effect is the increasing response to repeated doses of a drug that occurs when the rate of administration exceeds the rate of metabolism or excretion An idiosyncratic effect is unexpected and individual. Under response and over response to a drug may be idiosyncratic A drug interaction occurs when the administration of one drug before, at the same time as, or after another drug alters the effect of one or both drugs Latrogenic disease, disease caused unintentionally by medical therapy can due to drug therapy .
Dr/ Magda Bayoumi
Medication Adminstration 28/10/2012
the time interval required for the body's elimination processes to reduce the concentration of the drug in the body by one-half. Drugs that have no special pharmacologic action of their own but that inhibit or prevent the action of an agonist are called specific antagonists. physiologic dependence is due to biochemical changes in body tissues.Drug misuse: Drug abuse: is inappropriate intake of a substance.5% After 32 hours 6. Dr/ Magda Bayoumi Page 4 Medication Adminstration 28/10/2012 . Drugs may also produce a response by stimulating enzyme activity or hormone production. also called stress drugs. • Drug dependence is a person's reliance on or need to take a drug or substance. especially the nervous system. Psychologic dependence is emotional reliance on a drug to maintain a sense of well being.25% Key terms related to drug actions are as follows: • Onset action: the time after administration when the body initially responds to the drug. • Drug half-life (elimination half-life): the time required for the elimination process to reduce the concentration of the drug to one-half what it was at initial administration. may occur separately or together. • Plateau: a maintained concentration of a drug in the plasma during a series of scheduled doses. The types of dependence. • Action of drugs on the body: The action of a drug in the body can be described in terms of its half-life. One of the mechanisms is the drug interaction with a cellular receptor to produce a response known as an agonist. For example. Mechanisms of action: Pharmacodynamics: Is the process by which a drug alters cell physiology. if a drug's half-life is 8 hours. then the amount of drug in the body is as follows: Initially: 100% After 8 hours:50% After 16 hours: 25% After 24 hours: 12. • Peak plasma level: the highest plasma level achieved by a single dose when the elimination rate of a drug equals the absorption rate. physiologic and psychologic. • Illicit drugs. either continuously or periodically. • Drug habituation. the individual develops habit of taking the substance and feels better after taking it. accompanied by feelings of need or cravings for that drug. are those sold illegally.
The products of this process are called metabolites. During taken during pregnancy. saliva. Most metabolites are eliminated by the kidneys in the urine. • Biotransformation or metabolism.Pharmacokinetics: Is the study of the absorption. is a process by which a drug is converted to a less active form. Unless the drug is administered directly into blood stream. Most biotransformation takes place in the liver. (decrease gastric mobility and decrease gastric acid production and blood flow. Infants usually required small dosages because of their body size and the immaturity of their organs. perspiration. especially the liver and kidneys. absorption is the first step of movement of the drug through the body. however. and excretion of the drugs. • Distribution: is the transportation of a drug from its site of absorption to its site of action. • Dr/ Magda Bayoumi Page 5 Medication Adminstration 28/10/2012 . Factor affecting medication action: Developmental factor: during pregnancy women must be very careful about taking medications. some are excreted in the feces. distribution. In adolescence or adulthood. allergic reactions may occur to drugs formerly tolerated. • Absorption: is the process by which a drug passes into blood stream. and breast milk. breath. • Excretion: is the process by which metabolites and drugs are eliminated from the body. which can impair drug absorption) • Gender: differences in the way men and women respond to drugs are chiefly related to the distribution of the body fat and fluid and hormonal differences. Older adult have different responses to medications due to physiologic changes that accompany aging. biotransformation. where many drug-metabolizing enzymes in the cells detoxify the drugs.
• Illness and disease: can also affect the action of drug. Orally administered medications are absorbed more quickly if the stomach is empty.g. a tablet) is held in the mouth against the mucous membranes of the cheek until the drug dissolves. irritation of the gastric mucosa. and Genetic Factors. A client who takes a sedative or analgesic in a busy. in contrast. Sublingual: administration a drug is placed under the tongue. • Environment: the client environment can effect the action of drugs. Ethnic. harm to the client's teeth. in some cases. In oral administration. Thus oral medications taken 2 hrs before meals act faster than those taken after meals. the drug is swallowed. the drug is largely absorbed into the blood vessels on the underside of the tongue. least expensive and most convenient route for most clients. particularly those used to alter behavior and mood. or kidney dysfunction. Drug action is altered in clients with circulatory. The medication should not be swallowed. The drug may act locally on the mucous membranes of the mouth or . a medication • (e. The variation response is called drug polymorphism.drug commonly given in this manner Sublingual Buccal: means "pertaining to the cheek. irregular absorption from the gastrointestinal tract. • Routes of administration: • Oral: administration is the most common.. a client response to a drug is influenced by age. thus intensifying the action of vasodilators.Cultural. • Diet: nutrients can affect the action of the medication." In buccal administration. environment temperature may also affect drug activity when environmental temperature is high the peripheral blood vessels dilate. oral administration is also a safe method the major disadvantages are possibly unpleasant taste of the drugs. and body composition. size. (e. the liquid preparation of ferrous sulfate (iron) can stain the teeth. gender. slow absorption. noisy environment may not benefit as fully as if the environment were quiet and peaceful. Because the skin is not broken as it is for an injection. • Time of administration: a time of administration of oral medications affects the relative speed with which they act. and. • Psychological factors: a client's expectations about what a drug can do can affect the response to the medication. aspirin can reduce the body temperature of a feverish client but has no effect on the body temperature of a client without fever. liver. In • a relatively short time. Nitroglycerin is one example of a . where it dissolves.systemically when it is swallowed in the saliva Dr/ Magda Bayoumi Medication Adminstration 28/10/2012 Page 6 .g. a cold environment and consequent vasoconstriction inhibit the action of vasodilators but enhance the action of vasoconstrictors. For example vitamin K found in green leafy vegetables can counteract the effect of an anticoagulant such as worfarin. For example.
Air. The following are some of the more common routes for parenteral administration Subcutaneous (hypodermic)-into the subcutaneous tissue. intraosseous (into bone). rectum. Topical applications include the :following Dermatologic preparations: applied to the skinInstillations and irrigations.Parenteral: route is defined as other than through the alimentary or respiratory tract.bladder.lungs :Types of medication order Dr/ Magda Bayoumi Page 7 Medication Adminstration 28/10/2012 . nose. by needle. intrathecal or intraspinal (into the spinal canal).absorption Topical applications are those applied to a circumscribed face area of the body. epidural (into the epidural space). such as the urinary. intrapleural (into the pleural space). and intra-articular (into a joint). and vapor are generally used to carry the drug into the . just below the skinIntramuscular-into a muscle(Intradermal-under the epidermis (into the dermis Intravenous-into a vein- Some of the less commonly used routes for parenteral administration are intra-arterial (into an artery). eyes. or vagina Inhalations-administered into the respiratory tract by a nublizer or positive pressure breathing apparatus. They affect only the area to which they are applied. The main advantage is fast . ears.applied into body cavities or orifices. that is. oxygen. sterile equipment and sterile drug solution are essential for all parentral therapy. intracardiac (into the heart muscle).
g pain . permits the nurse to give a medication when the -4 nurse judgment. A standing order -3 (may be carried out indefinitely (eg: multiple vitamins daily A Prn order.Signature of the prescriber • • • • • • • • :Six "Rights"of Medication Administration :Right Medication .Four common medication orders are the stat order.(The form (e.Scheduled times are considered to meet the "right time" standard • Dr/ Magda Bayoumi Page 8 Medication Adminstration 28/10/2012 .required it :Essential parts of a drug order . and the prn A state order indicates that the medication is to be given immediately and only -1 once The single order or one-time order is for medication to be given once at specified -2 .The medication given was the medication ordered • Right Dose .Double check calculations that appear questionable • .The dose ordered is appropriate for the client • Give special attention if the calculation indicates multiple pills/tablets or a large • .Know the usual dosage range of the medication • . the client -5 . the standing order.g.Dosage of the drug . quantity of a liquid medication .Question a dose outside of the usual dosage range • Right Time Give the medication at the right frequency and at the time ordered according to • . tabs . or as needed order.time The standing order may or may not have a termination date.(Orders for drugs to given prn also include the reason they are to be given (e.agency policy .Frequency of administration . the single order.Full name of the client and ID . the client required it Permits the nurse to give a medication when the nurse judgment.Date and time the ordered written Name of the drug to be administered .
older than the metric sys tem.last names are on the nursing unit :Right Documentation After administering a medication. which is similar to the apothecaries' . Basic units can be multiplied or divided by 10 to form secondary units. and the basic unit of vol ume is the minim.Give the medication by the ordered route • . Multiples are calculated by moving the decimal point to the right. the nurse records it immediately on the . and glasses Dr/ Magda Bayoumi Page 9 Medication Adminstration 28/10/2012 . it is a decimal system. and the gram A p o t h e c a r ie s ' S y s t e The apothecaries' system. the apothecaries' system.meter.of wheat H o u s e h o ld S y s t e m Household measures may be used when more accurate systems of measure are not required. and divisions by moving the decimal point to the left . likened to a grain of wheat. cups. a volume of water equal in weight to a grain .Make certain that the route is safe and appropriate for the client • Right Client . teaspoons. the liter.Right Route . Basic units of measurement are the . table spoons. Included in household measures are drops.Check the client's identification band with each administration of a medication • Know the agency's "name alert" procedure when clients with the same or similar • .system M e t r ic S y s t e m The metric system is logically organized into units of 10. . The basic unit of weight in the apothecaries' system is the grain (gr). and the household system.Medication is given to the intended client • .administration form :System of measurement Three systems of measurement are used in North America: the metric system.
capsules) that drivers the available dose Note: the desires dose (D) and the on-hand (H) dose must be in the same unite of measurement.V: is the volume (liquid) or vehicle (tablets. then conversions must be done before . and the answer label (tablets.D: Is the desired dose or the dose ordered by the physician for client H: is the drug dose on hand or available for use. which is the first item of the equation. The dose is on drug label . or ml). which is the last .completing the formula :Dimensional Analysis Step 1: Identify the starting factor (amount ordered). If they are different unites.:Formulas for drug calculations :Formula Method D X V = AMOUNT TO GIVE H . capsules.item Dr/ Magda Bayoumi Page 10 Medication Adminstration 28/10/2012 .
The equivalent needed is 1 tablet = 0. if mg is in . How many tablets should be given :Step2. the answer label should not cancel .25 g g x 1 tab = tabs 0.Step 3: Solve the equation . convert to decimal.Reduce and multiply mg X 5 ml =1 0 ml 250 mg 125 1 Example 4 When dosage is ordered based on body surface area (commonly done for pediatric dosages): The body surface area is estimated on the basis of weight.measurable quantity . that is.25 1 . and multiply the numerators and the denominators g x 1 tab = 2 tabs 0.5 0. The starting factor is 0.The answer label is ml :Step2. mg must be in the denominator to cancel ..Multiply/divide to solve equation .25 1 Example 3 :When the dose ordered is available in a liquid form Dose ordered: Keflex 250 mg PO Available: 125 mg per 5 ml .the numerator. 1 g = 1000 mg).Cancel labels first.5 0. Set up the equa tion so that labels can be canceled.a .NOTE: If properly written. Solve the equation . and round to a .5 g ?The answer label is tablets.(Cancel labels (mg :Step3.(Cancel labels (g .Reduce the numerical values.g.Reduce numbers to lowest terms .b Example 1 :When the dose ordered has the same label as the dose available .b . Formulate the conversion equation mg X 5 ml = ml 250 mg 125 1 .Step1.Step 2: Identify appropriate equivalents with a 1: 1 ratio (e. Formulate the conversion equation .c Reduce answer to lowest terms. all labels except the answer label will cancel :Step3. Solve the equation . for exam ple. using standard charts Dr/ Magda Bayoumi Page 11 Medication Adminstration 28/10/2012 .Step1. The starting factor is 250 mg .
3 Child's dose = 75 mg NURSING DIAGNOSES Nursing diagnoses may be identified based on therapeutic effects or side effects of specific .54 m2• The normal single adult dose is 2 5 0mg Child's dose = 0. in which therapy alters the client's ability to respond normally to . steroids. or spiritual beliefs.7 Physician orders ampicillin for a child weighing12 kg.54 m2 X 250 mg (1 m2 1. Certain medications.prescribed medications or factors affecting the client's ability to self-administer drugs Ineffective Therapentic Regimen Management may be related to a knowledge deficit of the purpose of prescribed medications. and anticoagulants. The formula is a ratio of the child's body surface area compared with the . Noncompliance involves a person's informed decision not to adhere to a therapeutic regimen of medication administration.receiving eye or ear medications Dr/ Magda Bayoumi Page 12 Medication Adminstration 28/10/2012 . cultural. 7 square meters. which may be related to economic.The m2 units cancel out and can be ignored (2 Child's dose = 0.that the body surface area for this child is 0.7 . 7 m2 Child's dose = Surface area of child x Normal adult dose m2 1.54 X 250 mg (3 1.infection or bleeding Disturbed Sensory Perception (visual or auditory) may be appropriate in clients . such as chemotherapeutic agents.side effects Health-Seeking Behaviors (medications) is a useful nursing diagnosis when clients have a lmowledge deficit and want to learn how to provide self medication. or unpleasant . the complexity of a drug schedule. or 1.(body surface area of an average adult (1. may contribute to Ineffective Protection.7 X 250 mg = 75 mg 0.or nomogram. and the nomogram chart shows .
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The nurse should adhere to the following safety measures to prevent crosscontamination: • Each client should have his or her own bottle of eyedrops. refer to drops. Dr/ Magda Bayoumi Page 16 Medication Adminstration 28/10/2012 . and disks. and stain the cornea to identify abrasions and scars. Clients should never share eye medications. often referred to as ophthalmic medications. The nurse should review the abbreviations used in medication orders to ensure that the medication is instilled in the correct eye. Cross-contamination is a potential problem with eyedrops. • Discard any solution remaining in the dropper after instillation. as by touching the bottle or any part of the client’s eye. Diagnostically. • Discard the dropper if the tip is accidentally contaminated. eyedrops can be used to anesthetize the eye.Eye Medications Eye medications. ointments. These drugs are used for diagnostic and therapeutic purposes—to lubricate the eye or socket for a prosthetic eye and to prevent or treat eye conditions such as glaucoma (elevated pressure within the eye) and infection. The risk of transferring infection from one eye to the other is increased if the tip touches any part of the client’s eye. dilate the pupil.
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such as an insect. medical asepsis is used when instilling medications into the ear Medication should never be forced into the ear canal especially if it is occluded (as by wax).Ear Medications Solutions ordered to treat the ear are often referred to as otic (pertaining to the ear) drops or irrigations. Eardrops and irrigation fluids should be at room temperature. all procedures must be performed using sterile aseptic technique. or to facilitate removal of a forgien body. otherwise. The internal ear is very sensitive to changes in temperature. to produce anesthesia. If the tympanic membrane is damaged. hydrocortisone eardrops are contraindicated in clients with a fungal infection or a viral infection such as herpes. Eardrops may be instilled to soften ear wax. the nurse should inspect the ear for signs of drainage. to treat infection or inflammation. Before instilling a solution into the ear. Forcing medication into an occluded eardrum can injure the eardrum. Eardrops are usually contraindicated when the tympanic membrane is perforated. External auditory canal irrigations are usually performed for cleaning purposes and less frequently for applying heat and antiseptic solutions. Dr/ Magda Bayoumi Page 20 Medication Adminstration 28/10/2012 . an indication of a perforated tympanic membrane. Certain conditions have contraindications for specific drugs. Sudden changes can cause nausea and dizziness. for example.
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Nasal Instillations Nasal instillations can be performed with different preparations: drops or nebulizers (atomizer or aerosol). they may have a reverse or rebound effect by increasing nasal congestion. ethmoid. Nose drops can be instilled to remain in the nasal passage. however. Because many of these products are nonprescription drugs. to treat infections of the nasal cavity or sinuses. For example. or to reach the frontal or maxillary sinuses. to loosen secretions and facilitate drainage. to reach the ethmoid and sphenoid sinuses. clients should be taught their correct usage. Dr/ Magda Bayoumi Page 22 Medication Adminstration 28/10/2012 . The nasal sinuses (frontal. and sphenoid sinuses) communicate with the nasal fossae and are lined with mucous membranes similar to those that line the nose. nasal decongestants are common over-the-counter drugs used to shrink swollen mucous membranes. Nasal drugs are administered to produce one or more of the following effects: to shrink swollen mucous membranes. when these drugs are used in excess. maxillary.
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instruct the client to lie back with the head over the edge of the bed or a pillow under the shoulder so that the head is tipped backward. with the head turned toward the side to be treated. and (c) avoid blowing the nose for several minutes. To treat the maxillary and frontal sinuses. Teach Use of Respiratory Inhalants Dr/ Magda Bayoumi Page 24 Medication Adminstration 28/10/2012 .Nursing Alert: To treat the ethmoid and sphenoid sinuses. instruct the client to assume the same back-lying position. (b) remain in a back-lying position for at least 1 minute so that the solution will come into contact with all of the nasal surface. The client should also instructed to (a) breathe through the mouth to prevent aspiration of medication into the trachea and bronchi.
There are three types of oropharyngeal hand-held inhalers: metered-dose inhaler. This requirement prevents some clients. Mucolytics are used to liquify tenacious (thick) bronchial secretions. and disease related to weakness (such as chronic respiratory disease). Oropharyngeal hand-held inhalers deliver medications that produce both local and systemic effects. Dr/ Magda Bayoumi Page 25 Medication Adminstration 28/10/2012 . Bronchodilators are contraindicated in clients who have a history of tachycardia. The nurse needs to evaluate the client’s ability to adequately compress the inhaler to deliver a full dose and to inhale at the same time as the dose is expressed.Respiratory inhalants are delivered by devices that produce fine droplets that are inhaled deep into the respiratory tract. Clients must be able to form an airtight seal around the inhaling devices and be able to assemble the turboinhaler. flexibility (as in arthritic changes). These medication droplets are absorbed almost immediately through the alveolar epithelium into the bloodstream. Careful discharge instructions and observation of the client performing the task are important to continued therapeutic effect at home (see the accompanying display for home care application). The nurse should ensure that the client knows how to use the inhaler correctly so that the prescribed medication dose is delivered. turbo-inhaler. Bronchodilators improve airway patency and are used to prevent or treat bronchospasms. and allergic reactions. Failure to do either could prevent the client from receiving the full benefit of the inhaler. A metered-dose inhaler delivers a measured dose of the medication with each push of the canister. asthma. such as clients with visual or coordination impairments. The ability to compress the inhaler for dose delivery can be affected by hand strength (which diminishes with age). such as bronchodilators and mucolytics. from using these devices. and the nasal inhaler (previously discussed).
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Douches are ordered to apply antimicrobial solutions. foams. however. to reduce inflammation. Dr/ Magda Bayoumi Page 28 Medication Adminstration 28/10/2012 . Sterile technique is usually required by agency policy. and to prevent hemorrhage with warm or cold irrigations. small suppositories may come with an applicator and the suppository is placed in the applicator’s tip. After insertion of these preparations. These medications may be used to treat inflammation. If a suppository is given to treat infection.Vaginal Instillations Medications inserted into the vagina are in the form of suppositories. the client may notice drainage and should be informed that this is expected. gels. creams. Body temperature causes the suppository to melt and be absorbed. Standard Precautions are always used by the nurse when inserting suppositories. tell the client that the drainage may be foul smelling. or douches. Suppositories are usually inserted with the index finger of a gloved hand. gels. especially if there is an open wound when administering a vaginal douche (irrigation). to remove offensive or irritating discharge. provide privacy for the client. In this case. ointments. The nurse should ensure that the client does not have an allergy to iodine because many vaginal preparations contain povidone-iodine. or ointments usually come with a disposable tubular applicator with a plunger to insert the drug. or as a contraceptive measure. infections. The nurse should advise the client to wear a perineal pad to prevent soiling of the underpants. Vaginal creams. and discomfort. Many clients prefer to insert their own vaginal suppository.
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Rectal Instillations Dr/ Magda Bayoumi Page 30 Medication Adminstration 28/10/2012 .
The health care practitioner should be notified when the client is unable to retain a suppository so that another route can be ordered. Suppositories provide a safe and convenient route for administering drugs that interact poorly with digestive enzymes or have a bad taste or odor. Suppositories are often stored in the refrigerator to preserve the integrity of the drug form. suppositories. causing cardiac dysrhythmias (abnormal heart patterns). Dr/ Magda Bayoumi Page 31 Medication Adminstration 28/10/2012 . if the condition allows. Rectal ointments are used to treat local conditions and symptoms such as pain. inflammation. to harden a suppository. and hold the buttocks closed. reduce fever. Suppositories are also used to induce relaxation. They are also used to provide temporary relief for clients who cannot tolerate oral preparations: for example. place it under cold running water while it is still in its original wrapper. Rectal suppositories are contraindicated in cardiac clients because insertion may stimulate the vagus nerve. and ointments. Rectal instillations can be in the form of enemas. Rectal suppositories are cone-shaped masses of substances designed to melt at body temperature and to produce the intended effect at a slow and steady rate of absorption. The nurse should follow the six rights of medication administration and Standard Precautions when administering rectal instillations. to relieve nausea and vomiting. Some clients may experience problems in retaining the suppository. relieve pain and local irritation. A softened suppository is difficult to insert. These drugs are also avoided in clients recovering from rectal or prostate surgery because they may cause pain on insertion and trauma to the tissues. The nurse should assess the rectum for irritation or bleeding and check sphincter control. and stimulate peristalsis and defecation in clients who are constipated. The nurse should instruct such a client to remain in the Sims’ position for at least 15 minutes or should place the client on the abdomen. and itching caused from hemorrhoids.
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rashes. eyes. to protect the skin. to provide local anesthesia. ointments. Drugs directly applied to the skin to produce a local effect include lotions. Topical drugs are usually given to provide continuous absorption to produce different effects: to relieve pruritus (itching). creams. Dr/ Magda Bayoumi Page 33 Medication Adminstration 28/10/2012 . Before applying a topical preparation.Administer Topical Medications Topical medications may be administered to the skin. Topical medications are usually ordered two or three times a day to achieve their therapeutic effect. the nurse should always implement Standard Precautions when applying a topical drug. nose. The medication generally provides a local effect but can also cause systemic effects. powders. the nurse should assess the condition of the skin for any open lesions. ears. and vagina. pastes. or areas of erythema and skin breakdown. or to create a systemic effect. Because secretions are produced by the skin and mucous membranes. The rate and degree of the drug’s absorption are determined by the vascularity of the area. rectum. to prevent or treat an infection. throat. and aerosol sprays.
The nurse should cleanse the area by washing with soap and warm water. The nurse should check with the client and the medical record for any known allergies. is not used. Body oils may interfere with the adhesive properties of the patch. Open wounds require the nurse to use surgical asepsis. or tape. such as a sterile tongue depressor. Two to 4 hours after the application. A new sterile tongue depressor should be used whenever more medication is removed from the container.The medication can be transferred to the nurse if gloves are not worn or an applicator. The skin harbors microorganisms. this method prevents cross-contamination. smooth strokes in the direction of the hair follicles to prevent the medication from entering the hair follicles. When the skin is dry. The medication is transferred from the tongue blade to a gloved hand for application. the nurse should assess the area for signs of an allergic reaction Dr/ Magda Bayoumi Page 34 Medication Adminstration 28/10/2012 . or an ointment. The medication should be applied in long. the nurse should use a sterile tongue depressor to remove the medication from the container. the nurse can apply the medication. When applying a paste. and lesions can cause encrustation. cream. unless contraindicated by a specific order. disk. The skin should be thoroughly dry before a topical medication is applied.
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