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BSCC Homework 1st block nursing

How to administer medications to different routes

Vaginal Medication Administration

A female staff member must be present in the room when a male nurse administers a
vaginal medication. The patient should be positioned on her back, with knees bent. Her
legs should be drawn up toward the hips, and the heels should be flat on the bed. A sheet
across the abdomen and upper legs, falling just over the knees, will decrease the patient's
feeling of exposure. Directions for filling the applicator should followed. At this point,
the patient should be advised to drop her knees apart. The nurse should wash his or her
hands and put on disposable gloves. Using one hand, the nurse should spread the labia
and expose the vaginal opening. If there is drainage or exudate, the nurse should cleanse
the area with warm, soapy water, using cotton balls or a clean washcloth. The vaginal
opening should be rinsed and allowed to air dry. A small amount of water-soluble
lubricant should then be placed on the tip of the applicator or suppository, the labia
spread, and the suppository or applicator tipped into the vaginal opening. The suppository
or applicator should be moved gently down, toward the posterior (i.e., back) wall of the
vagina, toward the spine 2–4 inches (5-10 cm), or until resistance is felt. The suppository
or applicator should then be angled upward. When using an applicator to deliver cream or
gel, the plunger should be gently pushed to deliver the medicine. The nurse should then
remove his or her finger and/or the applicator from the vagina. The disposable latex
gloves should be disposed of properly

Rectal Medication Administration

Administration of rectal medication should be done after the patient is positioned

correctly. Lifting the upper buttocks will enable visualization of his or her rectal opening.
External lotions, ointments or creams can be applied directly, using a gloved finger or a
4×4 gauze pad. Prior to administering internal rectal medicine, the tip of the suppository,
enema catheter, or applicator should be lubricated with a water-soluble lubricant. To
insert a rectal suppository, the lubricated, tapered end of the suppository should be placed
at the rectal opening and gently pushed into the rectum. The suppository should be
pushed continually toward the umbilicus until the full length of the nurse's gloved index
finger has been inserted into the rectal opening (i.e., about 3 inches, or7.5 cm, for an adult
patient). When inserting suppositories into children, the suppository should be pushed
about 1 inch (2.5 cm) beyond the rectal opening, or up to the first knuckle of the nurses's
index finger. When inserting suppositories into infants, the little finger should be inserted
one-half inch (1.25 cm) beyond the rectal opening. The buttocks should be released and
the finger removed.

Topical Medication Administration

To apply topical medicine, the health care provider places a small amount on gloved
finger tips or a sterile gauze pad and spreads a thin layer of lotion, cream, or ointment
across the affected area. Cover the affected area and overlap slightly onto the unaffected
skin. A thin layer is usually sufficient. A thick coating may prevent air that is necessary
for healing from reaching the wound.

Sublingual and Buccal Medication Administration

To administer sublingual tablets, the clinician should have the patient open his or her
mouth and raise the tongue. The tablet should then be placed under the tongue.
Administration of buccal tablets is similar to that of sublingual tablets. First, the patient
should open his or her mouth. The tablet should be placed between the gum and the wall
of the cheek. With the mouth closed, the tablet should be held in this position for five to
10 minutes, or until it has dissolved. Lozenges are also placed in the mouth and held until
they dissolve. Administration of sublingual or buccal sprays also requires having the
patient open the mouth. The patient should be reminded not to breathe while the nurse is
spraying the medicine. If the spray is ordered sublingual, the spray should be held about
one inch (2.5 cm) away from the site, and directed toward the tongue. If the patient
cannot hold up his or her tongue voluntarily, the nurse tongue should be held by the nurse
with his or her non-dominant hand, using a 2x2 gauze pad to provide grip. If the spray is
ordered buccal, the tongue should be held out of the way, the cheek held outward, and the
spray directed into the gum area between the cheek and the teeth. Liquid suspensions
may be given in a medicine cup or squirted into the patient's mouth using a medicine
syringe with no needle. The patient should be directed to hold and swish the liquid in the
mouth for the amount of time designated by the physician's order. Some liquid
suspensions are then swallowed and some expectorated into a sink or basin. In all cases,
the physician's orders should be followed

Inhalant Medication Administration

Aerosol drug administration, also known as inhalation therapy, or in some cases,

nebulized drug therapy, is the method by which drugs are dispersed into the lungs or
bronchial airways in the form of tiny droplets—often bound to water, oxygen, or another
gaseous substance. Drugs are generally delivered by two means. The first is via a device
called a nebulizer. The nebulizer is a mechanical pump (of which there are many types)
that produces a fine mist in which the drug is dispersed via an appropriate nebulizer-
compatible face mask. This fine mist is inhaled deep into the lungs for maximum effect.
The second method of delivery is via a hand-held, nebulized aerosol device. These
devices, also known as "puffers," use the effects of a pressurized gas to create and
disperse the drug into a fine mist or spray, which is then inhaled.
Both methods of aerosol inhalation are very effective when used correctly. In cases of
extreme breathlessness or dyspnea (labored or difficult breathing), the mechanical pump
nebulizers are generally more effective, as they disperse the drug over a longer time
period; this, in turn, gives the recipient a longer time period, allowing the airways to open
more effectively.
In terms of medical treatment costs and medication costs, aerosol drug administration is
relatively inexpensive. Nebulized therapy via a mechanical pump is usually completed
within five to ten minutes. Delivery of drug via hand-held devices is completed within a
few seconds
NG & G tube Medication Administration

Always check placement of tube before administering anything in it. After placement is
verified, flush tubing with 30ml water and administer medication with syringe allowing
gravity to pull the medication down the tubing into the stomach. After medication is
given follow the medication with another flush of 30ml of water to clear the tubing and
ensure all medication is given. Clamp tubing, make sure pt is comfortable and recheck pt
10-20 after medication has been administered to check for any adverse effects.

Ear and Eye Medication Administration

To instill eardrops, have the patient lie on his or her side with the affected ear up.
Gently pull the lobe of the ear up and back to open the ear canal (down and back for
children under the age of three). Hold the medicine dropper just above the entrance to the
ear canal and squeeze out the correct number of drops. Release the ear and have the
patient remain still for five minutes to allow absorption of the eardrops. Repeat the
procedure on the other ear if ordered.

Sterilization is an important part of eyedrop instillation. Before eyedrops are

instilled, the ophthalmic assistant, technician, nurse, optometrist, or ophthalmologist
should wash his or her hands thoroughly. The ophthalmic staff member then should
gather all necessary supplies. For some eyedrops, the dispenser may want to warm the
drops to body temperature by holding the bottle in his or her hand for about two minutes.
Next, the dispenser should position the patient correctly. The patient should sit back in
the examination chair with their head slightly hyperextended. Once the patient is
correctly positioned, the dispenser should clean the eyelids from the inner canthus
outward with a sterile saline solution to remove any eye secretions or previously instilled
medications. The dispenser should wash their hands after these preparations are
Immediately before instillation, the dispenser should depress the patient's lower lid with
the finger of one hand and lightly pinch the patient's lower lid to make a pouch for the
medication. The upper lid should also be held open to prevent blinking during instillation.
The dispenser should tell the patient to look up. Using the other hand, the dispenser
should instill the drop into the everted lower lid. The drops should not be instilled on the
cornea. This precaution is necessary to avoid startling the patient, or causing unnecessary
After the appropriate amount of medication is instilled, the ophthalmic professional
should release the lid and remove any excess fluid. The patient should be told to gently
close their eyes so as to not release any medication. If another medication is to be
instilled, a delay of at least 30 seconds is required between instillations.