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oral and topical med
ati skills module
| Question | Answer |
|---|---|
| when should another med route be used on a client? | if the client is nauseated, vomiting, has decreased intestinal motility, npo , cant swallow or has a nasogastric tube in place |
| before administering oral meds .. | assess the client for any swallowing problems and place client in a sitting or side lying position to reduce the risk of aspirating or choking |
| if a client is unable to swallow pills .. | you might have to crush the med and mix it with food or a beverage before administering it |
| when mixing the med, use.. | the smallest amount of food or fluid possible bc it can alter the taste of food |
| what meds can not be cut? | sublingual, enteric-coated and time release preparations |
| sublingual meds are given.. | under the tongue |
| buccal meds are .. | placed towards the back of the mouth between the upper and lower molars and the cheek |
| sublingual and buccal routes both allow.. | for absorption thru the mucous membranes of the mouth and yield rapid systematic effects |
| it is important to alternate from left sides of the mouth when it comes to administering thru what | sublingual and buccal routes |
| sublingual and buccal medications cannot be chewed or swallowed but instead.. | should dissolve completely in the client's mouth to ensure reaching therapeutic blood levels |
| when administering liquid meds.. | hold the med bottle with the label towards the palm of your hand and the med cap on a solid surface at eye level |
| to ensure accuracy when administering liquid meds.. | measure the med at the base of the meniscus not at the edges. |
| when administering liquid meds to pediatric clients.. | liquid is often easier, if there is a bad taste.. you can mix with a small amount of food |
| when administering a small amount of medication ( less than a teaspoon) | use an oral dosing syringe to measure the med accurately |
| pediatric clients often take meds more willingly when .. | its their parent not the nurse |
| older adult clients are at a higher risk of what | med toxicity |
| clients who have a nasogastric ( NG ) tube or other enteral tube in place are given meds.. | thru that tube |
| if a med is not available in liquid form.. | you must first crush it or open the capsule and empty the ooweer then dissolve the med in warm water |
| if meds are in a gel capsule.. | the capsule must first be pierced then the contents dissolve in warm water |
| before administering meds thru a NG tube, the client should be placed in a | fowlers position for at least 30 degrees) |
| before administering meds thru a NG tube, the nurse does what | ensures clients position, verification of tube placement , check gastric residual |
| after administering meds to a client who is receiving continuous feeding, what position should the client be in? | head of bed elevated for a least 1 hr |
| to keep a NG tube from being occluded, flush it with | at least 15 to 30 mL 5 to 10 mL for pediatric |
| what is the first step if an NG tube or enteral tube becomes occluded | to try to irrigate it gently with the appropriate flush solution. if flush isn't effective obtain a prescription for pancrelipases |
| inhaled medications are for clients who.. | have a chronic respiratory disease ( asthma, copd) |
| what are the most common ways to adminster inhaled meds | metered dose inhalers and small volume nebulizers |
| metered dose inhalers disperse meds into | the lungs thru mist, aerosol spray or a fine powder * either with mouth closed or hold the inhaler 2 to 4 cm ( 1 to 2 in) in front of mouth |
| small volume nebulizers deliver.. | aerosolized meds for a short period of time |
| with using the metered dose inhalers and small volume nebulizers , it is important to | depress the inhaler as the client inhales to ensure the med reached the lower airways and not the back of the throat |
| clients who are receiving corticosteroids and using metered dose inhalers or small volume nebulizers should.. | rinse their mouth with warm water after each treatment * this reduces the risk for developing thrush, oral candidas ( yeast infection( |
| nasal sprays are often used to | relieve nasal congestion and moisten the mucous membranes of the nose |
| nasal drops or sprays help relieve | sinus congestion and common upper respiratory symptoms |
| before administering nasal medications , make sure the client.. | blows their nose gently to clear mucus and secretions and allow for distribution of the medication into the nasal passages |
| to make sure nasal drops reach the affected sinus, place the client in a .. | supine position with their head positioned properly |
| nasal drops for the posterior pharynx.. | tilt the head backwards |
| nasal drops for the ethmoid or sphenoid sinus.. | tilt the head backwards over the edge of the bed or over a small pillow |
| nasal drops for the frontal and maxillary sinuses .. | tilt the head over the edge of the bed or pillow with the head turned to the affected side |
| when administering nasal drops, keep the dropper.. | away from the nares to avoid contaminating the dropper and the medication |
| prolonged use of nasal sprays can increase.. | mucosal swelling and nasal congestion can worsen ( rebound effect) |
| ophthalmic meds are often prescribed following? | cataract removal and to treat eye conditions such as glaucoma and infections can be used to soothe irritated tissue, dilate or contrict pupils and provide anesthesia |
| when instilling eye meds, do not instill the meds directly onto.. | the cornea bc it contains many sensitive nerve fibers and is easily irritated |
| place eye drops in the .. | conjunctival sac bc this area is less sensitive |
| before instilling an ophthalmic meds.. | gently wipe any drainage or discharge along the eyelid margin or inner canthus ( inner to outter ) |
| if there is drainage or discharge left when instilling an ophthalmic med, it can | harbor microorganisms, increase the risk of infection and interfere with proper absorption of the med |
| to expose the conjunctival sac and avoid injuring the eye .. | use a cotton ball or tissue and place you thumb or index finger against the clients cheekbone just below the lower eyelid and then pull the eyelid gently downward |
| if the med has a potential to produce systemic effects.. | apply gentle pressure to the nasolacrimal duct for 30-60 secs. |
| to instill ophthalmic med in a pediatric client .. | ask the parent to hold the child on their lap and gently restrain the childs head |
| meds instilled into the ear are called | otic meds |
| otic meds do what.. | soften wax, relieve pain and treat infection |
| before instilling otic meds gently.. | remove any cerumen or drainage blocking the outermost portion of the ear canal with a cotton tipped applicator |
| otic meds should be at room temp, why? | to prevent dizziness and nausea |
| lotions, ointments and creams usually produce a .. | local effect |
| transdermal meds usually are in form of a patch produce | a systemic effect |
| when applying a topical med, cleanse the area | with soap and water to remove previously applied medication and any debris and wear gloves * if the client has a wound present, surgical asepsis should be used |
| applying new med over previously applied med can | increase the risk of infection and reduce the therapeutic effect of med |
| nitroglycerin ointment is prescribed .. | by applying a particular length |
| nitroglycerin ointment measuring strip should be on the skin | to allow it to absorb gradually |
| the patch should always be labeled with | time, date and initials |
| rectal meds are usually administered for | either their local effect on the gastrointestinal muscosa to promote defecation or systemic effects for relieving nausea, providing analgesia pr reducing fever |
| rectal meds SHOULD NOT be used on clients who | had rectal surgery or have active rectal bleeding |
| a rectal suppository is | inserted into the rectum and melts as a result of the clients body temp and is distributed to the rectal tissue |
| to instill a rectal suppository.. | place the med past the internal and sphincter and against the rectal mucosa avoiding insertion to the feces |
| when instilling a rectal suppository, have the client remain in | left lateral or left sims position for approximately 5. mins after to ensure absorption of the med |
| when inserting rectal meds .. | lubricate the rounded end of the suppository with a water soluble lubricant BEFORE insertion and instruct client to breath thru the mouth |
| pediatric clients are often given rectal meds to | reduce fever , relieve nausea and vomiting, provide analgesia or relieve constipation * you may need to hold the childs buttocks together for 5-10 minutes after |
| why may older clients have difficulty keeping the suppository in place? | due to the loss of sphincter control |
| vaginal meds treat | vaginal infections, relieve discomfort and alter the vaginas pH to maintain normal flora * should be refrigerated to keep from melting |
| after instillation of vaginal meds, clients may need to | wear a perineal pad to absorb any excess meds |
| what position should clients remain in after instilling vaginal meds? | supine position for 10 minutes after to ensure absorption of meds |
| documentation for enteral tube meds includes | method used to confirm placement of the ng tube amount of residual appearance and pH of gastric contents total amount of fluid used for administering the med response to the med at the times that correlate w onset, peak and duration of the med |
| documentation for meter dose inhaler includes | lung sounds before and after the med is administered respiratory rate and rhythm before and after the med is administered color and consistency of sputum teaching done for proper used of the device |
| documentation for nasal meds includes | appearance of the inside and outside of the nose any drainage ( amount, color and odor ) response to the med at times that correlate w the onset, peak and duration of med |
| documentation for ophthalmic meds includes | appearance of the eye ( redness , swelling ) any drainage ( amount, color and odor ) if instilled in one eye only and which one changes in vision response to the med at times that correlate w the onset, peak and duration of med |
| documentation for oral, sublingual and buccal meds includes | appearance of sublingual or buccal area any problems the client has w swallowing if the med was crushed, mixed w a liquid or food response to the med at times that correlate w the onset, peak and duration of med |
| documentation for otic meds includes | any drainage ( amount, color and odor ) if instilled in one ear only and which one changes in hearing response to the med at times that correlate w the onset, peak and duration of med |
| documentation for transdermal meds includes | appearance of the skin before applying topical med site of application of the med time the med is to be removed and if it is to be removed if removed, the appearance of the skin after removal |
| documentation for rectal meds includes | appearance of the anus ( redness, swelling , hemorrhoids) any pain, bleeding or discharge teaching done for self administration of the med response to the med at times that correlate w the onset, peak and duration of med |
| documentation for small volume nebulizer includes | lung sounds before and after treatment respiratory rate and rhythm before and after treatment color and consistency of sputum |
| documentation for vaginal meds includes | appearance of the genitalia and vagina canal any drainage ( amount, color and odor ) teaching done for self administration of the med response to the med at times that correlate w the onset, peak and duration of medv |
Created by:
saharmahmoud
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