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foundations exam 1
oral medications
| Question | Answer |
|---|---|
| solid forms | tablets, capsules, pills |
| liquid form | elixirs, spirits, suspensions, syrups |
| Oral route | having patient swallow drug |
| Enteral route | administering drug through an enteral tube - feeding tube, NG |
| Sublingual administration | placing drug under tongue |
| Buccal administration | placing drug between tongue and cheek |
| oral (po) is the | most common |
| oral onset | slower |
| oral meds are given with | fluid or food |
| oral meds are absorbed in | the GIT |
| things to assess on your pt before giving PO meds | LOC - enough to swallow do they have a gag reflex? any persistent n/v? NPO? |
| what if a pt is NPO and has oral meds? | there will be a specific order in the chart for their meds |
| what do you check after the med was given? | to make sure it was swallowed |
| was the drug really swallowed? | Some “pocket it” in their cheeks |
| can you leave a med at the bed side? | no, unless laxative this is a med error!!! |
| when giving oral meds, make sure | pt is sitting up right to prevent choking |
| pt preference on getting their meds | Some patients like to hand them one pill at a time or place them in their mouth. That is ok but just wear gloves. |
| tell the pt | what pills you are giving them and what it is for, open it in front of them |
| sublingual meds are placed | under the tongue |
| sublingual med examples | nitroglycerin, some peds meds |
| buccal meds are placed | in between back teeth and cheek-very vascular |
| buccal med examples | some opioids, seizure meds |
| buccal meds allow for | rapid absorption in the bloodstream by avoiding the GIT |
| what should you not give with buccal or sublingual meds | fluid, because you the meds to be absorbed |
| liquid meds are available in | in syringe, multi-dose vial with a dropper, single dose - liquid pain meds are in single servings |
| liquid meds should be | shaken before pouring dose (if applicable) |
| how to handle liquid drug container | Remove cap and place facing up Cover label to avoid destruction in case of a spill |
| preparation of liquid med | Place med cup at eye level before pouring |
| if you go over intended dose, | correct it, do not pour it back into the bottle- discard |
| before recapping med, | make sure the bottle is clean |
| when would you have to give enteral meds | Gastric Tube or Naso-gastric tube (GT or NGT) (Meds should say GT) Artificial Tube (NG Tube, Gastrostomy Tube, etc.) EnFit connectors |
| EnFit connectors are designed to | designed to provide secure and unique (different from intravenous) adaptors and connections specifically designed for enteral feeding systems |
| nasogastric tubes go into | stomach |
| nasoduodenal tubes go into | duodenum |
| nasojejunal tubes go into | jejunem |
| other GTs | levin tube salem sump tube |
| levin tube | a flexible rubber or plastic single lumen can add connector for feeding and medication administration tubes are inflexible and cause patient discomfort |
| salem sump tube | flexible, double lumen allows air to escape and suction to occur can add connector for feeding and medication administration most common, only tube nurses can put in NOT FOR LONG TERM |
| nasogastric (NG) tubes | single lumen, dobhoff |
| NG tubes are used for | medication administration and enteral feedings |
| Naso-Intestinal (Duo-Tube) Double Lumen are used for | medication administration and enteral feedings |
| Percutaneous Endoscopic Gastrostomy [PEG] | doesn't go through the mouth, just goes straight into the stomach used for long term |
| kangaroo pump | used for tube feeds, give it a program to administer H2O and feed |
| before giving any meds through a tube, | review correct placement prior to use!! |
| how can you check placement | check the length and the nose and make sure it matches the xray which you can use to make sure the tube is in the correct location |
| all crushed meds being given through the tube should be | given separately because you do not know how they are going to react in their different forms |
| what meds can't be crushed | ER, DR, EC |
| checking placement of NG tube | X-ray Marking at nose after confirmation |
| for pt receiving enteral meds/feed, they should be | elevated in Semi-Fowlers or Fowlers position for at least 30 minutes and have suction |
| pt is on fluid restriction, what can be done for tubes | flush with little water! |
| what do you have to make sure you document | fluid use to flush on I&O |
| topical application to the skin has | slow absorption because of the physical makeup of the skin |
| Medications placed on the mucous membranes and respiratory airways are | absorbed quickly because these tissues contain many blood vessels |
| Does topical go through first-pass effect? | no |
| Inhaled: Metered Dose Inhaler (MDI) - absorption | Rapid Absorption and relief for breathing difficulties. Also anesthesia |
| If multiple inhalers, what order should you give | give bronchodilator first. Want to give corticosteroids last and rinse out mouth after. This will prevent fungal infection |
| Nebulizers | liquid medicine placed in dispenser and inhaled through mask |
| administration of nasal drops | Gloves Tilt head back flat or supine Stay for 1-2 minutes Not sterile but maintain asepsis Clean tip off after use |
| administration of nasal sprays | Sitting up or with head tilted Spray during inhalation |
| Otic (ear drops) treat | ear infections and soften wax |
| ear drops should be | room temp |
| administration of ear drops | Side-lying, ear up, drops alongside the canal Gently massage the tragus to move medication if needed Stay on side about 5-10min |
| when to pull up ear vs pull down ear | pull back and up for adults pull back and down for children under 3 |
| transdermal (skin) are absorbed through | the skin |
| transdermal (skin) sites should be | rotated |
| where should you not place transdermal (skin) drugs | on abrasions, unless ordered that way |
| what do you have to do when using transdermal patch | write the date, time, and your initials on the patch |
| administering opthalamic (eye) drops | Gloves Tilt the head back Wipe eyes if any secretions Apply drops to conjunctival sac Apply pressure to naso-lacrimal duct |
| when giving eye drops, make sure you dont | touch dropper to eye |
| if eye drops are an ointment, | apply from inner canthus to outer canthus |
| after giving the eye med, | Apply pressure (or have patient) to the inner canthus for a minute to stop it from going into the tear duct. Wipe away any excess on the outside of the eye. Do not touch the tip of applicator/dropper to eye |
| if you have multiple eye meds, wait | 5 minutes in between each |
| rectal medications (PR) are | Suppositories-antipyretic (fever), laxative or stool softener |
| why are rectal meds given | because relief is needed quickly and the rectum is a vascular area |
| how to position your pt for a rectal med | Position your patient on left side with upper leg flexed (gravity helps here towards the colon) |
| what do you have to do to suppository before administering | Add lubricant to the rounded end of suppository |
| where do you insert the rectal med to | into the rectum at least 1 inch past the anal sphincter |
| vaginal meds types | Foams, creams, liquids, gels, suppositories used for infection or contraception |
| preparing for vaginal administration | wear gloves may have to perform peri-care first position in lithotomy position on pad in case of secretions |
| when is the best time to give vaginal medications | at bedtime to allow medicine to remain in place |
| if using vaginal medications, don't use | tampons |
Created by:
leh195