Flashcards in ATI Med Admin Content Deck (28):
Ophthalmic medications include:
Opthalmic medications used:
-following cataract removal
-to treat such eye conditions as glaucoma and infections
-used to soothe irritated tissue, to dilate or constrict the pupils, and to provide anesthesia.
When instilling ophthalmic medications what should you avoid?
Touching the tip of the medication bottle or tube to the eye to avoid the transfer of micro-organisms to the medication and injury to the eye.
What keeps the medication from entering the nasal and pharyngeal passages and being absorbed by the systemic circulation?
Applying gentle pressure to the nasolacrimal duct for 30 to 60 seconds.
When should the oral route for medication NOT be used?
-If a patient is nauseated, is vomiting, has decreased intestinal motility,
-is NPO (receiving nothing by mouth),
-has a nasogastric tube in place
How do you measure liquid medication?
Hold the medication bottle with the label toward the palm of the hand and the medicine cup at eye level, pour the prescribed dose into the cup.
Topical medications include:
Why do you cleanse the area first by gently washing it with soap and water to remove previously applied medication and any debris?
Because dead tissue and encrustations can harbor microorganisms and keep the medication from absorbing, simply applying new medication over previously applied medication can increase the risk of infection and reduce the therapeutic effect of the drug.
Medical vs Surgical asepsis when applying topical medications:
-If the patient’s skin is intact, clean technique (medical asepsis) is acceptable.
-If the patient’s skin is not intact, you must use sterile technique (surgical asepsis).
Older adults and topical medications:
-The skin becomes thinner with age, so older patients tend to absorb topical medication more rapidly than younger patients do.
Purpose of vaginal medications:
-treat vaginal infections
-alter the vagina’s pH to maintain normal flora
Purpose of otic medications:
To prevent dizziness and nausea when instilling otic medications:
-warm otic medications to room temperature before placing them in a patient’s ear.
To instill otic medications in the ears of children younger than 3 years:
-gently pull the pinna down and back
Rectal medications are usually administered:
-for their local effect on the gastrointestinal mucosa to promote defecation
-for their systemic effects for relieving nausea, providing analgesia, or reducing fever
Patients who are receiving steroids through a MDI or small-volume nebulizer should:
-rinse their mouth and gargle with warm water after each treatment.
-This reduces the risk of developing thrush, a yeast infection of the mouth that is also called oral candidiasis.
Determining that you have the right drug involves:
-checking the medication label against the medication administration record (MAR) at least three times before you administer the drug.
Before administering medications through an NG tube:
place the patient in high Fowler’s position and verify the placement of the tube in the stomach or, for a nasoenteric tube, in the small intestines.
How do you check gastric residual before administering medications through an NG tube?
Connect a syringe, usually a 60-mL syringe, to the end of the nasogastric tube, then pull back evenly and gently on the syringe to aspirate contents. If the aspirate is less than the amount of fluid or enteral formula given via the tube in the past 2 hours, return it to the stomach and administer the medications. If the aspirate is more than what has been given enterally in the past 2 hours, return it to the stomach, withhold medications, and notify the patient’s physician.
To keep an NG tube from becoming occluded:
-Flush it with at least 10 to 30 mL of a facility-approved fluid before and after administering each medication and 30 to 60 mL after you have given all the patient’s medications.
-Flush it before and after checking the residual volume and every 4 to 6 hours around the clock.
The oral route, including the buccal and sublingual routes, is inappropriate when:
a patient has a condition that alters gastrointestinal function, such as nausea and vomiting, reduced motility (after general anesthesia, for example), bowel inflammation, or surgical resection of portions of the gastrointestional tract.
Before giving oral medications, determine:
-the patient’s ability to swallow
-the presence of a gag reflex
-the ability to cough
Why can’t I crush enteric-coated or sustained-released medications before giving them to a patient who can’t swallow pills?
-Crushing an enteric-coated medication releases irritating components of the medication that subsequently come into contact with the oral or gastric mucosa, causing mucositis or gastric irritation.
-Sustained-release medications, if crushed, release all of the medication to be absorbed at once, resulting in higher-than-expected initial levels of the medication and a shorter-than-anticipated duration of action.
What is the difference between the sublingual and the buccal routes of administration?
-The sublingual route is specific for medications designed to be absorbed readily after placement under the patient’s tongue. The patient must not chew or swallow a sublingual medication or drink anything until it is completely dissolved; otherwise, the medication will not have the desired effect. If the patient’s mouth is dry, wet the mucous membranes under the tongue with approximately 1 mL of normal saline solution or water to promote absorption.
-The buccal route involves placing a solid medication inside the mouth against the mucous membrane of the cheek until the medication is dissolved. Just like the sublingual route, patients must not chew or swallow it or drink any liquids with it. A local effect is achieved via the buccal route but can be used to achieve a systemic effect when the dissolved medication is swallowed in the patient’s saliva. If subsequent doses are to be administered, the patient should alternate cheeks to avoid mucosal irritation.
What medications can I give through a nasogastric tube?
-Administer liquid forms of medications, such as suspensions, elixirs, or solutions, via the nasogastric route whenever possible to prevent tube obstruction.
-Dissolve powders and tablets that are approved to be crushed in 15 to 30 mL of a facility-approved fluid and administer them separately, flushing with 1 to 30 mL of fluid between each medication.
-Break apart capsules containing powder and dissolve the powdered medication according to manufacturer’s instructions.
-Medications that cannot be crushed include buccal, sublingual, sustained-released medications, and enteric-coated medications.
-Whole medications or medications that are not completely dissolved before administration increase the risk of tube obstruction.
-Medications that tend to solidify, such as hydrophilic (water-attracting) gels (psyllium-based bulk laxatives, for example) increase the risk of clogging the tube.
How should I position a patient after instilling vaginal medication?
Instill vaginal medication with the patient in the dorsal recumbent position. This position provides easy access and good exposure of the vaginal canal, thus allowing for the vaginal medication to dissolve (if a suppository) and spread (cream, jelly, or foam) along the vaginal walls. Instruct the patient to maintain this position, if possible, for at least 10 minutes to keep the medication inside the vaginal canal and allow optimal distribution and absorption.
When is it unsafe to give patients rectal suppositories?
Rectal suppositories are contraindicated for patients who have had rectal surgery or have active rectal bleeding.