Transcript Administration of Liquid-Form Oral Medications

Chapter 9
Enteral Administration
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 9
Lesson 9.1
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2
Objectives
• Correctly define and identify oral dose forms
of medications
• Identify common delivery systems used to
administer oral medications
• Describe general principles of administering
solid forms of medications and the different
techniques used with a medication card,
computer-controlled, and unit dose
distribution systems
• Compare techniques used to administer liquid
forms of oral medication using the medication
card and unit dose systems of distribution
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 3
Administration of Oral Medications
• Capsules – small, cylindrical gelatin containers
used to administer unpleasant-tasting
medications
 Timed-release capsules – provide gradual and
continuous release of a drug
• Lozenges, troches – flat disks in a flavored base
• Tablets – powdered drugs that have been
compressed
• Orally-disintegrating tablets – rapidly dissolve on
tongue within seconds
• Elixirs – drugs dissolved in water and alcohol
• Liquid suspensions, syrups
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 4
Administration of Oral Medications
(cont’d)
• Common methods used to administer oral
medications
Unit dose packaging – provides a single dose
Soufflé cups
Medicine cups
Medicine droppers
Teaspoons
Oral syringes – plastic syringes calibrated and
used to measure liquid medications
 Nipples with additional holes – used for infants
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Slide 5
Administration of Solid-Form
Oral Medications
• Two techniques for administering medications
 Medication card
 Unit dose distribution
• Perform premedication assessment in all cases
• All techniques follow the six rights
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RIGHT patient
RIGHT drug
RIGHT route
RIGHT dose
RIGHT time
RIGHT documentation
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 6
Administration of Solid-Form
Oral Medications (cont’d)
• General principles apply to all distribution
systems
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Give the most important medications first
Do not touch the medication with your hands
Encourage liquid intake to ensure swallowing
Remain with patient while medication is taken;
DO NOT leave the medication at bedside
unless an order to do so exists
 Discard the medication container
• Provide complete documentation of
administration and responses to therapy
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 7
Administration of Solid-Form
Oral Medications (cont’d)
• Chart date, time, drug name, dosage, and route
of administration
• Regularly record patient assessments to evaluate
therapeutic effectiveness
• Chart and report any sign of adverse effects
• Perform and validate essential education
about drug therapy and other aspects of
intervention for the individual
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 8
Administration of Liquid-Form
Oral Medications
• General procedures are the same as with
solid-form oral medications
• Perform premedication assessment in all
cases
• Liquid medications are most commonly given
to infants using a syringe or dropper
• Place the syringe between the cheek and
gums, halfway back into the mouth, and
slowly inject medication to allow the infant to
swallow
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 9
Administration of Liquid-Form
Oral Medications (cont’d)
• General principles for infants, children, and
adults
 Give adults and children the most important
medications first
 NEVER dilute medications without specific
orders. DO NOT leave a medication at the
bedside without an order to do so
 Check an infant’s ID and be certain the infant
is alert
• Provide complete documentation of
administration and responses to therapy
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 10
Administration of Liquid-Form
Oral Medications (cont’d)
• Measuring techniques vary according to
receptacle used
• Measuring cup
 Cover label to prevent smearing; place
fingernail at exact level on measuring cup;
read the volume at the level of meniscus
• Oral syringe
 Select syringe of appropriate size. Draw up
prescribed volume of medication from bottle or
medicine cup
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 11
Chapter 9
Lesson 9.2
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Slide 12
Objectives
• Cite the equipment needed, techniques used,
and precautions necessary when
administering medications via a nasogastric
tube
• Meet the person’s basic metabolic
requirements and provide adequate
nutritional intake through the use of enteral
nutrition support
• Cite the equipment needed and technique
required to administer rectal suppositories
• Cite the equipment needed and technique
used to administer a disposable enema
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 13
Administration of Medications
by Nasogastric Tube
• Drugs are administered via nasogastric tube
for specific patients, using a liquid form
whenever possible.
• Remember:
 Always flush the tube before and after
administration with 30 mL of water
 Perform premedication assessment
 Assemble equipment before administration
 Flush between each medication with
5 to 10 mL of water
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 14
Administration of Medications
by Nasogastric Tube (cont’d)
• Prepare doses as for administration of
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solid- or liquid-form oral medications
Check nasogastric tube placement
Follow procedure for administering
medication
DO NOT attach suction for 30+ minutes
Provide complete documentation of
administration and responses to therapy
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 15
Administration of Enteral Feedings via
Gastrostomy of Jejunostomy Tube
• Enteral formulas are designed to provide
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basic metabolic requirements and adequate
nutritional intake
Prescribed enteral formula should be
checked
Formula should be fully labeled
Discard unused formula every 24 hours
Follow the guidelines specific for patients
receiving general nutrition via intermittent or
continuous feedings
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 16
Administration of Enteral Feedings via
Gastrostomy or Jejunostomy Tube (cont’d)
• Verify tube placement and initiate feeding
• Flush with 30 mL water, then clamp tube
• Proceed with tube feeding technique
 Intermittent: use Toomey syringe
 Continuous: use disposable feeding container
and enough formula for a 4-hour period
• Check gastric residual volume before next
feeding; listen for bowel sounds
• Provide complete documentation of
administration and responses to therapy
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 17
Administration of Rectal
Suppositories
• Suppositories are solid medication designed
to dissolve inside a body orifice
• Equipment is simple
 Finger cot or disposable glove
 Water-soluble lubricant
 Prescribed suppository
• Perform standard premedication assessment
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 18
Administration of a Disposable
Enema
• The dose form will be a prepackaged,
disposable-type enema solution
• Technique begins with the six rights
 Explain procedure and check pertinent
parameters
• Time of last defecation
 Position patient on left side
 Apply lubricant to rectal tube
 Insert lubricated tube and insert solution.
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 19