6 Rights of Medication Administration
- Right Patient
- Right Medication
- Right Dose
- Right Time
- Right Route
- Right Documentation
- Three Checks
- Check for Allergies
- Assess the Patient
- Education
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
- Subcutaneous Injections
- 3/8 or 5/8 inch
- Intramuscular (IM)
- 1-1.5 inches
Peak and Trough
- Peak
- Highest Concentration
- Trough
- Lowest Level of Therapeutic Range
- Obtain Before Next Dose
- Half-Life
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
Conversions: Pounds and Kilograms
- 2.2 lb (pounds)
- 1 kg (kilogram)
- Know Your Own Weight
Routes of Administration Part One
- Oral
- Sublingual
- Buccal
- Rectal
- Tubes
- Transdermal
- Drops/Spray
- Vaginal
- Inhalation
Routes of Administration Part Two (Parenteral)
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal
Parenteral Medications
- Fast-Acting
- Greatest Risk
- Common Injections Sites: Deltoid, Vastus Lateralis, Ventrogluteal, and Dorsogluteal Muscles
- Absorbed Fast
- Vaccines and Epinephrine
- 3 mL Limit
- Common Injections Sites: Abdomen, Arm, and Thigh
- Absorbed Slower
- Insulin and Hormones
- Small Volumes
- Common Injection Sites: Back of Forearm and Upper Back
- Longest to Absorb
- Tuberculosis and Allergy Testing
- Under 0.5 mL
Intramuscular Medication (IM) Administration
- Injury to Nerves, Bone, and Blood Vessels
- Deltoid
- Vastus Lateralis
- Ventrogluteal
- Selection of Needle Length
- Aseptic Technique for Drawing Up
- Z-Track
- 90 Degree Angle
- Max Amount (2-5 mL Adult, 1 mL Child)
- Techniques to Reduce Pain
Intradermal Medication Administration
- Tuberculin Screening
- Allergy Testing
- Dermis
- Inner Forearm or Upper Back
- 1mL Syringe (26 or 27 Gauge Needle)
- 5 to 15 Degrees
- Small Bleb
Transdermal Medication Administration
- Patch or Disc
- Directly on Skin of Arms, Chest, Upper Back
- Avoids First Pass Metabolism
- Sustained Administration of Medication
- Clean Skin After Removal
- Rotate Sites of Patches
- Apply to Dry Skin
- Avoid Shaved Skin
- Avoid Heat
- Nitro Effects Lost After 24 Hours
Ear Drops Medication Administration
- Earwax Buildup
- Ear Infections
- Child - Back and Downward
- Adult - Back and Upward
- Side-Lying with Ear Up
- Instill Medication
- Stay for 2-3 Minutes
- Room Temperature
- May Massage Tragus
- Perforated Eardrum
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
Eye Medication Administration
- Supine with Neck Hyperextended
- Wash Away Crusts
- Cotton Ball on Cheekbone
- Instill Drops into Conjunctival Sac
- Repeat if Missed or Patient Blinks
- 5 Minutes Before 2nd Medication
- Thin Stream Along Inner Edge
- Inner Canthus to Outer Canthus
Asthma Implementation and Education
- Oxygen
- Corticosteroids
- Ipratropium (Anticholinergic)
- Albuterol
- Inhaler/nebulizer
- Pulse Oximetry
- Pursed Lip Breathing
- Carry Inhaler
- Rinse Mouth after Inhaler
- Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Loop Diuretic Education
- Furosemide (Lasix)
- Heart Failure
- Pulmonary Edema
- Acute Renal Failure (ARF)
- Edema
- Notify the provider of weakness, dizziness, or muscle cramping
- Increase Potassium Intake
- Check BP Daily
- Daily Weights and Monitor IandOs