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Rectal Suppository Administration
Medical Equipments: Medication Administration Record (MAR) Prescribed Rectal suppository Water Soluble Lubricant (K-Y Jelly) Non-sterile Gloves Tissue Bedpan (as optional)
Nursing Procedures: Identify any allergies that patient has Gather necessary equipments Determine the written order on MAR Wash your hands Check the patient’s identification As patient if she or he wants to void Explain the procedure to the patient briefly Don non sterile gloves Place patient in the Sim’s left lateral position with the upper leg flexed Open the package of lubricant and remove the foil wrapper from the suppository Apply a small amount of lubricant to the smooth rounded end of the suppository Lubricate the gloved index finger Ask the patient to breathe through the mouth Insert the suppository into the rectal canal beyond the internal sphincter about 4 inches for an adult and 1 inch for a child Avoid inserting the suppository into feces Withdraw the finger and wipe the anal area with tissue Ask patient to remain in bed for 15 minutes and to resist urge to defecate Remove glove and wash hand Record the name of the drug, dosage, route, and time of administration on MAR Observe the effectiveness of medication Oral Medications: Pills - Can be swallowed directly or sublingual (leave these under the tongue until dissolved) - Open pack & drop into medicine cup Granule/ Powders - Pour into a cup up to correct dosage Liquids - Unit dose is a sealed container - Water based liquid - read meniscus down - Oil based liquid - read meniscus up
Parentral Meds: Syringes - Unit doses and self prepared - The numbers represent: 1. Volume 2. Gauge of needle (diameter of inside of needle) the higher the number the smaller the needle hole 3. Length of needle - Insulin syringes and needles - Tuberculin syringes and needles - The color of the packaging represents the gauge of the needle - All needles are interchangeable except for the insulin syringe - The tuberculin syringe is not lure-locked, needle pulls off- can measure in tenths and hundredths- pediatrics
- 2 types of insulin syringes - a. 100 U = 1cc - each line = 2 Units b. 50 U - each line = 1 Unit - Unit dose syringe comes prefilled by the company - usually use entire contents - discard what will not be used. - Tubex syringe - cartridge with holder - prefilled - discard into sharps container.
Administering a Metered Dose Inhaler (self administration)
Equipments: Medication Administration Record (MAR) Inhaler Non-sterile Gloves Wash basin or sink to rinse mouth Tissue (optional)
Nursing Actions: Check any allergies that patient has or any medical condition that is contraindicated with the use of thd drug Obtain all equipments Check the written order on MAR Wash hands Follow the five right of medication administration Check the patient identification Allow the patient o hold and manipulate the canister and explain how the canister fits into the inhaler. Have the patient demonstrate the insertion of the canister Discuss the metered-dose concept and frequency of dose to the patient Explain that the inhaler should be shaken before each use Remove the mouthpiece and cap from the bottle and insert the stem into the small hole on the flattened portion of the mouthpiece. The patient should grasp the inhaler with thumb and first two fingers Instruct the patient to exhale, place the mouthpiece into the mouth and tighten the lips (seal) around the mouthpieces Ask the patient to firmly push the cylinder down against the mouthpiece only once, while slowly inhaling until the lungs feel full Instruct the patient to remove the mouthpiece while holding the breath for about 10 seconds then exhale slowly through pursed lips Repeat the doses as prescribed and waiting 1 minute between puffs A mouthwash can be use by the patient to remove the taste of the medication Demonstrate to the patient how to wash the mouthpiece under tepid running water to remove secretions If two or more inhaler medication are prescribed, wait 5-10 minutes between inhalations or as specifically ordered by physician Record all the drug’s name, dose, date, and time for medication on MAR Observe for effectiveness of medication and relief of the patient’s symptoms
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