MEDICINE

ADMINISTRATION
HAIDY ROCIO OVIEDO CORDOBA

MG. OF NURSING

DOCTOR IN NURSING SCIENCES

JUNIOR RESEARCHER
 CONSIDERATIONS WHEN MANAGING
MEDICINES
• Without a doctor's order, medication is not allowed
to be administered.
• Check that the “five rules” (patient name, drug
name, dose, route and time) agree with the
prescription given by the doctor.
• Basic asepsis measures must be observed.
• The medication should be administered
immediately after it has been prepared, and it
should be done by the same person.
• Make sure the user receives the medication
• Inform the user of what is going to be done.
• Perform the steps of the nursing care process at all
times: assess data that may influence medication
administration, detect problems and present them in
the form of nursing diagnoses, determine objectives,
and execute and evaluate medication administration.
• Nursing staff must know the action of the drug, its
correct forms of administration and safety doses, and
must control its effectiveness, its side effects and
adverse responses to the drug.
 Drugs administered enterally
ENTERAL VIA travel through the
gastrointestinal tract until they reach the bloodstream and/or are
eliminated.

Rating (V). Assess contraindications, history, knowledge of the patient, correct

• Objectives (O). They will be considered
placement of the nasogastric tube (if present), possibility of self-medication, according to the diagnoses presented by
patient's condition, family predisposition, etc. the patient.

Diagnosis (D). The most common ones that can be considered are: • Execution (E). Common guideline in
Impaired swallowing, medication preparation and administration:
wash your hands, check the correct ten;
Ineffective health maintenance,
check if it should be taken before, during or
Failure to comply with treatment,
after meals, calculate the dose and inform
Self-care deficit (diet and nutritional imbalance) the patient.
Impaired physical mobility, acute pain and chronic pain.
 ORAL WAY: PREPARATION AND ADMINISTRATION OF
MEDICINE
Deposit the medication container, previously Place the container marked level).
in its container without washed. in the hands of If your state allows it.
touch it (if it is liquid, the It must be up to par patient Instruct him to drink a
of the eyes; fill up to little water,

Divide the medication, if dilute place the medication

The patient will swallow
is allowed, for the at the rear
the
get the prescribed dose of the language and
medicine without
or crush it so you can drink a little again
tilt head towards
be taken by him of water.
back.
patient. medication in 10-
In case of probe 15 ml of water, only in the
nasogastric, crush and Pharmaceutical forms
allowed.
 ORAL WAY: PREPARATION AND ADMINISTRATION OF
MEDICINE. IF THE PATIENT CANNOT ON HIMSELF
Administer medication Stay with him 15 ml of water, only in the
with syringe. Avoid patient until he takes the Pharmaceutical forms with
introduce the medication medication. allowed.
20-30 ml of water before and
with pressure or towards In case of probe
after administering the
oropharynx. nasogastric, crush and
The probe should be washed medication.
dilute the medication in 10-

You must split the

medication, if available
During the evaluation
allowed, to obtain the
should be valued
prescribed dose or crush it
patient response to
so that it can be
the 15-30 min of the
taken by the patient.
shot.
 SUBLINGUAL ROUTE:
PREPARATION AND
MEDICATION
ADMINISTRATION
• In the sublingual form, the medication is placed
under the tongue (if the patient is not
incapacitated or unconscious) and its absorption
is facilitated by removing the medication
frequently.

• During the evaluation process, the user's

response 10 minutes after taking the shot must
be evaluated.
RECTAL VIA: PREPARATION AND ADMINISTRATION
OF THE MEDICINE

Suppository: keep it in
refrigerator or under a stream of
cold water before removing it from the
wrapping, to give
consistency.

Ointments or enemas: coat

with water-soluble lubricant
applicator.
RECTAL VIA: PREPARATION AND ADMINISTRATION
OF THE MEDICINE

During the evaluation they must

evaluate the results between
the next 5 and 30 minutes,
depending on the medication.
PARENTERAL VIA: PREPARATION AND
MEDICATION ADMINISTRATION

* EDid€

nH and
ne sc
It is one in which it is necessary to cross the skin to administer the
medication and thus pass it into the bloodstream directly or through the
Rating (V). Rate the
different tissues where it is administered.

MEDICATION ADMINISTRATION
Breakable blister .
Break line below the colored
point.
PARENTERAL WAY: PREPARATION AND
Check the 5 rules
Handwashing,
and calculate dosage
put on gloves
prescribed
Blister: hit
Place your thumb over the colored dot and
break the blister by pressing back. Load medication smoothly and quickly
with a needle other than top for
the one that is going to that all the liquid
be used accumulate in the part
to inject lower
Take the vial
insert the syringe
Secure the
with loading needle
blister neck,
to the bottom of the
break it firmly
ampoule and aspirate
the
plunger with direction
 PARENTERAL VIA: PREPARATION AND
MEDICATION ADMINISTRATION

Pull the plunger towards

Vial: clean seal
rubber with antiseptic.
will do when preparing
Insert the charging aspirate.
needle Invert the vial and aspirate,
on rubber stamp gently, the
vial and inject the medication (pressure
air positive injected into the
vial will push the liquid
outside so many
centimeters
cubic as medication
want to load (not
cytostatics).
towards the syringe).
The needle bevel should
remain, in everything
moment, below the level
of the liquid.
 PARENTERAL WAY: PREPARATION AND
MEDICATION ADMINISTRATION

Wash your hands and

Locate the area of
put on your gloves,
Throw away medication puncture and disinfect the
Avoid breathing in air Make sure you don't check ten
that has been loaded rules and report to
skin with a
the containers. bubbles remain. spiral movement.
into patient.
excess.
Discard the material Do not rub or use
Do not vigorously shake the
used in a disinfectants
medication to reconstitute it
special container and colored
once the mixture is done, just
change needle according
rub the vial between your hands
the area where you go
or
to practice the injection
heat it with warm water.
 INTRADERMAL WAY: PREPARATION AND
ADMINISTRATION
The medication should be a Load the medication g” into
a syringe
administered into the
millimeter of 1 cc or ml.
thickness of the skin.
Use a 16 mm long/25 G
gauge (0.5 mm)
intradermal needle.
It is usually used for
diagnostic purposes, to Puncture area: the most
perform immunological suitable are: the forearm,
on the inside
tests.
 INTRADERMAL WAY: PREPARATION AND
ADMINISTRATION
Stretch the skin, place the
syringe so that the needle
is parallel to the surface
cutaneous and with the bevel facing
above.
Inject slowly
encounters some resistance)
and a papule will appear
about 6mm
approximately, colored
lighter than skin.
Advance about 3 mm between
the
Insert the needle with a
epidermis and dermis, being
maximum angle of
visible bezel throughout
inclination between 15 and
moment.
20°.
During the evaluation you must
assess the reaction of
Remove the needle, apply a
patient and the injected area,
gauze, gently, without
marking the area
press or massage.
punctured with a circle
3 cm from the puncture point,
SUBCUTANEOUS ROUTE:
PREPARATION AND
ADMINISTRATION
1. Locate the puncture area. Make sure
that in the chosen area you can form a fold
of about 2.5 cm when pinching it.

SUBCUTANEOUS ROUTE:
PREPARATION AND
2. These areas are: theADMINISTRATION
external I lower abdomen (special for j heparins)
surface of the arms and thighs, the part and the upper portion of the back.

3. Place the needle at a 45° angle to 4. Check that there is no reflux of

the skin at the base of the pinch (90° if blood (never if heparin is to be
the puncture is in the abdomen), insert injected). If so, remove the needle and
the needle and release the pinch. start again.

5. If no blood reflux, slowly inject the

medication, including 0.1 ml air bubble, 6. Remove the needle and apply gentle
into the abdomen heparin administration. pressure to the area with gauze. Do not
rub or massage.
 INTRAMUSCULAR ROUTE: PREPARATION AND
ADMINISTRATION The medication must be administered into the muscle tissue.
Depending on the solution administered, it will be absorbed
within 10-30 min.
You have to take into account the area
a) Use a puncture, since according to the
chosen muscle will be tolerated Dorsogluteal area: the
needle from 25 to 40 up to 4-5 ml of medicine. quadrant injection
external superior of
mm/21-23G (0.7- the gluteus.
0.8mm).
The upper external zone is the
suitable for puncture, since
This way we avoid injuring the nerve
To locate it, draw a
b) Use a line that goes from the
sciatic. Holds up to 5 ml (only
in adults). The patient
greater trochanter to the iliac crest
2-5 ml syringe. superior postero.
will be placed in a prone position or
lateral, or standing.
 INTRAMUSCULAR ROUTE: PREPARATION AND
ADMINISTRATION The medication must be administered into the muscle tissue.
Depending on the solution administered, it will be absorbed
within 10-30 min.

Deltoid area: located

a) Use a at the top of the
needle from 25 to 40 arm, about three fingers
mm/21-23G (0.7- below the acromion.
Holds up to
0.8mm). 2 ml.
The patient will be
placed
sitting, standing or
b) Use a supine position.
2-5 ml syringe.
 INTRAMUSCULAR ROUTE: PREPARATION AND
ADMINISTRATION The medication must be administered into the muscle tissue.
Depending on the solution administered, it will be absorbed
within 10-30 min.

Vastus lateralis area and four fingers below

a) Use a rectus femoris: located in of the inguinal ligament and
needle from 25 to 40 the external lateral face four fingers
(vastus lateralis) or on the face above
mm/21-23G (0.7- anterior (rectus femoris) of the of the
0.8mm). thigh, kneecap, in the
third
half.
b) Use a
2-5 ml syringe.
Intramuscular injection in the vastus lateralis
located in the middle third of the thigh
The patient will
be placed in
supine position, with
leg slightly bent.
 INTRAMUSCULAR ROUTE: PREPARATION
AND ADMINISTRATION
Stretch the skin and, with a TECHNIQUE
fast and firm movement, change plane, and if not
CONVENTIONAL.
fully insert the needle reflux blood inject
syringe in direction slowly take the
perpendicular to the skin at 90°. medication.

Confirm the location of the

needle, gently aspirating.
If blood refluxes, it is due
Once administered
medication, remove the needle
with
one quick motion and apply
a light massage
(contraindicated if the drug
is irritating or absorbing
slow).
 INTRAMUSCULAR ROUTE: PREPARATION AND
ADMINISTRATION

Z-SHAPED TECHNIQUE.

With one hand, move With the other hand, proceed

laterally the skin on in the same way as with the
relation to the point of conventional technique.
insertion.

Once I finish
Loosen the skin and remove
inject the medicine,
the
wait 10 s before removing
needle. Do not massage,
the needle, keeping the
just
displacement.
 INTRAVENOUS WAY: PREPARATION AND
There are three ways to use it: direct or bolus,
ADMINISTRATION . continuous drip infusion and intermittent drip infusion.

Upper limbs: dorsal vein and vein

Regarding the puncture area,
cephalic, on the back of the hand; come to
you have to consider different
factors: duration of cephalic and inferior portion of the vein
treatment, solutionthat goes middle antebrachial, on the forearm; come
away to
to infuse, needle size, basilica, cephalic and median basilica and
type of vein, age of the patient cephalic, in the antecubital fossa, and vein
and state consciousness.
basilica, on the arm.
INTRAVENOUS WAY: PREPARATION AND
ADMINISTRATION There are three ways to use it: direct or bolus, continuous drip
infusion and intermittent drip infusion.

Once the area the

has been chosen zone in an
area of 5-7 cm
Put on sterile gloves.
diameter
Immobilize the dilated vein with the
around the
thumb, pulling the skin down.
point of
and placed
puncture.
the user, a
Guide the
tourniquet is
needle or
applied to
catheter
4-8 cm above the
direction of
area in which
blood flow,
that the puncture
with
is going to be
45° inclination
performed
on the skin and
(only on the
with the bevel
limbs) and cleans
facing up.
There are two puncture techniques:
pass through the skin over the vein
puncture and practice a puncture
0.3-0.5 cm from the chosen vein.
Instruct patient to breathe
deeply and perform the puncture

with slow and sure movement

INTRAVENOUS WAY: PREPARATION AND
There are three ways to use it: direct or bolus,
ADMINISTRATION . continuous drip infusion and intermittent drip infusion.

Reduce insertion the Observe for blood

angle subcutaneous reflux, if any.
until the needle is tissue and a thus, advance
almost greater until the catheter
parallel to the skin resistance when or the needle are
surface passing through it located in the
and direct it come to. inside the vein
towards the Puncture it gently and remove the
chosen vein. but tourniquet.
You will notice firmly.
some resistance in

If you are performing a and/or

venous catheterization, when continue
reflux of blood is observed, advancing
remove the chuck 0.5 cm the catheter
plastic until inserted Then completely remove the
totally in the vein. chuck and connect the system
infusion, previously purged.
 INTRAVENOUS WAY: PREPARATION AND
There are three ways to use it: direct or bolus,
ADMINISTRATION . continuous drip infusion and intermittent drip infusion.

With intermittent infusion Once injected intermittent is advisable

or continue, looking for medication, remove the maintain
the catheter to avoid needle intravenous
accidental exit. pressing the point of line
puncture for 5 min. permeable.

The second,
There are two possible
To do this, place the specific with heparin,
methods.
cap and wash the catheter. flush the
For the first, with serum
catheter with 1-2 ml
physiological, flush the
of physiological saline with
catheter
heparin, at a
with 1-2 ml of serum
concentration of 10-100
physiological;
IU/ml,
If the administration is
INTRAVENOUS WAY: PREPARATION
AND ADMINISTRATION

Process evaluation.

during Possible
administration of the complications:
Immediate
medication: swelling extravasation,
response from
abrupt, pain, phlebitis,
patient.
redness, coldness infection in the area,
and/or signs
Puncture area pallor. of circulatory
overload.
Monitoring and surveillance
specific when managing
certain medication,
Prescribed drip rate
(ml/h or drops/min).
 INTRASPINARY ROUTE:
PREPARATION AND
ADMINISTRATION
intraspinal
It consists of performing a lumbar puncture
(between L4 and L5) of the epidural space
or the subarachnoid space.

It is aseptic and correct positioning of the

patient is essential.

It is performed by the doctor and is used for

spinal anesthesia, administration of
antibiotics, corticosteroids, etc.
 OTHER PARENTERAL ROUTES

• Intra-arterial • Intra-articular route

route • It is used to • It is injected into the synovial cavity of a
administer radiological contrasts and/or joint.
regional antineoplastic chemotherapy.
• It is done by the doctor.
 Drugs administered via the respiratory route are
absorbed into the nasal mucosa, sinuses, pharyngeal mucosa
RESPIRATORY and
TRACT alveolar, depending on the purpose of the medication used.

Rating (V). mobility.

Contraindications,
history, knowledge,
understanding and ability
to correctly use
medications, and monitor
the status of the
respiratory tract.
Diagnostics (D). Risk of injury,
ineffective maintenance of health,
deterioration of the oral mucosa,
ineffective management of the
therapeutic regimen, disorder of
thought processes, disorder of
sensory perception (tactile and
visual) and impairment of physical
Objectives process (O). They guidelines
depend on the discussed in the
nursing diagnoses previously
presented by the described routes of
patient. administration will
be followed for the
preparation and
administration of
Execution (E). The the medication.
 RESPIRATORY ROUTE: INHALATION:
PREPARATION AND
ADMINISTRATION
The drug enters the pathway Prepare the inhaler,
Shake the bottle to
respiratory through the pressurized bottle,
homogenize the
mouth and dust device
medication, if necessary
the bronchi and dry and/or the device
necessary.
absorbs at the alveolar spacer.
level.

Although its action is

local, by passing part to Place the patient
bloodstream, incorporated or in
can produce effects semi-Fowler position
undesirable systemic
RESPIRATORY ROUTE: INHALATION:
PREPARATION AND
ADMINISTRATION
PRESSURIZED INHALER

Hold the inhaler, upside down, Introduce the mouthpiece of

with your thumb on the mouth the inhaler into your mouth,
end and your index finger on squeezing it with your teeth,
the top of the bottle. move your lips around it and
inhale slowly and deeply
through your mouth.
IGa PM?'
oral

press
finger a ADAM SISIMA COMPLIO

Warn the user to wait 2-5 min Instruct the patient to rinse
inhaling, holding
n inspiration
between inhalations. their mouth afterwards.
for 10 seconds,d then exhale

slowly through your lips

 RESPIRATORY ROUTE: PREPARATION INSTILLATION
AND ADMINISTRATION
Y Y
o o

The medication is administered through the mouth or nose 3--

in the form of drops or a nebulizer. Its effect occurs on the Partinson

Maxillary sinus
nasal mucosa or sinuses and a tiny part passes into the Frontal sinus

bloodstream.

ethmoid sinus
Sphenoid sinus

Pharynx: Fowler head

back
RESPIRATORY ROUTE: PREPARATION AND INSTILLATION
ADMINISTRATION

procedure Instruct the patient to breathe through the mouth.

Direct the dropper or sprayer towards the intended area, always in a vertical position
and directing the instillation towards the side walls of the cavity.

Avoid letting the dropper applicator come into contact with the nasal mucosa.

Ask the patient to remain in the same position, with head supported, for 5 min.

If the patient aspirates the medication, sit him up and instruct him to cough it out.
During the evaluation process, assess the response within 15-30 minutes and
the possibility of self-medication.
ENDOTRACHEAL VIA

In cardiopulmonary resuscitation, if an atropine, naloxone, lidocaine, etc.).

intravenous line is not available, some It consists of administering doses three
medications can be administered times higher than the intravenous dose
endotracheally when performing through the endotracheal tube, diluting it in
cardiopulmonary resuscitation (adrenaline, at least 10 ml of sterile water.

Several insufflations must be performed with the resuscitation bag to

distribute the drug and facilitate its absorption.
 TOPICAL ROUTE: PREPARATION AND ADMINISTRATION:
Topically administered drugs are those that
They act and are absorbed through the skin and mucous membranes (otic, ocular,
etc.), producing local and systemic effects.

Rating (V). Contraindications, knowledge,

history, condition of the skin and mucous Objectives (O). They depend
membranes and possibility of self-medication. of the diagnoses of
nursing that presents the
patient.

Diagnostics (D). Risk of Execution (E). will be followed

decay of skin integrity,
the guidelines discussed in
ineffective health maintenance,
acute pain, ineffective management of routes of administration
therapeutic regimen, impairment of previously described
physical mobility and mobility disorder to prepare and manage
sensory perception (tactile and visual). the medication.
S/form
VIATOPICS: PREPARATION AND ADMINISTRATION:
Creams, ointments and powders: applied to the palm of the hand
pharmacist (with gloves) the prescribed amount, rub both hands and apply to the area, in the direction of hair growth.
Skin: (Cutaneous Route): Locally applied medications, whether lotions,
ointments, pastes or patches, can cause reactions
systemic when absorbed through the skin

a) Discard the first b) Clean the area of the

Part of skin of the patient with
medicine. water and mild soap.
Pastes: applied directly to the skin, with a palette.

c) Apply the
medication with
moist skin, except
when applied Lotions: applied directly to the skin by tapping or with a brush.
powders and pastes.

Patches: they are applied to healthy skin, trying to clean the area
where they were placed and changing the application site to prevent
the skin from becoming irritated.
 VIATOPICS: PREPARATION AND ADMINISTRATION:
Skin: (Cutaneous Route): Locally applied medications, whether lotions,
ointments, pastes or patches, can cause reactions
systemic when absorbed through the skin

S/ Creams, ointments and powders: the prescribed amount is applied to

a) Discard the first b) Clean the area of the pharmaceutic the palm of the hand (with gloves), both hands are rubbed together
and applied to the area, in the direction of hair growth.
Part of skin of the patient with al form
medicine. water and mild soap.
Pastes: applied directly to the skin, with a palette.

c) Apply the
Evaluation: Monitor
medication with
the skin during and
moist skin, except
after application. Lotions: applied directly to the skin by tapping or with a brush.
when applied
powders and pastes.
Patches: they are applied to healthy skin, trying to clean the area where they were placed
and changing the application site to prevent the skin from becoming irritated.
 TOPICAL ROUTE: EYE MUCOSA: Ophthalmic medication acts at a local
level and rarely at a systemic level.

a) Place the user in d) After administration, e) If you want to avoid a

supine position or
sitting, with head
Warm the eye drops to
room temperature,
discard the first drop.
slightly tilted towards
back.
physiological (from the
b) Write down the date
the bottle was opened
and its expiration date.
tell him to close possible systemic effect,
gently the eyelids lightly press the
and pick up the tear duct during
medication instillation of drops.
excess with c) Instruct the patient
gauze. that
b) Clean eye look up. Pull
with serum gently from the eyelid
bottom and apply the
internal angle to medication in the bag
external). conjunctival.
Evaluate, assess pain or possible effects
eye burning and systemic.
 Otic medication acts at the ear level
TOPICAL ROUTE: external and middle.
OTICA
b) Pull the pinna back
Warm the and up. Instill the drops
Preparation
bottle to room into a lateral and
temperature posterior area of the
canal.
before
administering
it, to avoid d) If after instillation
the placement of plugs
dizziness. is indicated, the cotton
will be slightly
Explain to the moistened to prevent it
from absorbing the
patient or a)Place the user in a
sitting position, with the applied liquid.
family and head tilted or in a lateral
decubitus position,
discard the leaving the ear to be
first drop. treated in the upper
area. Clean the area.
Perform a light
massage on the ear,
over the tragus, and
instruct the patient to
remain in that position
for 2 to 5 minutes.
Assess the appearance of pain, burning, or itching in the ear canal and the possible
appearance of vertigo.
 GUIDE FOR SAFE ADMINISTRATION
REVIEW THE DRUG
CHECK THE INDICATION

Name of the drug, dose, route of

administration, frequency, time
of application, last administration
of the drug

Review patient data, especially

history of allergy or
hypersensitivity Observe existence in color changes,
precipitates or foreign bodies
 GUIDE FOR SAFE ADMINISTRATION
Verify patient identity RECORD

Check the identification band,

reiterate verbally, especially if there
are identical or similar names, verify
Be sure to record on the medication
administration sheet as soon as they
are applied.
Document any situation related to the
administration of the drug (inability of
the patient to ingest the drug, lack of
medication, absence of the patient)

Be sure to only give medications you

have prepared yourself.

Detect, report and record any adverse Dispose of used equipment properly and
Do not handle the tablets, check that events safely.
they are swallowed. NEVER leave
medications on the patient's
nightstand
GUIDE FOR SAFE ADMINISTRATION
ADVERSE REACTIONS

IF THERE IS A DOUBT,….NO
MANAGE!!!!!!!
INTERACTIONS
PHARMACOLOGICAL
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