Chapter 10

Drug Administration

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 Drug Administration
 Self-administration in medication
 Institute for Safe Medication Practices
 Free booklet: “Your Medicine: Play It Safe”
 https://www.ismp.org/consumers/safemeds.pdf

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 Forms and Routes of
Drug Administration
 Forms and routes of administration
 Sublingual, buccal
 Oral
• Tablets, capsules; liquids, suspensions, elixirs
 Transdermal, topical
 Instillation
• Drops, sprays
 Inhalation
 Nasogastric and gastrostomy tubes
 Suppositories
 Parenteral

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 Forms and Routes of
Drug Administration (Cont.)
 Instillations
 Inhalations
 Eyedrops

Figure 10.3 To administer eyedrops, gently pull down the skin below the eye to
expose the conjunctival sac.

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 Forms and Routes of
Drug Administration (Cont.)
 Eye ointment

Figure 10.4 To administer eye ointment, squeeze a 1⁄4-inch-wide strip of ointment

onto the conjunctival sac.

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 Forms and Routes of
Drug Administration (Cont.)
 Eardrops

Figure 10.5 Administering eardrops:

(A) Children under 3 years of age: straighten the external ear canal by pulling down and
back.
(B) Adults and children over 3 years of age: pull auricle upward and outward.
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 Forms and Routes of
Drug Administration (Cont.)
 Nose drops and sprays

Figure 10.6 Administering nose drops.

Figure 10.7 Administering nasal spray.

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 Forms and Routes of
Drug Administration (Cont.)
 Nasogastric and gastrostomy tubes
 Always check for proper placement and gastric
residual before administering drugs
 Place the patient in high Fowler position or elevate
the head of the bed at least 30 degrees

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 Forms and Routes of
Drug Administration (Cont.)
 Suppositories
 Rectal

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 Forms and Routes of
Drug Administration (Cont.)
 Suppositories
 Vaginal

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 Parenteral Drug Administration
 Intradermal
 Action
 Sites
 Equipment

Figure 10.13 Needle-skin angle for intradermal,

subcutaneous, and intramuscular injections.

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Parenteral Drug Administration (Cont.)
 Subcutaneous
 Action
 Sites
 Equipment

Figure 10.14 Common sites for subcutaneous

injections.

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Parenteral Drug Administration (Cont.)
 Intramuscular
 Action, sites, equipment, techniques
 Ventrogluteal

Figure 10.15 Ventrogluteal injection site.

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Parenteral Drug Administration (Cont.)
 Intramuscular
 Deltoid

Figure 10.17 Deltoid injection site.

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Parenteral Drug Administration (Cont.)
 Intramuscular
 Vastus lateralis

Figure 10.18 Vastus lateralis injection site in children.

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Parenteral Drug Administration (Cont.)
 Intramuscular
 Z-track injection

Figure 10.19 (A) Pull the skin to one side and hold; insert needle. (B) Holding
skin to side, inject needle and medication. (C) Wait for 10 seconds, then
withdraw the needle and release the skin.

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 Intravenous Drug Administration
 Action
 Site
 Equipment
 Technique

Figure 10.20 Common sites for intravenous

administration.

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Developmental Needs of Pediatric
Patients
 Stranger anxiety
 Hospitalization, illness, or injury viewed as
punishment
 Fear of procedure

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 Technological Advances
 Examples
 Pain-free delivery of insulin through a transdermal
patch
 Insulin pumps that deliver insulin based upon
monitoring of glucose level
 Robotic mixing of antineoplastic drugs

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Nursing Process: Overview of Drug
Administration
 Assessment
 Nursing diagnoses
 Planning
 Nursing interventions
 Patient teaching
 Cultural considerations
 Evaluation

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 Practice Question #1
An 18-year-old has an external ear infection to be
treated with eardrops. The nurse correctly instructs
the patient to angle the ear

A. down and back.

B. up and out.
C. down and forward.
D. up and forward.

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 Practice Question #2
A nurse is planning to administer an intradermal
injection to a patient. Which represents the
appropriate technique for this route?

A. 21-gauge needle at 33 degrees

B. 20-gauge needle at 90 degrees
C. 23-gauge needle at 45 degrees
D. 26-gauge needle at 15 degrees

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 Practice Question #3
Which statement about transdermal drugs is true?

A. Transdermal drugs are preferred because they exert

only a local effect.
B. Transdermal drugs provide more consistent blood
levels than oral and injection forms.
C. For maximum effectiveness, transdermal patches
should be reapplied to the same location when
reapplied.
D. For maximum effectiveness, the skin should not be
cleansed with soap once it has been exposed to a
transdermal drug.

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 Practice Question #4
The Z-track method is the preferred method of
administration for which drug?

A. Vitamin B12
B. Iron dextran
C. Penicillin
D. Morphine

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