Medical Procedures and Nursing Interventions | Medication Administration |

 

Medical Procedures and Nursing Interventions :

Medication Administration :

1. Introduction to Pharmacology and Drug Classifications

Pharmacology is the branch of medicine and biology that focuses on the study of drugs, their origins, composition, effects, and uses. Understanding pharmacology is essential for nurses to ensure safe and effective patient care.

Key Concepts of Pharmacology:

• Pharmacokinetics: The process of how the body absorbs, distributes, metabolizes, and excretes drugs.
• Pharmacodynamics: The effects of drugs on the body, including therapeutic effects and side effects.

Drug Classifications: Drugs are classified based on their chemical structure, mechanism of action, therapeutic use, and legal status. Major drug classifications include:

• Analgesics: Pain relievers (e.g., paracetamol, ibuprofen)
• Antibiotics: Used to treat infections (e.g., penicillin, azithromycin)
• Antihypertensives: Used to lower blood pressure (e.g., amlodipine, losartan)
• Antidiabetics: Used to control blood sugar levels (e.g., insulin, metformin)
• Sedatives and Hypnotics: Used to induce sleep or relaxation (e.g., diazepam, zolpidem)

Importance of Pharmacology in Nursing: Nurses play a crucial role in administering medications safely, monitoring patients for side effects, and providing patient education regarding drug use and adherence.

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2. 5 Rights of Medication Administration

To ensure patient safety and avoid medication errors, nurses follow the "5 Rights" of medication administration. These principles serve as a checklist before administering any drug.

1. Right Patient: Verify the patient’s identity using two identifiers, such as name and date of birth, or patient ID.
2. Right Drug: Check the name of the drug on the prescription and the drug label. Confirm it matches the doctor's order.
3. Right Dose: Verify the prescribed dose and ensure it is accurate. Use appropriate measuring devices for liquid medications.
4. Right Route: Ensure the route of administration (oral, intravenous, intramuscular, subcutaneous, etc.) is as prescribed.
5. Right Time: Administer medications at the correct time, adhering to specific intervals as prescribed (e.g., before meals, after meals, or at bedtime).

Additional Rights (optional):

• Right Documentation: Record the administration details immediately after giving the medication.
• Right Reason: Understand why the medication is being given to the patient.
• Right Response: Monitor the patient's response to the drug and note any side effects or adverse reactions.

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3. Oral, Parenteral, and Topical Drug Administration Techniques

A. Oral Drug Administration:

• Definition: The administration of medication through the mouth to be swallowed and absorbed via the gastrointestinal (GI) tract.
• Forms: Tablets, capsules, syrups, suspensions, and lozenges.
• Procedure:

1.       Check patient’s ability to swallow.

2.       Offer water to facilitate swallowing.

3.       Position the patient upright (at least 30-45 degrees) to prevent aspiration.

4.       Verify the "5 Rights" of medication administration.

5.       Ensure the patient has swallowed the medication completely.

B. Parenteral Drug Administration:

• Definition: The administration of drugs through injections bypassing the GI tract.
• Routes of Parenteral Administration:

o    Intramuscular (IM): Injection into the muscle (e.g., deltoid, gluteus maximus).

o    Subcutaneous (SC): Injection into the fatty tissue under the skin (e.g., insulin injections).

o    Intradermal (ID): Injection into the dermis (e.g., allergy tests, tuberculin skin tests).

o    Intravenous (IV): Direct injection into a vein, often for immediate drug action.

• Procedure:

1.       Select the appropriate needle size and syringe.

2.       Identify and prepare the injection site.

3.       Clean the site with an alcohol swab.

4.       Administer the injection at the correct angle (IM = 90°, SC = 45°, ID = 10-15°).

5.       Dispose of needles and syringes in a sharps container.

C. Topical Drug Administration:

• Definition: The application of drugs directly to the skin or mucous membranes.
• Forms: Creams, ointments, gels, lotions, transdermal patches.
• Procedure:

1.       Wash and dry the area where the medication will be applied.

2.       Use gloves or an applicator to avoid direct skin contact.

3.       Apply the prescribed amount of medication.

4.       Cover the area if necessary (e.g., with a dressing for transdermal patches).

5.       Document the site of application and any observations.

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4. Managing Adverse Drug Reactions (ADRs) and Medication Errors

A. Adverse Drug Reactions (ADRs):

• Definition: Unintended and harmful reactions that occur after taking a drug, even at normal doses.
• Types of ADRs:

o    Mild Reactions: Nausea, dizziness, rash.

o    Severe Reactions: Anaphylaxis, severe hypotension, respiratory distress.

• Prevention of ADRs:

o    Conduct allergy assessments before drug administration.

o    Start with a low dose if possible, and observe for initial responses.

o    Educate patients on potential side effects and what to report.

• Management of ADRs:

o    Stop the drug if necessary (following the physician’s advice).

o    Provide emergency support (e.g., epinephrine for anaphylaxis).

o    Record the incident and inform the healthcare provider.

B. Medication Errors:

• Definition: Mistakes in prescribing, dispensing, or administering drugs that lead to harm or potential harm.
• Common Causes:

o    Incorrect drug or dose.

o    Miscommunication between healthcare providers.

o    Incorrect patient identification.

• Types of Medication Errors:

o    Prescribing Errors: Wrong drug, dose, or instructions.

o    Dispensing Errors: Incorrect labeling, packaging, or formulation.

o    Administration Errors: Wrong route, patient, or time of administration.

• Prevention of Medication Errors:

o    Use of the "5 Rights" of medication administration.

o    Double-check medications with another nurse, especially high-risk drugs.

o    Use barcode scanning for patient identification and drug verification.

• Management of Medication Errors:

o    Report errors immediately to the supervisor or healthcare provider.

o    Monitor the patient for signs of adverse effects.

o    Follow institutional protocols for error documentation and follow-up.

Please Note : Before given any medication by any route nurses should be follow doctor order and follow local policies.