- First, a well-lighted area should be used to assess the site of injection.
- Second, when giving repeated doses on a regular basis, the use of a site rotation chart should be instituted and kept on the Medication
- Third, avoiding exposing the needle in the patient’s line of vision decreases level of anxiety.
- Site of choice is the abdomen, because the layer of subcutaneous tissue here does not lie over any major muscles, leading to decreased chance of hematoma formation and movement.
- Syringe of Choice is 1/2-inch, 25- to 27-gauge.
- Changing the needle once the medication is drawn up to prevent heparin from remaining in needle, which could lead to inadvertent delivering of the medication into the intradermal tissue.
- Controversial views on aspirating prior to injection (review agency policy on this issue).
- Do not Massage after heparin injection. Massaging the site after injection can increase incidence of bruising.
- Rotation of sites around abdomen to decrease irritation to tissue.
- A medication order must include the patient's full name, the date, and time the order was written, the name of the medicine, the dose, the route, frequency, and signature of the person writing the order.
- Medications must be checked for the five rights with each administration: right patient, right medication, right dose, right route, and right time.
- Allergies should be checked prior to each medication administration.
- Some medications have special administration instructions, such as the patient must remain upright after administration.
- Many medications are made by more than one company, and may have similar names. if an order is unclear, check with the prescriber before administration.
Special condiderations must be taken for certain age group to ensure safe medication administration.
- Do not refer to medications as candy.
- For infants, a syringes of droper is the best.
- Place syringe alongside the tongue to prevent gagging and expulsion of medication.
- Postion the infant in a semi-reclining posion and administer in small amounts, to prevent chocking.
- If using a spoon, collect and re-feed expelled medication.
- Play techniques may help elicit the child's coopoeration.
- For children taking sweerened medicaitons, especially on a long term basis, follow mendication with oral hygiene to assist in decreasing dental caries.
Special considerations for Elderly patients
The elderly are often on multiple medications from various physicians. Look for possibe drug interactions as well ad prescriptions for more than one drug from the same class (such as bta-blockers).
- To create systemic and/or local effects.
- Maintain skin hydration.
- Protect skin surfaces.
- Reduce local skin irritation.
- Create local anesthesia.
- Treat local infections.
Tropical medications should not be administered if skin integrity is altered, unless otherwise indicated. Skin must be cleaned before application to ensure beneficial therapeutic outcomes.
- To produce systemic effects or a local effect on gastrointestinal mucosa.
- Approach is convenient and safe.
- To prevent irritation to the gastrointestinal tract.
- To prevent destruction of medication by first-pass hepatic effect of gastric juices.
- To achieve a rapid effect.
Check for five rights of medication administration. Review patient's allergies.
- This method provides rapid drug absorption because muscle tissue is highly vascular.
- Muscle is less sensitive to irritating and viscous medications.
- If volume of medication exceeds 5ml in adult of 3ml in a child, tow separate injection should b given at different sites.
- If medication is irritating to the tissue, use Z-tract method.
- Needle length should be 2" to prevent medication delivery to subcutaneous tissue.
- Viscosity of solution should be considered when selecting gauge of needle.
- For diagnostic testing for exposure to specific diseases or method of diagnostic testing for allergens
- For test dose of antibiotics
- Patient is related to allergen sensitivity.
- The reaction could be fatal, know the location of resuscitation equipments
- Have appropriate antidotal medications (usually epinephrine hydrochloride, bronchodilator, and antihistamine) available.
- Used during emergencies, with critically unstable patients, and as a route when rapid and predictable responses are required.
- Antibiotic administration.
- For Blood Transfusion.
- This route is suitable for Fluids administration.
- Check five rights of medication administration.
- Verify allergies of patient.
- Be aware of information about drug before administration; Action, purpose, side effects, normal dosage, nursing implications.