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Fundamentals of Nursing: The Art and Science of Person-Centered Care, 10th Ed., Taylor, Lynn & Bartlett
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Chapter 30: Medications

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Fundamentals of Nursing: The Art and Science of Person-Centered Care, 10th Ed., Taylor, Lynn & Bartlett | Registered Nurse (RN) School Study Aid

Chapter 30: Medications
15 Picmonics to Learn | 33 mins
Parenteral Medications
Intravenous (IV)
Fast-Acting
Greatest Risk
Intramuscular (IM)
Common Injections Sites: Deltoid, Vastus Lateralis, Ventrogluteal, and Dorsogluteal Muscles
Absorbed Fast
Vaccines and Epinephrine
3 mL Limit
Subcutaneous (SC)
Common Injections Sites: Abdomen, Arm, and Thigh
Absorbed Slower
Insulin and Hormones
Small Volumes
Intradermal (ID)
Common Injection Sites: Back of Forearm and Upper Back
Longest to Absorb
Tuberculosis and Allergy Testing
Under 0.5 mL
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5 mins
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
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2 mins
Eye Medication Administration
Procedure
Supine with Neck Hyperextended
Wash Away Crusts
Cotton Ball on Cheekbone
For Ophthalmic Drops
Instill Drops into Conjunctival Sac
Repeat if Missed or Patient Blinks
5 Minutes Before 2nd Medication
For Ophthalmic Ointment
Thin Stream Along Inner Edge
Inner Canthus to Outer Canthus
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2 mins
Intradermal Medication Administration
SKIN TESTING
Tuberculin Screening
Allergy Testing
INTRADERMAL SITES
Dermis
Inner Forearm or Upper Back
INTRADERMAL Injection
1mL Syringe (26 or 27 Gauge Needle)
5 to 15 Degrees
Small Bleb
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2 mins
6 Rights of Medication Administration
Right Patient
Right Medication
Right Dose
Right Time
Right Route
Right Documentation
Nursing Considerations
Three Checks
Check for Allergies
Assess the Patient
Education
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2 mins
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
Selection of Needle Length
Aseptic Technique for Drawing Up
Z-Track
90 Degree Angle
Max Amount (2-5 mL Adult, 1 mL Child)
Techniques to Reduce Pain
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2 mins
Ear Drops Medication Administration
Indications
Earwax Buildup
Ear Infections
Pulling The Pinna
Child - Back and Downward
Adult - Back and Upward
Procedure
Side-Lying with Ear Up
Instill Medication
Stay for 2-3 Minutes
Nursing Considerations
Room Temperature
May Massage Tragus
Perforated Eardrum
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2 mins
Enema Administration
Types
Tap Water/Soapsuds
Normal Saline
Hypertonic Solution
Medication
Oil Retention
Administration
Procedure Education
Wear PPE
Put Patient in Sims Position
Insert Tip
Start Flow Slowly
Stop With Discomfort
Potential for Vagus Response
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2 mins
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
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2 mins
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
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2 mins
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
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2 mins
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
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3 mins
IV Calculation Formulas
IV TUBING
Drop Factor
Macrodrip
Microdrip
FLOW RATES
Total Volume to Infuse (mL) X Drop Factor/ Time in Minutes = Drops/Minute (gtt/min)
INFUSION TIME
Total Volume to Infuse / mL per Hour Being Infused = Infusion Time
Number of mL/Hr
Total Volume in mL / Time in Hours = Number of mL per Hour
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3 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
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1 min
Total Parenteral Nutrition (TPN)
Mechanism
Nutrition Given Outside GI
Side Effects
Hyperglycemia
Hyperlipidemia
Refeeding Syndrome
Nausea and Vomiting
Considerations
Slow IV Infusion
Use Large Central Vein
No Added Meds to TPN Line
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2 mins

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