JMRG- 1BSN26

FUNDA LAB- P3

Rectus femoris muscle

MEDICAL ADMINISTRATION
• Belongs to the quadriceps muscle group and is situated on
the anterior aspect of the thigh.
Dorsogluteal Muscle • Advantage: clients who administer their own injections can
•This site is composed of the thick gluteal muscles of the reach this site easily
buttocks.
• The site should not be used for children under 3 years old
unless the child has been walking for at least 1 year.
• The midwife must choose the site carefully to avoid striking
the sciatic nerve
Reminder!
• Avoid hitting the sciatic nerve to prevent paralysis known as
"sciatica paralysis”.
• The nurse palpates the posterior superior iliac spine, then
draws an imaginary line to the greater trochanter of the
femur. This line is lateral to and parallel to the sciatic

Deltoid muscle
• It is found on the lateral aspect of the upper arm.
• This site is recommended for the administration
- Use three/two fingers
•The nurse should carefully administer medication using this
site because it is very close to the radial

• The client needs to assume a prone position with the toes

pointed inward or a side-lying position with the upper knee
flexed and in front of the lower leg. These positions promote
muscle relaxation and therefore minimize discomfort from the
injection.

Vastus lateralis muscle

• It is recommended as the site of choice for intramuscular
injections for infants 1 year and younger.
Because there are no major blood vessels or nerves in the • Advantage: rapid absorption
area, it is desirable for infants whose gluteal muscles are • The upper landmark for the deltoid site is located by the
poorly developed. nurse placing four fingers across
• It is situated on the anterior lateral aspect of the infant's
thigh.
• The landmark is established by dividing the area between IM injection technique:
the greater trochanter of the femur and the lateral femoral
• Z-track technique has been found to be less painful than
condyle into thirds and selecting
the traditional injection technique.
- Z-track use in abdomen
Procedure:
- Pull the skin to the side using the ulnar side of the
nondominant hand
- Inject the medication using your dominant hand (as if
holding a pencil).
- Hold the barrel of the syringe steady with your
non-dominant hand.
- Aspirate. If no blood, place back your nondominant hand
pulling
-Withdraw the needle and apply gentle pressure at the site
JMRG- 1BSN26
FUNDA LAB- P3

Topical
• Application of medication to a circumscribed surface area
of the body. They affect only the area to which they are
applied. Topical applications include the following:
-Dermatological preparations = applied to the skin
• Wash and dry area well before application to facilitate
absorption
- Instillation and irrigations = applied into the body cavities or
orifices, such as urinary bladder, eyes, ears, nose, rectum, or
vagina.

Ophthalmic instillation
• Instillation of medications through the eyes.
• Position client either sitting or lying.
• Use sterile technique.
• Clean the eyelids and eyelashes with sterile cotton balls
moistened with sterile normal saline
• Instill eye drops into the lower conjunctival sac.
• Avoid dropping the solution onto the cornea
• The conjunctival sac the appropriate site for instilling eye
(ophthalmic) medications
- Not direct in eyes
• Instruct the patient to close the eyes gently ad apply gentle
pressure using your finger in the
inner canthus, for the medication to be absorbed.

Otic instillation
• Instillation of medications to or irrigation of the ear.
- Pull up the ear if adult, downwards if bata
- Warm the solution first at room temperature.
- Place the client in a side lying position with the ear being
treated uppermost.
- Strengthen the auditory canal
- Not direct in the ear canal , may damage eardrums.
• Instill the ear drops on the side of the auditory canal to
allow the drops to flow in and to continue to
- adjust to body temperature.
• Press gently the tragus of the ear assist the flow of
medication o the ear canal
- Client should remain in the position for a minute to help
absorb the solution.

Nasal instillation
• Used to administer medication for treatment of infections in
the nasal cavity or sinuses
• Have the client blow the nose prior to nasal instillation.
• Assume a back lying position, or sit up and lean head back.

Intravenous
• Giving medicines or fluids through a needle or tube inserted
into a vein. This allows the medicine or fluid to enter your
bloodstream right away.
JMRG- 1BSN26
FUNDA LAB- P3
2. Teach them about their medication side effects
Vaginal (anticipated) medication we give to our px.
• Use applicator or sterile gloves when administering cream 3. Ensure adherence to the medication regime and
jelly, foam, or suppository evaluate the px and family caregivers ability to
self-administer medication.
Rectal • Generic name = is given before a drug becomes officially
an approved medication. It is generally used throughout the
• The suppository medication needs to be refrigerated so as drug's use. WHO FIRST DEVELOP
not to soften. • Official name = the name after which it is listed in one of
• Use gloves for insertion. the official publications.
• Have the client lie on the left side and breathe through the • Chemical name = the name by which describes the
mouth to relax the anal sphincter. constituents of the drug precisely.
Insert suppository as far high • Brand name or Proprietary Name = the name given to a
• Clients should remain on the side for 20 minutes after drug by a manufacturer. Also called "trade name".
injection to promote adequate absorption of the medication. • Pharmacology = is the study of the effect of drugs on living
organisms.
Inhalations • Pharmacy = is the art of preparing and compounding
• administered into the respiratory tract by a nebulizer. • Pharmacist = is a person licensed to prepare and dispense
- Semi or high-Fowler's position to enhance full chest drugs Tarad and to make up prescriptions.
expansion allowing deeper inhalation of medication.
- Shake the canister Classification Of Medication:
• Position the mouthpiece 1 to 2 inches from the client's open - Effects of the medication
mouth. - Symptoms of the medication relieves
• As the client starts inhaling, press the canister down to - Medication desired effects
release one dose of medication. This allows delivery of the
medication more accurately into the bronchial tree Pharmacokinetics (ADME)
• Instruct client to hold breath for 10 seconds to enhance - Absorption
complete absorption of the medication. - Distribution
- Metabolism
Ten Rights of Medication Administration - Excretion
• Right medication
- We check the medication 3x Types of Drug Preparation
1. Before removing the container from the shelf
2. Bago Ibuhos ORAL (SOLID FORM)
3. Pag babalik yung container sa shelf • Caplet = a solid form, shaped like a capsule, coated and
• Right dose easily swallowed.
• Right time • Capsule = a gelatinous container to hold a drug in powder,
• Right route liquid, or Braut il form.
• Right client • Tablet = a powdered drug compressed into a hard small
• Right documentation disc; some are readily broken along a scored line
• Right client education • Enteric-coated capsule = Does not dissolve in the
• Right to refuse stomach; coating dissolves in the intestine we’re medication
• Right assessment (history) is absorbed.
• Right advice/Information - Never crush enteric-coated or sustained- release
tablets. Crushing enteric-coated tablets allows the
Process of Administering Medications: irritating medication to come intact with the oral or
1. Identify the client gastric mucosa, resulting in mucositis or gastric
2. Inform the client irritation.
3. Administer the drug • Lozenge (troche) = a flat, round, or oval preparation that
4. Provide adjunctive interventions as indicated dissolves and releases a drug when held in the mouth.
5. Record the drug administered
6. Evaluate the client's response to drug ORAL (LIQUID FORM)
• Aqueous solution = one or more drugs dissolved in water.
Definition of Terms • Aqueous suspension = need to shake, when suspension
• Medication = is a substance administered for the is left standing, particles settle into the bottom.
diagnosis, cure, treatment, or relief of a symptom or for • Extract = Removing active part of medicine from it’s other
prevention of disease. (In the healthcare context, the words component ex: Malunggay Extract
medication and drug are generally used interchangeably) • Elixir = a sweetened and aromatic solution of alcohol used
- In all settings, nurses are responsible for as a vehicle for medicinal agents.
1. Evaluating the effects of medications on patients' • Syrup = an aqueous solution of sugar often used to
ongoing health status. disguise unpleasant- tasting drugs
JMRG- 1BSN26
FUNDA LAB- P3
TOPICAL substance. Excessive increase in the dosage is required in
• Aerosol spray or foam = a liquid, powder, or foam order to maintain the desired therapeutic effect.
deposited in a thin layer on the skin by air pressure. • Drug antagonism = conjoint effect of two drugs is less
• Cream = a non greasy, semisolid preparation used on the than the drug acting separately.
skin ** Drug synergism = the combined effects of drugs is
• Gel or jelly = a clear or translucent semi solid that liquefies greater than the sum of each individual agent acting
when applied to the skin. independently.
• Liniment = a medication mixed with alcohol, oil, or soapy
emollient and applied to the skin. Medication Error
• Ointment = a semisolid preparation of None or more drugs • Report all medication errors.
used for application to the skin and mucous membrane. • Patient safety is top priority when an error occurs.
• Documentation is required.
MEDICATION FORMS • The nurse is responsible for preparing a written occurrence
• Powder = a finely ground drug or drugs; some are used or incident report with an accurate, factual description of
internally, others externally. what occurred and what was done.
• Suppository = one or several drugs mixed with a firm base
such as gelatin and shaped for insertion into the body (e.g., Therapeutic Actions of Drugs
the rectum); the base dissolves gradually at body • Palliative = relieves the symptoms of a disease but does
temperature, releasing the drug. not affect the disease itself.
• Transdermal patch = a semipermeable membrane shaped • Curative = treats the disease condition.
in the form of a disc or patch that contains a drug to be • Supportive = sustains body functions until other treatment
absorbed through the skin over a long period of time. of the body's response can take over.
• Intraocular Disk = for eyes • Substitutive = replaces body fluids or substances
• Chemotherapeutic = destroys malignant cells.
Types of Doctor's Order • Restorative = returns the body to health
• STAT order = indicates that the medication is to be given
immediately and only once.
Routes of Administration
• Single order = or "one-time order", is for medication to be
given once at a specified time.
• Standing order = may or may not have a termination date. • Sublingual = is placed under the tongue, where it
Standing order = may be carried out indefinitely until an dissolves
order is written to cancel it, or it may be carried out for a - The medication should not be swallowed because
specified number of days. the medication is absorbed in the blood vessels on
• PRN order = permits the nurse to give medication when, in the underside of the tongue.
the nurse's judgment, the client requires it. The nurses • Buccal = means "pertaining to the cheeks".
should use good judgment about when the medication is - A medication, usually a tablet, is held in the mouth
needed and when it can be safely administered. against the mucous membranes of the cheek until
the drug dissolves
Essential Parts of a Drug Order • Parenteral = is defined as other than through the
alimentary or respiratory tract; that is needle.
• Date and time the order is written
• Signature of the person writing the order
Routes for parenteral administration
Effects of the Drug • Intradermal = under the epidermis (into the dermis)
• Subcutaneous (hypodermic) = into the subcutaneous
• Therapeutic effect = Expected or Predicted physiological
tissue, just below the skin
response. Also called "desired effect".
• Intramuscular = into a muscle
• Adverse Effect= unintended, undesired, often
• Intravenous = into a vein
unpredictable
- Side effect = the effect of the drug that is
Intradermal
unintended. Also called "secondary effect".
- Toxic Effect- accumulation of med in bloodstream ↳ Skin test
- Idiosyncratic reaction- unknown, overreaction or • Under the epidermis (into the dermis)
diff reaction from normal • Indicated for allergy and Using tuberculin syringe.
• Drug allergy = the immunologic reaction to the drug. • The sites 0.9m 6ilm are the inner lower arm,
• Anaphylactic reaction = a severe allergic reaction which upper chest and back, and beneath the scapula.
usually occurs immediately following administration of the • The sites are the inner lower arm, upper chest and back,
drug. and beneath the scapula.
• Medication Interaction = When one medication modifies • Needle at 10 15 degree angle; bevel up
the action of another • Inject a small 0.1ml amount of drug slowly over 3 to 5
• Drug tolerance = a decreased physiologic response to the seconds to form a wheal or bleb.
repeated administration of a drug or chemically related
JMRG- 1BSN26
FUNDA LAB- P3
- Do not massage the site of injection to prevent
irritation of the site, and to prevent absorption of the Pediatric Dosage
drug into the subcutaneous.
- Clark’s rule
Subcutaneous (hypodermic) [Link] lbs/150 x usual adult dose = safe child’s dose
• into the subcutaneous tissue, just below the skin.
• Drugs administered subcutaneously are as follows: - Freid's rule
• Vaccines (measles), insulin, heparin. Wage in months/150 x usual adult dose = safe child’s dose

• Sites of administration: - Young’s rule

- Outer aspects of the upper arm, anterior aspect of the Age in years/ age + 12 x adult dose = safe child’s dose
thighs, abdomen, scapular areas of the upper back, and
ventrogluteal and dorsogluteal areas.
- Rotate sites of injection to minimize tissue damage.
- Use a 5/8 needle for adults when the injection is
administered at a 45 degree angle; 1½ is used at a 90
degree angle.
- For thin patients: 45 degree angle.
- For obese patients: 90 degree angle of needle.

Intramuscular
• into a muscle
• Needle length is 1", 1 1/2", 2" to reach the muscle layer.
* Inject the medication slowly to allow the tissue to
accommodate the volume

CALCULATING DOSAGES
MEDICINE TICKET

Oral Medication Solids/Liquids

Objective: To be able to guide the nurse to follow the
Doctor’s Order.
FORMULA: Same as liquid iba lang unit
Dose on hand/Quantity on hand Medicine ticket includes:
= Desired dose/Quantity desired(x) Name of px
- D/S x Q Age
- ALWAYS INCLUDE UNITS Room no.
1m= 1000mg Date
1L= 1000ml Name of drug
- For example: Sulfamethoxazole (Bactrim) 800 mg tablet is Route
ordered. The available tablet form contains 400 mg/tablet. Time frequency
How many tablets? Dose
Doctor’s name
IV fluid rates Nurse on duty + signature

FORMULA:
gtts(drops)/min Frequency + Color
= Volume in cc x gtt factor/ no. of hrs to consume x 60 OD- Once a Day- WHITE
min BID- Twice a Day- BLUE
TID- Thrice a Day- PINK
• Reminder!
QID- 4x a Day- YELLOW
• gtt factor (micro drop) = 60 µgtts/mL PRN- as needed- GREEN
** gtt factor (macro drop) = 15 atts/mL or 20 gtts/mL q2h- every 2 hours- WHITE
depending on the manufacturer 93h- every 3 hours- WHITE
- Can be round off 94h- every 4 hours- YELLOW
- Convert liter q6h- every 6 hours - WHITE
- ugtt= pedia (micro 60 ugtt/ml) q8h- every 8 hours - RED
q12h- every 12 hours- WHITE
- gtt= adult (macro 15 or 20 gtt)
HS- hours of sleep- RED

- For example: The doctor's order is to administer D5LR 1L

to a pediatric patient to be infused for 18 hours. How should
the midwife regulate the fluid rate
JMRG- 1BSN26
FUNDA LAB- P3
Types of unoccupied bed:
MEDICINE TICKET SHAPES 3 TYPES • Open bed folded back top covers are so the patient can
Rectangle- Oral easily get back.
Ribbon- Parenteral • Close bed sheets are spread up to the head of the
Diagonal- inhalation mattress.
• Part-operative / surgical bed
IV CANNULA - AKA recovery bed / Aner thetic bed
- A Small plastic tube, inserted to the vein in your
hand. TYPES OF LINEN:
- Small number of gauge= needle is big/long ● Bath sheet (For drape)
- High number of gauge= needle is small/short ● Bottom sheet
● Rubber sheet
● Draw sheet
● Top sheet
● Blanket
●
Instruction for folding linen:
• Bath sheet and blanket - lengthwise wrong side out
• Top sheet - lengthwise and right side out, wider on head
part
• Draw and Rubber sheet- crosswise + wrong side out

BED MAKING

- Bed making preparing different types of bed and

making patients comfortable
• Fan Folding- folding the edger if the sheets 4-8 inches
outward
• Mitered corner- anchoring the sheet on mattress
• Toe pleat a fold mage in sheets that allows a patient in bed
move his feet
• Foot drop plantar flexion of the foot
• Foot board to support the immobilized client's foot in a
normal right angle to prevent fort drop.
• Intravenous rods -usually made of metal to support patient
IV containers

Common types of bed:

• Occupied bed
• Unoccupied bed