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Medication Administration Routes Explained

The document outlines various medication administration routes, including oral, topical, and mucosal, along with their definitions and examples. It emphasizes the importance of proper techniques, special considerations for narcotics, and guidelines for administering medications to different patient populations. Additionally, it covers documentation, error prevention, and safety issues related to medication administration.

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bbyjve
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8 views16 pages

Medication Administration Routes Explained

The document outlines various medication administration routes, including oral, topical, and mucosal, along with their definitions and examples. It emphasizes the importance of proper techniques, special considerations for narcotics, and guidelines for administering medications to different patient populations. Additionally, it covers documentation, error prevention, and safety issues related to medication administration.

Uploaded by

bbyjve
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

🩺 CH 36

Outcome 1: Define various terms associated with oral,


topical, and mucosal medications

📘 Textbook Pull

Medication routes describe how a drug enters the body. Oral goes through the digestive tract,
topical through the skin, and mucosal through membranes such as the eyes, nose, rectum, or
vagina.

🧠 Simplified Explanation

Think of routes like entry doors for medicine:

 Oral = Mouth door (swallow)


 Topical = Skin door (rub or stick on)
 Mucosal = Mucus membrane door (under tongue, eye, nose, butt, etc.)

🔑 Key Words

 Route
 Absorption
 Topical
 Mucosal
 Systemic vs. Local effect

🧑🏽‍🏫 Instructor Notes

Always match route with form of medication (e.g., ointment = topical, suppository = rectal).
🧾 Exam Tip

“Which route is used for systemic absorption through mucous membranes?”


✅ Sublingual or buccal (mucosal)

💊
Outcome 2: Differentiate between the use of oral, sublingual,
and buccal routes of administration

📘 Textbook Pull

 Oral: Swallowed → digested → absorbed in intestines


 Sublingual: Placed under tongue → absorbed directly into bloodstream
 Buccal: Placed between cheek & gum → absorbed through mucosa

🧠 ADHD Explanation

 Oral = “Swallow it”


 Sublingual = “Slide it under your tongue” 👅
 Buccal = “Tuck it in your cheek like gum” 😬

🔑 Key Concepts

 Avoid swallowing sublingual/buccal meds


 Don’t eat/drink/smoke until fully dissolved
 Rapid absorption = faster relief

🧾 Exam Tip
“Patient swallows nitroglycerin instead of placing it under tongue — what
happens?”
❌ Slower effect, less absorbed → not effective.

🧴
Outcome 3: Describe the variety of oral, topical, and
mucosal forms of drugs

📘 Textbook Pull

Forms include tablets, capsules, liquids, powders, patches, creams, drops, sprays, suppositories,
and inhalers.

🧠 ADHD Version

💊 Oral: Pills, liquids, chewables

🩹 Topical: Lotions, ointments, gels, patches

Mucosal: Eye drops, nasal spray, rectal/vaginal suppository, under-tongue tabs

🔑 Keywords

 Enteric-coated
 Sustained-release
 Transdermal patch
 Suppository

🧾 Instructor Note
Never crush enteric-coated or extended-release meds!

🧾 Exam Tip

“Which oral medication form should not be crushed?”


✅ Enteric-coated tablets.

🧪
Outcome 4: Explain how to prepare liquid medications

📘 Textbook Pull

Use a medication cup or oral syringe. Read at eye level (meniscus). Shake suspensions before
use.

🧠 ADHD Breakdown

 Shake first (like juice 🍹)


 Pour on flat surface
 Read line at the bottom of the curve (meniscus)
 Wipe bottle lip

🔑 Key Words

 Meniscus
 Suspension
 Oral syringe
 Calibrated cup
🧾 Exam Tip

“Why do you read the dose at the meniscus?”


✅ To ensure accurate measurement.

💉
Outcome 5: Describe special considerations for
administration of narcotic medications

📘 Textbook Pull

Controlled substances require secure storage, double nurse verification, documentation, and
waste witness.

🧠 ADHD Summary

Narcotics = “locked-up meds.”

Two nurses count, sign, and watch disposal. Don’t leave them out!

🔑 Keywords

 Controlled substances
 DEA
 Witnessed waste
 Count verification
🧾 Exam Tip

“Which action is correct when wasting half a narcotic?”


✅ Have another nurse witness and sign.

🥤
Outcome 6: Describe precautions for patients on tube
feedings

📘 Textbook Pull

Hold feedings 30–60 min before/after meds if needed.

Flush tube before, between, and after each medication.

🧠 ADHD Breakdown

Tube = skinny straw. Keep it clean:

 Stop feeding
 Crush or use liquid form
 Flush before and after

🔑 Key Words

 Enteral
 Flush
 Aspiration
🧾 Exam Tip

“Why flush between meds?”


✅ Prevent drug interactions or clogging.

🩻
Outcome 7: Principles for administering through enteral
tube

📘 Textbook Pull

Confirm tube placement before giving meds. Use sterile or warm water for flushes.

🧠 Simplified

 Check location (stomach, not lungs!)


 Flush water → med → flush water
 Keep patient upright 30 min

🧾 Exam Tip

“Why confirm placement before giving meds?”


✅ To avoid delivering into lungs = aspiration risk.

👶🏽👵🏼
Outcome 8: Differences in administering meds to children,
adults, and older adults

📘 Textbook Pull

 Children: Smaller doses, may resist meds.


 Older adults: Slower metabolism, polypharmacy.

🧠 Breakdown

Kids = “Tiny tummy, tiny dose”

Elders = “Slow body, slow clearance”

🔑 Key Words

 Polypharmacy
 Metabolism
 Growth & development

🧾 Exam Tip

“Which patient requires dose adjustment due to decreased liver function?”


✅ Older adult.

🩹
Outcome 9: Guidelines for topical/transdermal routes
📘 Textbook Pull

Clean site, wear gloves, remove old patch, label new patch.

🧠 ADHD Style

Gloves on 🧤 → wipe off old patch → slap new one on clean skin → date/time it.

🧾 Exam Tip

“What should nurse do before applying a new patch?”


✅ Remove old one, clean site.

Outcome 10: Eye, ear, and nasal meds

📘 Textbook Pull

 Eye: drop into conjunctival sac.


 Ear: up/back (adult), down/back (child <3).
 Nose: tilt head back, avoid blowing nose.

🧠 ADHD Breakdown

“Eye → pocket, not eyeball.


Ear → pull + drop.

Nose → sniff, not blow.”

🧾 Exam Tip

“Which direction to pull ear of 2-year-old?”


✅ Down and back.

💗
Outcome 11: Vaginal medications

📘 Textbook Pull

Used for infections or hormones. Patient supine 10–15 min afterward.

🧠 ADHD Style

Tell patient to “lay like a queen 👑” for 10–15 min after inserting.

🧾 Exam Tip

“After vaginal med, how long should patient remain lying down?”
✅ 10–15 min.
🍑
Outcome 12: Rectal meds

📘 Textbook Pull

Used when NPO, vomiting, or need local effect. Contraindicated with bleeding or diarrhea.

🧠 ADHD Summary

Left-side (Sims), lube it, insert gently. No go if rectal bleeding!

🧾 Exam Tip

“What position for rectal suppository?”


✅ Left Sims.

Outcome 13: Metered-Dose vs. Dry-Powder Inhalers

📘 Textbook Pull

 MDI = uses propellant spray


 DPI = breath-activated powder
🧠 ADHD Version

MDI = “push and puff”

DPI = “suck it in strong” 💨

🧾 Exam Tip

“Which inhaler requires deep fast inhalation?”


✅ DPI.

Outcome 14: Nursing responsibilities

📘 Textbook Pull

Assess, administer safely, evaluate, and document.

🧠 ADHD Breakdown

Check → Give → Watch → Write.

🧾 Exam Tip
“What’s the last nursing step after giving a med?”
✅ Document.

📝
Outcome 15: Documentation

📘 Textbook Pull

Document immediately after giving — not before.

🧠 ADHD Reminder

“If you didn’t write it, you didn’t do it.”

🧾 Exam Tip

“When should a nurse document medication?”


✅ Right after administration.

⚠️
Outcome 16: Preventing errors

📘 Textbook Pull
Follow 7 rights, avoid distractions, clarify unclear orders.

🧠 ADHD Breakdown

Pause. Focus. Double check label every time.

🧾 Exam Tip

“Which action prevents med errors?”


✅ Compare MAR to label three times.

🚨
Outcome 17: What to do if a med error occurs

📘 Textbook Pull

1️⃣ Assess patient

2️⃣ Notify provider

3️⃣ Complete incident report

4️⃣ Don’t chart error in patient’s record

🧠 ADHD Steps
Patient first → Call doc → Report, not hide.

🧾 Exam Tip

“First action after realizing med error?”


✅ Assess patient.

🧩
Outcome 18: Connection features

📘 Textbook Pull

Focuses on safety, critical thinking, and patient-centered care links in practice.

🧠 ADHD Note

It’s the “real world” section — ties the skill to clinical judgment.

🦺
Outcome 19: Safety issues

📘 Textbook Pull
Gloves, correct route, avoid contamination, lock meds.

🧠 ADHD Version

“Glove up, label right, lock tight.”

🧠
Outcome 20: Answering skill questions

📘 Textbook Pull

Understand why each step is done (not just how).

🧠 ADHD Study Hack

Ask yourself:

💭 “If I skip this, what could go wrong?”

That’s your safety reasoning for exams.

Common questions

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Holding tube feedings is recommended to prevent reduced drug absorption, undesirable interactions, and tube clogging. Certain nutrients can affect the absorption of medicines, and giving them at separate times ensures that both the nutritional and pharmacological effects are optimized .

Checking tube placement is crucial to ensure the medication is delivered into the stomach and not the lungs, which would pose a significant aspiration risk. Administering medication into the lungs can lead to aspiration pneumonia, making verification of tube placement a critical safety step before medication administration .

Precautions for administering narcotic medications include secure storage, double nurse verification, proper documentation, and ensuring witnessed disposal of unused portions. This process prevents misuse and diversion of these substances, which have high potential for abuse and addiction, ensuring both patient safety and compliance with legal guidelines .

Oral medications are swallowed, digested, and absorbed in the intestines, leading to a slower onset of action. Sublingual medications are placed under the tongue, allowing for direct absorption into the bloodstream for rapid effect. Buccal medications are placed between the cheek and gum and are absorbed through the mucosal membranes, also providing a faster absorption than oral but possibly slower than sublingual depending on the drug formulation .

MDIs use a propellant to deliver medication in a fine spray form when activated, while DPIs are breath-activated, requiring a deep inhalation by the user to inhale the powder form of the medication, which can provide better control over dose delivery based on inhalation strength .

The seven rights of medication administration—right patient, right drug, right dose, right route, right time, right reason, and right documentation—provide a comprehensive framework to prevent errors by ensuring that every aspect of the medication process is double-checked. This reduces the likelihood of mistakes that can occur due to human error, mitigating potential adverse effects and increasing overall patient safety .

When administering medications to children, dosage must be carefully calculated based on weight or body surface area to avoid toxicity, and formulations suitable for age and ability to swallow should be chosen. Children may resist medications, requiring adaptations including taste-masking or using liquid forms. Monitoring for adverse effects should be more vigilant due to their developing physiology .

Enteric-coated tablets should not be crushed because crushing disrupts the coating designed to protect the stomach lining from irritation or to ensure that the drug is released in the intestines rather than the stomach. Crushing these tablets can lead to reduced efficacy or increased gastric irritation .

Not wearing gloves when applying topical medications can lead to self-contamination for the caregiver, potentially resulting in adverse effects if the medication is absorbed through the skin. It also can cause cross-contamination, posing a risk of infection to the patient due to potential transfer of microorganisms from the caregiver's hands .

Documenting immediately after administration ensures accuracy and clarity, maintaining a legal and accurate record of care. Pre-documentation can lead to errors if circumstances change, such as a patient's refusal of medication, or if the medication is administered to the wrong patient .

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