Medication Administration Procedures

Medical assistants must know the different forms of medications and how they are prepared and administered correctly to the patients.

Medication Administration Step-by-Step

Eyes: 

• Hand patient a tissue
• Cotton balls
• Have patient look up as far as possible
• Pull down on lower eye lid
• Rest hand that is instilling the med on the forehead
• Instill drops into lower lid at inner corner
• Close lid
• Have patient move eye around
• Hold cotton ball at corner while patient rolls eye
• Ointment can cause blurriness until it all melts

Ear:

• Tilt head to side where medication is to be applied
• Pull ear up and back for adults
• Pull ear down and back for children
• Put drops down into ear
• Have patient wait 5 min. with ear up
• Can use cotton ball to ensure medication stays
• Apply to other ear 5 min. later

Nose Drops:

• Put pillow under patient's shoulders
• Tilt head back
• Place tip of applicator into nostril
• Instill correct number of drops
• Direct patient to keep head back so it absorbs into the sinus

Nasal Sprays:

• Have patient sit up
• Insert tip of container into nostril
• Have patient take a deep breath as you squirt
• No need to tilt head back
  

Lung Sprays:

• Have patient stand up
  - this lowers the diaphragm and allows for better lung expansion
• Shake the inhaler well - shake for 15-30 sec.
• Let patient place the spacer device on the inhaler
• Instruct patient to breathe out to the end of a normal breath
• Ask patient to tilt chin up - do not hyper-extend
• Let patient place spacer tube in mouth
  - instruct patient to seal lips around the tube
• Ask patient to activate inhaler
  - patient must inhale slowly and deeply over 5 seconds
  - be sure patient doesn't use the nose
  - patient must hold breath for 10 seconds - before exhaling
• Wait for 2-5 minutes before next puff
• Give water to rinse mouth after all doses are taken
  

Topical Meds:

Open wound 

• sterile technique - Sterile cotton swabs or tongue depressor

Nitro paste:

• Use a unit dose patch
• Shiny area up, remove sealed portion

Prepare own nitro paste: 

• Tear off piece of nitro paper
• Light print showing thrugh is the side you want up
• Start at beginning of line, squeeze slowly so med is no bigger or smaller than top of tube
• Fold paper in half
  - spread medication over all paper
• Open and place on patient
• Tape in place
  -move around patient in clockwise manner
• If ordered chest only, then alternate side to side
  - Look for previous patch before applying your new patch

To remove: 

• Wet one end of paper towel
• Take off, wipe, and dry area
• Watch for reactions to this medication
  - headache and lightheadedness

Rectal/ Vaginal: 

• Need lubricating jelly, suppository insterter with medication
• Wear gloves
• Remove suppository from package
• Lubricate with jelly
• Insert suppository into rectum or vaginal canal (rectal:1 finger for adults, ½-1 inch for children
• Patient remains lying for 10-15 min after insertion to ensure absorption of medication

Oral Medications: 

Pills

- Can be swallowed directly or sublingual (leave these under the tongue until dissolved)
- Open pack & drop into medicine cup

Granule/ Powders

- Pour into a cup up to correct dosage

Liquids

- Unit dose is a sealed container
- Water based liquid - read meniscus down
- Oil based liquid - read meniscus up

 

Parentral Meds: 

Syringes

- Unit doses and self prepared

The numbers represent:

1. Volume a
2. Gauge of needle (diameter of inside of needle)
- the larger number the smaller the needle's orifice (hole)
3. Length of needle

- Insulin syringes and needles
- Tuberculin syringes and needles
- The color of the packaging represents the gauge of the needle
- All needles are interchangeable except for the insulin syringe
- The tuberculin syringe is not lure-locked, needle pulls off
- can measure in tenths and hundredths- pediatrics

  2 types of insulin syringes

a. 100 U = 1cc - each line = 2 Units
b. 50 U - each line = 1 Unit

  Unit dose syringe comes prefilled by the company

• usually use entire contents
• discard what will not be used

- Tubex syringe
- cartridge with holder
- prefilled
- discard into sharps container

 

Mixing Insulin

♦ Clear - Regular
♦ Cloudy - NPH or 70/30

        Mnemonic: Cloudy air - clear air - clear draw - cloudy draw

- Gently roll between hands to mix

- Always draw up clear first

• Clean both tops with alcohol
• Inject desired amount of air into NPH
• Inject desired amount of air into regular
• Withdrawal desired amount of Regular
• Remove air bubbles
• Withdrawal desired amount of NPH slowly
  - can not have air bubbles & must be exact measurement!