Signs/symptoms of anaphylaxis
Skin reactions including hives, itching, and flushed or pale skin
Low blood pressure (hypotension)
Constriction of the airways and a swollen tongue/throat which can cause
wheezing and trouble breathing
Weak and rapid pulse
Nausea, vomiting, diarrhea
Dizziness or fainting
Adverse reactions
Severe, unintended, unwanted, and unpredictable drug reaction
May occur after one dose or develop over time
Medication is immediately stopped
Components of a medication prescription
Patients name
Date and time order is written
Name of drug to be administered
Dosage of the drug
Route of drug administration
Frequency of drug administration
Signature of the person writing the order
How to access a medication vial
check expiration date
never shake; rub between palms
pull off lid
clean with alcohol swab 30 sec, inner to outer
pump as much air as you need medication
turn upside down
pull needle out a little bit to make sure its in medication
Six rights of medication administration
right patient
right route
right time
right dosage
right documentation
right medication
Insulin administration
done by units NOT mL
subcutaneous
use insulin syringe with orange cap
check expiration date
have another person verify correct dosage
push air amount same as medication dosage
90 degrees for obese patients, 45 degrees for normal size
Medication Administration Routes
, Oral
intended to be absorbed through stomach and small intestine
patients ability to swallow, level of consciousness, gag reflex, and
whether the patient is experiencing nausea and vomiting are assess to
make sure patient can take medication by oral route
Sublingual/Buccal
rapid absorption
bypasses the liver
nitroglycerin (chest pain)
placed under the tongue and allow to dissolve
NPO until medication is completely dissolved
Buccal is side of the mouth against the inner cheeks
oAlternate cheeks to avoid mucosal irritation
oShould not be chewed, swallowed, or taken with liquids
Liquids:
Measured on flat surface
Down to look at level to make sure right medication dosage
Check expiration date
Semi-fowlers position
Tablets/Capsules:
Some capsules may be opened and contents added to a small
amount of applesauce, pudding, or ice cream
Enteric-coated tablets cannot be crushed/chewed
Intramuscular:
Deltoid (upper arm):
o1 mL max
oLandmark:
3 fingers down from acromion process
Vastus Lateralis (upper thigh):
o3 mL max
oLandmark:
Make L with one hand on greater trochanter
Make L shape with other hand at the rectus femoris
Ventrogluteal:
o3 mL max
oLandmark:
make v shape with pointer and middle finger at the
anterosuperior iliac spine
Know syringe and needle sizes
oAdult Syringe:
1-5 mL depending on site and muscle mass
oAdult Needle Selection:
19-25 gauge, 1-3 inch
Subcutaneous:
45 degrees for normal size patient
90 degrees for obese patient
Mostly placed in abdomen at different sites each time (clockwise)
Skin reactions including hives, itching, and flushed or pale skin
Low blood pressure (hypotension)
Constriction of the airways and a swollen tongue/throat which can cause
wheezing and trouble breathing
Weak and rapid pulse
Nausea, vomiting, diarrhea
Dizziness or fainting
Adverse reactions
Severe, unintended, unwanted, and unpredictable drug reaction
May occur after one dose or develop over time
Medication is immediately stopped
Components of a medication prescription
Patients name
Date and time order is written
Name of drug to be administered
Dosage of the drug
Route of drug administration
Frequency of drug administration
Signature of the person writing the order
How to access a medication vial
check expiration date
never shake; rub between palms
pull off lid
clean with alcohol swab 30 sec, inner to outer
pump as much air as you need medication
turn upside down
pull needle out a little bit to make sure its in medication
Six rights of medication administration
right patient
right route
right time
right dosage
right documentation
right medication
Insulin administration
done by units NOT mL
subcutaneous
use insulin syringe with orange cap
check expiration date
have another person verify correct dosage
push air amount same as medication dosage
90 degrees for obese patients, 45 degrees for normal size
Medication Administration Routes
, Oral
intended to be absorbed through stomach and small intestine
patients ability to swallow, level of consciousness, gag reflex, and
whether the patient is experiencing nausea and vomiting are assess to
make sure patient can take medication by oral route
Sublingual/Buccal
rapid absorption
bypasses the liver
nitroglycerin (chest pain)
placed under the tongue and allow to dissolve
NPO until medication is completely dissolved
Buccal is side of the mouth against the inner cheeks
oAlternate cheeks to avoid mucosal irritation
oShould not be chewed, swallowed, or taken with liquids
Liquids:
Measured on flat surface
Down to look at level to make sure right medication dosage
Check expiration date
Semi-fowlers position
Tablets/Capsules:
Some capsules may be opened and contents added to a small
amount of applesauce, pudding, or ice cream
Enteric-coated tablets cannot be crushed/chewed
Intramuscular:
Deltoid (upper arm):
o1 mL max
oLandmark:
3 fingers down from acromion process
Vastus Lateralis (upper thigh):
o3 mL max
oLandmark:
Make L with one hand on greater trochanter
Make L shape with other hand at the rectus femoris
Ventrogluteal:
o3 mL max
oLandmark:
make v shape with pointer and middle finger at the
anterosuperior iliac spine
Know syringe and needle sizes
oAdult Syringe:
1-5 mL depending on site and muscle mass
oAdult Needle Selection:
19-25 gauge, 1-3 inch
Subcutaneous:
45 degrees for normal size patient
90 degrees for obese patient
Mostly placed in abdomen at different sites each time (clockwise)
