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PARENTERAL

ADMINISTRATION
 Injection of a drug into subcutaneous
tissue, muscle or vein.

 Drugs can be injected into a spinal canal


pleura cavity, cardiac muscle, bone, or
peritoneal cavity.
TYPES OF INJECTIONS
 INTRADERMAL / INTRACUTANEOUS

SITE inner aspects of forearm


scapular area of the back

PURPOSE ANST or tuberculin tests

AMOUNT ranges 0.01 – 0.1 cc


 SUBCUTANEOUS

SITE Abdomen, lateral aspects of


upper arm or thigh

PURPOSE For medications that are


absorbed slowly, to produce a
sustained effect

AMOUNT small amt not more than 1 cc


 INTRAMUSCULAR
SITE Vastus lateralis, gluteus maximus,
ventral gluteal area, deltoid

PURPOSE Promote rapid absorption


Provide an alternative route
A less painful alternative

AMOUNT Variable
 INTRAVENOUS

SITE Peripheral IV access


Central lines
Vascular access/ implantable
infusion port
NEEDLE SIZES
STEPS IN GIVING
PARENTERAL MEDICINES
 Check the medication card against DOS and
MTR for accuracy and validity
 Identify the patient
 Explain the procedure
 Wash hands
 Prepare prescribed dose of the drug
 Have the NUM/ANUM/CN/CP counterchecked
prepared drugs
 Identify the patieny
 Select the correct site
STEPS IN GIVING
PARENTERAL MEDICINES
 Select site of injection and disinfect
 Inject needle quickly (correct angle)
 Aspirate the blood if necessary
 Inject the drug (slowly)
 Withdraw the needle (quickly)
 Massage the area firmly if necessary
 Dispose the needle properly(sharp collector)
 Chart promptly and correctly
 Document on the MTR and Nurse’s notes
NURSING
RESPONSIBLITIES
NURSING RESPONSIBILITIES
 Observe Handwashing
 Honor the “ Three- time check” in preparing
medications
 Administer only the drug that you prepare.
 Administer no drug without an order.
 Be familiar with the medication to be
administered to your patient (e.g. general
purpose, side effects, average dose, safety
precautions).
NURSING RESPONSIBILITIES
 Identify drug and amount in each dose unit.
 Be certain that the name of the medicine
ordered is spelled precisely as that on the
label—if in doubt.
 Evaluate client's condition and medication
compatibility.
 Do not administer until the question is
resolved.
 Do not use outdated medicines.
NURSING RESPONSIBILITIES
 If drug appears unusual due to discoloration
or precipitation, do not use.
 Administer medicine at the time specified or
as close to that time as possible—if there is
a delay, document it.
 Identify patient.
 Use Aseptic technique when delivering and
administering client's medication.
 Do not leave medication at bedside
NURSING RESPONSIBILITIES
 Permit patient to self-administer medicines
only if permitted by physician's written order
 Unless authorized by physician, do not use
drugs patient brought to hospital
 If an alert patient questions the drug's identity
or appropriateness for use, recheck the
identity of the patient and the drug
 If patient refuses medication, document this
on chart and notify the physician responsible
for the care of the patient at that time.
MEDICATION SAFETY
MEDICATION SAFETY
 "Pharmacists should actively participate in the
medication-use process, including, at a
minimum, being available for consultation with
prescribers on medication ordering,
interpretation and review of medication
orders, preparation of medications,
dispensing of medications, and administration
and monitoring of medications."
—National Quality Forum
RECONSTITUTING POWDERED
MEDICATIONS
 Injectable medications that may be unstable in
solution, are packaged in powder form. All
package or label directions must be followed
exactly.
 In a multi-dose vial, it is essential that the
nurse mark on the container the date and time
of preparation, the strength of the resulting
solution, the expiration of potency, storage
directions and his/ her initials.
RECONSTITUTING POWDERED
MEDICATIONS

Keep the vial, upright, on the counter top.


Push the needle of the syringe on the vial
& inject the air from the syringe to the vial.
RECONSTITUTING POWDERED
MEDICATIONS
 Some package directions list several
preparation methods to yield different
strengths of medication. Select the strength
closest to the ordered dose .

 The patient age, body weight and build and


injection site for administration must all be
considered when reconstituting powdered
medications.
PREVENT INJURIES
 needles should not be
recapped by hand,
purposely bent or broken by
hand, removed from
disposable syringes, or
otherwise manipulated by
hand.

 After they are used,


disposable syringes and
needles, scalpel blades, and
other sharp items should be
placed in puncture-resistant
containers for disposal
PREVENT INJURIES

Recap the needle by slipping it into


the cap with your hand away from the
rim of the cap.
RESPONSIBILITY
 Immediately report all exposures Don't wait. After
disinfecting the area, promptly report your exposure.

 Comply with post-exposure follow-up The difficult


period following exposure requires frequent blood
testing, safer sex practices, and carrying the burden of
uncertainty about your health.

 Support your peers We must offer support to nurses


who are potentially exposed. The uncertainty of being
exposed to HIV or hepatitis can have a devastating
effect on personal lives.
NON-COMPLIANCE
 Patients who do not take prescribed drugs
because they did not understand the
instructions
 Patients who do not take the recommended
drugs because they do not trust the
physician.
 Patients who do not take the prescribed
drugs because they make them feel bad.
RESPONSIBILITY
 Health Teachings

 Learn to hear these


people. They are
often correct.

 Refer to Dr. ASAP