Pharmacology For Nurses: A Pathophysiologic Approach: Fifth Edition

Pharmacology for Nurses: A Pathophysiologic
Approach
Fifth Edition
Chapter 3
Principles of Drug
Administration
Copyright © 2017, 2014, 2011 Pearson Education, Inc. All Rights Reserved
The Nursing Process in Drug Administration
• Nurses are expected to understand the

pharmacotherapeutic principles for all medications given
to each patient
Nurse Responsibilities (1 of 3)
• What drug is ordered

• Name (generic and trade) and drug classification
• Intended purpose or use
• Effects on body
• Contraindication
• Special considerations (e.g., how age affects response)
• Side effects
• Why the medication was prescribed
• How the medication is supplied by the pharmacy

• How the medication is to be administered, including
dosage ranges
• What nursing process considerations related to the
medication apply to this patient
• Before drug is administered, the nurse must know all

variables of the patient's condition
• Be prepared to recognize and react to adverse effects
(adverse events)
Allergic Reactions
• Allergic reaction—an acquired hyperresponse of body

defenses to a foreign substance
– If discovered, nurse responsible for labeling charts,
informing all personnel, and placing alert bracelet on
patient
Anaphylaxis
• A severe allergic reaction involving the massive, systemic

release of histamine and other chemical mediators of
inflammation that can lead to life-threatening shock
Five Rights of Drug Administration
• Five rights used as the basis of safe delivery of

medications. They are:
– Right patient
– Right medication
– Right dose
– Right route of administration
– Right time of delivery
Three Checks of Drug Administration
• Checking drug with MAR or medication information

system when removing it from storage
• Checking drug when preparing it, pouring it, taking it out
of the unit-dose container, or connecting the IV tubing to
bag
• Checking drug before administering it to the patient
Mistakes and Liability
• Despite five rights and three checks, mistakes still occur

• Nurses are held accountable for correct administration of
drugs, but responsibility also rests on other positions like
prescriber and pharmacist
Four Most Common Medication Errors
• Errors in patient assessment

– e.g., inadequate medication history
• Errors in prescribing
– e.g., wrong drug, incorrect dose
• Administration errors
– e.g., route or time of administration
• Distracting environmental factors
– e.g., interruptions during preparation
Drug Compliance (1 of 2)
• Compliance is taking a medication in the manner

prescribed by the health care provider
– Patient has an active role in ensuring compliance
Drug Compliance (2 of 2)
• Factors that can cause a patient to deviate from

compliance:
– Cost of drug
– Forgetting doses
– Annoying side effects
– Self-adjustment of doses
– Fear of dependency
• Nurse must be vigilant in questioning patients about their
medications
Special Drug-Administration
Abbreviations
• STAT—medication is to be given immediately, and only

once
• ASAP—drug should be available for administration within
30 minutes of the written order
• PRN—drug is administered as required by the patient's
condition
Table 3.1 Drug Administration
Abbreviations (1 of 3)
Abbreviation Meaning
ac before meals
ad lib as desired/as directed
AM Morning
bid twice a day
cap capsule
gtt drop
h or hr hour
IM intramuscular
IV intravenous
no number
pc after meals; after eating
PO by mouth
PM afternoon
prn when needed/necessary
qid four times per day
every 2 hours (even or when first
q2h
given)
q4h every 4 hours (even)
q6h every 6 hours (even)
Q8h every 8 hours (even)
Q12h every 12 hours
Rx take
STAT immediately; at once
tab tablet
tid three times a day
Note: The Institute for Safe Medical Practices recommends the following abbreviations
be avoided because they can lead to medication errors: q: instead use “every”; qh:
instead use “hourly” or “every hour”; qd: instead use “daily” or “every day”; qhs: instead
use “nightly”; qod: instead use “every other day.” For these and other recommendations,
see the official Joint Commission “Do Not Use List” at
http://www.jointcommission.org/assets/1/18/dnu_list.pdf
Drug-Administration Abbreviations
• Do not use these abbreviations as they can lead to

medication errors: q, qh, qd, qhs, qod
Drug-Administration Written Orders
• Single order—drug is to be given only once at a specific

time
• Orders not written as STAT, ASAP, NOW, or PRN are
called routine orders
• Standing order—written in advance of a situation that is
to be carried out under specific circumstances
Drug-Administration Procedures (1 of 2)
• Drug orders must be reviewed by the attending physician

within specific time frames, at least every seven days
• Drugs may need administration during or between
meals, depending on interaction with food
• Central nervous system drugs and antihypertensives are
often best administered at bedtime
Drug-Administration Procedures (2 of 2)
• Nurses must educate patients carefully about timing of

taking medications
• Nurses must document carefully the details of
medications given to patient—after they have been given
– Refusal or omission of medication must be
documented
Three Systems of Measurement Used in
Pharmacology
• Metric—most common
• Apothecary—oldest
• Household
Nurse Must Be Able to Convert Among All
Three Systems
• Metric, Apothecary, and Household Approximate

Measurement Equivalents
• Joint Commission (JCAHO), the accrediting organization
for health care agencies, has placed apothecary
measurements on its “do not use” list
• Nurses should encourage use of accurate medical dosing
devices at home
Table 3.2 Metric, Apothecary, and Household
Approximate Measurement Equivalents (1 of 2)
Metric Apothecary Household
1 mL 15–16 minims 15–16 drops
4–5 mL 1 fluid dram 1 teaspoon or 60 drops

1 tablespoon or 3–4
15–16 mL 4 fluid drams
teaspoons
30–32 mL 8 fluid drams or 1 fluid ounce 2 tablespoons
240–250 mL 8 fluid ounces 1½ pint

halfpint 1 glass or cup
500 mL 1 pint 2 glasses or 2 cups
Table 3.2 Metric, Apothecary, and Household
Approximate Measurement Equivalents (2 of 2)
Metric Apothecary Household
4 glasses or 4 cups or 1
1L 32 fluid ounces or 1 quart
quart
1 mg 1/slash
1 60 60grain
grain Blank
60–64 mg 1 grain Blank
300–325 mg 5 grains Blank
1g 15–16 grains Blank
1 kg Blank 2.2 pounds
Note: To convert grains to grams: Divide grains by 15 or 16. To convert grams to grains:
Multiply grams by 15 or 16. To convert minims to milliliters: Divide minims by 15 or 16.
Routes of Drug Administration
• Three broad routes are enteral, topical, and parenteral

– Subsets within each
Common Protocols and Techniques for All
Routes of Administration (1 of 2)
• Verify medication order, check allergy history

• Wash hands and apply gloves, if indicated
• Use aseptic technique when preparing and administering
parenteral medications
• Identify patient (two forms of ID)
• Ask patient about known allergies
• Inform patient about drug
• Position patient
Common Protocols and Techniques for All
Routes of Administration (2 of 2)
• Remove prepackaged drug at bedside

• Unless instructed to do so, do not leave drugs at bedside
• Document administration and pertinent patient
responses
Enteral Route (1 of 2)
• Enteral route includes drugs administered

– By mouth
▪ Tablets, capsules, sublingual, and buccal
– Via nasogastric tube or gastrostomy tube
Enteral Route (2 of 2)
• Tablets and capsules most common form of drugs

– Can be crushed or opened only if manufacturer
instructed; enteric-coated tablets must remain intact
• Sustained-release tablets or capsules are designed to
dissolve very slowly
– Created to increase compliance by reducing
frequency of dosage
Table 3.3 Enteral Drug Administration (1 of 4)
Drug Form
(Example) Administration Guidelines
A. Tablet, capsule, 1. Assess that the patient is alert and has the ability to
or liquid (Orally swallow.
disintegrating tablets 2. Place the tablets or capsules into a medication cup.
and soluble films are 3. If the medication is in liquid form, shake the bottle to
placed on the tongue mix the agent, and measure the dose into the cup at
and then swallowed) eye level.
4. Hand the patient the medication cup.
5. Offer a glass of water to facilitate swallowing the
medication. Milk or juice may be offered if not
contraindicated.
6. Remain with the patient until all the medication is
swallowed.
Drug Form
B. Sublingual 1. Assess that the patient is alert and has the ability to hold
the medication under the tongue.
2. Place the sublingual tablet under the tongue.
3. Instruct the patient not to chew or swallow the tablet or
move the tablet around with tongue.
4. Instruct the patient to allow the tablet to dissolve
completely.
5. Remain with the patient to determine that all the
medication has dissolved.
6. Offer a glass of water after the medication has dissolved,
if the patient desires.
Drug Form
C. Buccal 1. Assess that the patient is alert and has the ability to hold
the medication between the gums and the cheek.
2. Place the buccal tablet between the gum line and the
cheek.
3. Instruct the patient not to chew or swallow the tablet or
move the tablet around with tongue.
4. Instruct the patient to allow the tablet to dissolve
completely.
5. Remain with the patient to determine that all of the
medication has dissolved.
6. Offer a glass of water after the medication has dissolved,
if the patient desires.
Drug Form
D. Nasogastric and 1. Administer liquid forms when possible to avoid clogging the tube. Contact
gastrostomy the pharmacist or health care provider if unsure if the medication may be
given through the tube.
2. If the medication is solid, crush finely into a powder and mix thoroughly
with at least 30 mL of warm water until dissolved. Enteric-coated, extended-
release, and other dosage types may not be crushed. Always check the drug
information before crushing.
3. Assess and verify tube placement per agency protocol.
4. Turn off the enteric feeding, if applicable to the patient.
5. Aspirate stomach contents and measure the residual volume as per
agency protocol. If greater than 100 mL for an adult, check agency policy.
6. Return the residual via gravity and flush with water.
7. Pour the medication into the syringe barrel and allow to flow into the tube
by gravity. Give each medication separately, flushing between with water.
8. Keep the head of the bed elevated for 1 hour to prevent aspiration.
9. Reestablish continual feeding, as scheduled. Keep the head of the bed
elevated 45 degrees to prevent aspiration.
Sublingual and Buccal Drug
Administration (1 of 2)
• Tablet is kept in mouth

• Sublingual
– Medication is placed under the tongue and allowed to
dissolve slowly
▪ Rich blood supply causes rapid onset
– Used only after oral medications have been
swallowed, if multiple drugs are ordered
– No food or drink until completely dissolved
Figure 3.1a Sublingual Drug Administration
Sublingual and Buccal Drug
• Buccal
– Tablet or capsule placed in oral cavity between the
gum and the cheek
– Preferred for sustained delivery
– Generally does not cause irritation
– Like sublingual drugs, buccal drugs are formulated to
bypass first-pass metabolism
Figure 3.1b Buccal Drug Administration
Rapid-Dissolving Tablets and Films
• Orally distintegrating tablets (ODTs) or oral dissolving

films
– Medication placed on the tongue
– Dissolves in less than 30 seconds
– Eliminates need for external source of water and aids
compliance
– Ondansetron first FDA-approved drug in this form
Nasogastric and Gastronomy Drug
• Nasogastric (NG) tube is a soft, flexible tube inserted by

way of the nasopharynx with the tip lying in the stomach
– Generally for short-term treatment
Nasogastric and Gastronomy Drug
• Gastrostomy (G) tube is surgically placed directly into the

patient's stomach
– Longer-term treatment
• Both methods generally use liquid drugs
Enteral Drug Administration Advantages
• Convenient
• Overdose can be countered by retrieval of undigested
medicines through vomiting
• Safest route because skin barrier not compromised
• Uses vast absorptive surfaces of the oral mucosa,
stomach, or small intestine
Enteral Drug Administration
Disadvantages
• Difficulty swallowing by some patients

• May be inactivated if tablets or capsules crushed or
opened
• Can be inactivated by enzymes
• Depends on patient gastrointestinal motility and mobility
• First-pass metabolism: inactivation of drug by processing
in the liver
Topical Drugs Applied to Skin or Mucous
Membranes
• Applications:
– Dermatologic preparations: applied to skin—most
common
– Instillations and irrigations: applied into body cavities
and orifices
– Inhalations: applied to the respiratory tract by
inhalers, nebulizers, or positive-pressure breathing
Purposes of Topical Drugs (1 of 2)
• Many intended for local effect—for example antibiotics to

treat a skin infection
• Fewer side effects because generally absorbed very
slowly
Purposes of Topical Drugs (2 of 2)
• Some given for slow absorption into general circulation,

designed for their systemic effects
– Systemic vs local effect is important distinction for a
nurse
Transdermal Delivery System
• Transdermal patches provide effective means of

delivering some medications
• Rate of delivery and dose may vary with drug
• Avoids first-pass effect of liver and enzymes
• Full documentation by nurses applies
Figure 3.2a Transdermal Patch Administration:
Protective Coating Removed from Patch
Figure 3.2b Transdermal Patch Administration
patch immediately applied to clean, dry, hairless skin and labeled with
date, time, and initials
Ophthalmic Administration
• Used to treat local conditions of the eye and surrounding

structures
• Common indications of problems:
– Excessive dryness, infections, glaucoma, and dilation
of the pupil during eye examinations
• Special procedures, sometimes even immobilization,
may be needed for children
Figure 3.3 Instilling an Eye Ointment into
the Lower Conjunctival Sac
Otic Administration
• Used to treat local conditions of the ear, including

infections and soft blockages of the auditory canal
• Eardrops, irrigations
• Usually used for cleaning purposes
Figure 3.4 Instilling Eardrops
Source: Andy Crawford/DK Images.
Nasal Administration (1 of 2)
• For both local and systemic administration

• Ease of use, avoids first-pass effect and digestive
enzymes
• Mucosal irritation common; potential for damage
Nasal Administration (2 of 2)
• Often used for local astringent effect—shrink swollen

mucous membranes or loosen secretions and facilitate
drainage
Figure 3.5 Nasal Drug Administration
Source: Ph College/Pearson Education, Inc.
Vaginal Administration
• For treating local infections and to relieve vaginal pain

and itching
• Suppositories, creams, jellies, or foams
• Nurse must explain purpose of treatment and provide for
privacy and patient dignity
Figure 3.6a Vaginal Drug Administration:
Instilling a Vaginal Suppository
Figure 3.6b Vaginal Drug Administration: Using
an Applicator to Instill a Vaginal Cream
Rectal Administration
• Local or systemic administration

• Usually suppository form, but sometimes administered as
enema
• First-pass effect and digestive enzymes avoided
Parenteral Drugs Are Administered via
Needle
• Types: intradermal, subcutaneous, intramuscular,

intravenous
• Require aseptic technique
• Nurse must have knowledge of anatomical locations
• Nurse must know correct equipment to use
• Nurse must know procedure for disposing of hazardous
equipment
Parenteral Locations
• Intradermal: dermis layer of skin

• Subcutaneous: deepest layers of the skin
• Intramuscular: specific muscles
• Intravenous: directly into bloodstream
• Advanced parenteral delivery may be directly into body
cavities or organs
Intradermal and Subcutaneous
Administrations (1 of 3)
• Avoid the hepatic first-pass effect and digestive

enzymes; offer method for those who cannot take
medicine orally
• Only small volumes can be administered; injections can
cause pain and swelling
• Intradermal (ID) injection administered into the dermis

layer of the skin
– More easily absorbed than in subcutaneous
– Small amount of drug
Figure 3.7a Intradermal Drug Administration:
Cross Section of Skin Showing Depth of Needle
Insertion
Figure 3.7b Intradermal Drug Administration: The
Administration Site Is Prepped
Figure 3.7c Intradermal Drug Administration: The
Needle Is Inserted, Bevel up At 10–15 Degrees
Figure 3.7d Intradermal Drug Administration: The
Needle Is Removed and the Puncture Site Is
Covered with an Adhesive Bandage
• Subcutaneous injection delivered to the deepest layers

of the skin
• Used for easy access and rapid absorption
• Important to rotate injection sites
• Aspiration not usually necessary, but depends on drug
Figure 3.8a Subcutaneous Drug Administration:
Cross Section of Skin Showing Depth of Needle
Insertion
Figure 3.8b Subcutaneous Drug Administration:
The Administration Site Is Prepped
Figure 3.8c Subcutaneous Drug Administration:
The Needle Is Inserted at a 45 Degrees Angle
Figure 3.8d Subcutaneous Drug Administration: The
Needle Is Removed and the Puncture Site Is Covered
with an Adhesive Bandage
Intramuscular Administration
• Delivers medication into specific muscles

• More rapid onset of action than with oral, ID, or
subcutaneous administration
• Can accept larger volume of medication than
subcutaneous
• Injection site very important; must avoid bone, blood
vessels, and nerves
Figure 3.9a Intramuscular Drug Administration: Cross
Section of Skin Showing Depth of Needle Insertion
Figure 3.9b Intramuscular Drug Administration:
The Administration Site Is Prepped
Figure 3.9c Intramuscular Drug Administration:
The Needle Is Inserted at a 90 Degrees Angle
Figure 3.9d Intramuscular Drug Administration: The
Needle Is Removed and the Puncture Site Is Covered
with an Adhesive Bandage
Four Common Intramuscular Injection
Sites
• Ventrogluteal
• Deltoid
• Dorsogluteal
• Vastus lateralis
Table 3.5 Parenteral Drug Administration
(1 of 5)
Drug Form Administration Guidelines

A. Intradermal route 1. Verify the order and prepare the medication in a tuberculin or 1-mL
/ 8  toto5 eighths
syringe with a preattached 26- to 27-gauge, 33 eights 5 / 8 -inch needle.
2. Apply gloves and cleanse the injection site with antiseptic swab in a
circular motion. Allow to air dry.
3. With the thumb and index finger of the nondominant hand, spread the
skin taut.
4. Insert the needle, with the bevel facing upward, at an angle of 10–15
degrees.
5. Advance the needle until the entire bevel is under the skin; do not
aspirate.
6. Slowly inject the medication to form a small wheal or bleb.
7. Withdraw the needle quickly, and pat the site gently with a sterile 22 × by22
gauze pad. Do not massage the area.
8. Instruct the patient not to rub or scratch the area.
9. Draw a circle around the perimeter of the injection site. Read in 48 to
72 hours.
(2 of 5)

B. Subcutaneous 1. Verify the order and prepare the medication in a 1- to 3-mL syringe using
route a 23- to 25- gauge,11 half
2 toto 5  8 -inch needle. For heparin, the
5 eighths
recommended needle is 3  8 inch and 25–26 gauge.
3 eighths
2. Choose the site, avoiding areas of bony prominence, major nerves, and
blood vessels. For heparin and other parenteral anticoagulants, check
with agency policy for the preferred injection sites.
3. Check the previous rotation sites and select a new area for injection.
4. Apply gloves and cleanse the injection site with antiseptic swab in a
circular motion.
5. Allow to air dry.
6. Bunch the skin between the thumb and index finger of the nondominant
hand.
7. Insert the needle at a 45 degrees or 90 degrees angle depending on body
size: 90 degrees if obese; 45 degrees if average weight. If the patient is
very thin, gather the skin at the area of needle insertion and administer at
a 90 degrees angle.
8. Inject the medication slowly.
9. Remove the needle quickly, and gently massage the site with antiseptic
swab. For heparin and other parenteral anticoagulants, do not massage
the site, as this may cause increased bruising or bleeding.
(3 of 5)

C. Intramuscular 1. Verify the order and prepare the medication using a 20- to 23-gauge, 1- to
route: 1.5-inch needle.
ventrogluteal 2. Apply gloves and cleanse the ventrogluteal injection site with antiseptic
(different swab in a circular motion. Allow to air dry.
administration 3. Locate the site by placing the hand with the heel on the greater trochanter
guidelines and the thumb toward the umbilicus. Point to the anterior iliac spine with
would apply to the index finger, spreading the middle finger to point toward the iliac crest
the (forming a V). Inject the medication within the V- shaped area of the index
dorsogluteal, and third finger. (Note: This is how to locate the ventrogluteal site.)
vastus lateralis, 4. Insert the needle with a smooth, dartlike movement at a 90 degrees angle
and deltoid within the V-shaped area.
muscle sites) 5. Depending on agency policy and type of drug, aspirate, and observe for
blood. If blood appears, withdraw the needle, discard the syringe, and
prepare a new injection.
6. Inject the medication slowly and with smooth, even pressure on the
plunger.
7. Remove the needle quickly.
8. Apply pressure to the site with a dry, sterile 22 by
× 22 gauze and massage to
promote absorption of the medication into the muscle.
(4 of 5)

D. Intravenous 1. To add a drug to an IV fluid container:
route 2. Verify the order and compatibility of the drug with the IV fluid.
3. Prepare the medication in a 5- to 20-mL syringe using a 1- to 1.5-inch, 19- to
21-gauge needle from the original medication vial or ampule. If a needleless
system is used, use the appropriate syringe or tip required per the system in
use.
4. Apply gloves and assess the injection site for signs and symptoms of
inflammation or extravasation.
5. Locate the medication port on the IV fluid container and cleanse with
antiseptic swab.
6. Carefully insert the needle or needleless access device into the port and
inject the medication.
7. Withdraw the needle and mix the solution by rotating the container end to
end.
8. Hang the container and check the infusion rate.
9. To add drug to an IV bolus (IV push) using an existing IV line or IV lock
(reseal):
10. Verify the order and compatibility of the drug with the IV fluid.
(5 of 5)

D. Intravenous 11. Determine the correct rate of infusion.
route 12. Determine whether IV fluids are infusing at the proper rate (IV line) and that
the IV site is adequate.
13. Prepare the drug in a syringe, following the procedure described above.
14. Apply gloves and assess the injection site for signs and symptoms of
inflammation or extravasation.
15. Select the injection port, on tubing, closest to the insertion site (IV line).
16. Cleanse the tubing or lock port with antiseptic swab and insert the needle
into the port.
17. If administering medication through an existing IV line, occlude tubing by
pinching just above the injection port.
18. Slowly inject the medication over the designated time—usually not faster
than 1 mL/min, unless specified.
19. Withdraw the syringe. Release the tubing and ensure proper IV infusion if
using an existing IV line.
20. If using an IV lock, check agency policy for use of saline flush before and
after injecting medications.
Intravenous Administration (IV)
• Medications and fluids are administered directly into the

bloodstream and are immediately available for use by the
body
• Fastest drug onset action, but also most dangerous
method
– Contamination
– Swift adverse reactions
Figure 3.10 Injecting a Medication by IV
Push
Source: Pearson Education, Inc.
Three Types of Intravenous
• Large-volume infusion: for fluid maintenance,

replacement, or supplementation
• Intermittent infusion: small amount of IV solution
arranged tandem with or piggybacked to primary large-
volume infusion; used to instill adjunct medications
Three Types of Intravenous
• IV bolus (push) administration: concentrated dose

delivered directly to circulation via syringe to administer
single-dose medications
Figure 3.11 An Infusion Pump Is Used for Both
Continuous and Intermittent IV Administration
(Universal Images Group Limited/Alamy).
Parenteral Advantages and Disadvantages
• Advantages:
– Bypasses first-pass effect and enzymes
– Available to patients unable to take medication orally
• Disadvantages:
– Only small doses can be used
– Possible pain and swelling at injection site
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Pharmacology for Nurses: A Pathophysiologic

• Nurses are expected to understand the

• What drug is ordered

• How the medication is supplied by the pharmacy

• Before drug is administered, the nurse must know all

• Allergic reaction—an acquired hyperresponse of body

• A severe allergic reaction involving the massive, systemic

• Five rights used as the basis of safe delivery of

• Checking drug with MAR or medication information

• Despite five rights and three checks, mistakes still occur

• Errors in patient assessment

• Compliance is taking a medication in the manner

• Factors that can cause a patient to deviate from

• STAT—medication is to be given immediately, and only

• Do not use these abbreviations as they can lead to

• Single order—drug is to be given only once at a specific

• Drug orders must be reviewed by the attending physician

• Nurses must educate patients carefully about timing of

• Metric, Apothecary, and Household Approximate

Metric Apothecary Household

1 mL 15–16 minims 15–16 drops

4–5 mL 1 fluid dram 1 teaspoon or 60 drops

240–250 mL 8 fluid ounces 1½ pint

500 mL 1 pint 2 glasses or 2 cups

60–64 mg 1 grain Blank

300–325 mg 5 grains Blank

1g 15–16 grains Blank

1 kg Blank 2.2 pounds

• Three broad routes are enteral, topical, and parenteral

• Verify medication order, check allergy history

• Remove prepackaged drug at bedside

• Enteral route includes drugs administered

• Tablets and capsules most common form of drugs

• Tablet is kept in mouth

• Orally distintegrating tablets (ODTs) or oral dissolving

• Nasogastric (NG) tube is a soft, flexible tube inserted by

• Gastrostomy (G) tube is surgically placed directly into the

• Difficulty swallowing by some patients

• Many intended for local effect—for example antibiotics to

• Some given for slow absorption into general circulation,

• Transdermal patches provide effective means of

• Used to treat local conditions of the eye and surrounding

• Used to treat local conditions of the ear, including

Source: Andy Crawford/DK Images.

• For both local and systemic administration

• Often used for local astringent effect—shrink swollen

Source: Ph College/Pearson Education, Inc.

• For treating local infections and to relieve vaginal pain

• Local or systemic administration

• Types: intradermal, subcutaneous, intramuscular,

• Intradermal: dermis layer of skin

• Avoid the hepatic first-pass effect and digestive

• Intradermal (ID) injection administered into the dermis

• Subcutaneous injection delivered to the deepest layers

• Delivers medication into specific muscles

Drug Form Administration Guidelines

Drug Form Administration Guidelines

Drug Form Administration Guidelines

Drug Form Administration Guidelines

Drug Form Administration Guidelines

• Medications and fluids are administered directly into the

Source: Pearson Education, Inc.

• Large-volume infusion: for fluid maintenance,