This document discusses various routes of medication administration including oral, intravenous, intramuscular, subcutaneous, intrathecal, rectal, ophthalmic, otic, and nasal routes. It provides steps for administering medications via each route including preparation, positioning, dosage, and documentation. The objectives are to familiarize readers with different routes of medication administration and the nurse's responsibilities for each.

1. Fundamentals of nursing
M.S Yosra Raziani
M.Sc. pediatric nursing
KUST
Spring-2020
session 8
Administration of Medications-II

2. objectives
◈ After this session you will be familiar to:
a. Routes of medications administration
b. Oral, Intravenous, intramuscular, subcutaneous, intrathecal
c. Irrigations: eye, ear, nose and bladder.
d. Inhalations
e. Medications and nurse’s responsibility
2

6. Administration of oral medication
Definition:
Drugs given by the oral or gastric route are absorbed
into the bloodstream through the gastric or intestinal
mucosa. Usually the patient swallows the drug.

8. Preparation of Oral Medication
⚫ Wash hands
⚫ Gather equipment:
a. Medication Sheet
b. Medication tray
c. Glass of water or preferred liquid
d. Drinking straw
e. Pill Crusher device

9. Oral Drug Administration
⚫ Prepare one client’s medication at a time.
⚫ Calculate correct drug dose.Take time. Double check calculation.
⚫ If the client has difficulty in swallowing, grind tablets in a pill crusher until smooth.
⚫ Measure liquid medication by holding the medication cup at eye level.
⚫ Re-check each medication with the MAR and physician order.
⚫ Don’t use liquid medication that are cloudy or have changed in color.

10. ⚫ Ask the patient his or her name with a staff witness.
⚫ Assist the patient to a comfortable position.
⚫ Administer the medication
⚫ Remain with the client until he or she has taken all medication
⚫ Wash hands
⚫ Record medication administration.
– Sign after giving the medication
– Counter sign with another nurse for high risk medication.
– If client refuses the medication, record according to the hospital policy.
– check the client after 30 minutes
Oral Drug Administration

11. • Sublingual Administration:
Some medications are readily
absorbed when placed under the
tongue to dissolve.
• Buccal Administration:
Administration of a medication by
placing in the mouth against the
mucous membranes of the cheek
until it dissolves.

15. Intradermal injection
• The introduction of a hypodermic needle into the dermis
• To obtain a local effect at the site of injection of local anesthesia such
as xylocaine
• To Diagnostic test ,tuberculin test
• To test for allergic reaction to a drug

16. Intradermal Administration
⚫ Site: inner forearm
⚫ Volume: 0.01-0.05 ml
⚫ Equipment:
gloves, TB syringe (1ml, 25-27g,
⅝ or . inch needle), alcohol swab.
⚫ Administration angle: 10-15°

17. Subcutaneous injection
• Placing medication into the loose connective tissue under the dermis
• It means the introduction of medicine into the subcutaneous tissue
beneath the upper layers of the skin
• To administer the medication that is ineffective in the GIT
• To administer smaller doses
• For slow drug absorption

18. Subcutaneous Injection Sites

19. Subcutaneous Administration
⚫ Common subcutaneous injections are
heparin, lovenox and insulin
⚫ Onset: within a half hour
⚫ Volume: up to 1ml
⚫ Equipment: TB or Insulin syringe (25-27g, .
to⅝ inch needle), gloves, alcohol swab.
⚫ Administration Angle: 45° or 90 °

20. Intramuscular injection
• Introduction of medicine into the muscle in form of solution
• To obtain a quick effect of medicine than is obtained by oral
administration and subcutaneous administration
• The medicines that is not suitable for intravenous administration

21. Intramuscular Administration
⚫ Administered into a muscle or muscle group
⚫ Onset: variable
⚫ Volume: up to 4ml
⚫ Equipment: gloves, 1-5 ml syringe, needle (18-23 g, ⅝ to 3 inch needle), alcohol swab
⚫ Administration angle: 90°

23. Intravenous injection
• Introduction of a small quantity of drug into the vein by venous puncture
• Introduction of drug directly into the bloodstream
• To have a fast action of the medicine as in emergency
• To give medicine that are irritating or ineffective when give by other routes

24. The commonly used veins
• Basilica and cephalic veins (forearm)
• Median cubital ,cephalic and basilica
veins(antecubital fossa)
• Radial vein (radial area)
• Dorsal metacarpal veins (the hand)
• Veins in the foot
• Femoral and saphenous veins (thigh)
• Veins in the scalp (for infants)

25. Some medications are administered into body cavities. These
additional routes include
• Epidural
• Intrathecal
• Intraosseous
• Intraperitoneal
• Intrapleural
• Intraarterial

26. • Epidural : Epidural medications are administered in the epidural space.
• Intrathecal : Administration into subarachnoid space or one of the ventricles of the brain.
• Intraosseous: Administration of medication directly into the bone marrow.
• Intraperitoneal: Medications administered into the peritoneal cavity
• Intrapleural: Administration of medications directly into the pleural space.
• Intraarterial: Intraarterial medications are administered directly into the arteries.

31. Rectal route
• Administration of drugs into the rectum which is absorbed by the rectum blood vessels .
• More frequently used in children than adult
• Drugs administered rectal have a faster action than via the oral route
• Rectal medications are contraindicated after rectal surgery, with rectal bleeding, and with low
platelet counts.
• Equipment:
Gloves
Lubricant
Drape
Toilet tissue

32. Steps of rectal route
1. Explain the procedure to the patient.
2. Position patient on left side with upper leg flexed over lower leg toward the waist (Sims position).
3. Provide privacy and drape the patient with only the buttocks and anal area exposed.
4. Place a drape underneath the patient’s buttocks.
5. Apply clean non-sterile gloves.
6. Remove wrapper from suppository and lubricate rounded tip of suppository and index finger of
dominant hand with lubricant.
7. Separate buttocks with non-dominant hand and, using gloved index finger of dominant hand, insert
suppository (rounded tip toward patient) into rectum.
8. With your gloved finger, insert suppository along wall of rectum about 5 cm . Do not insert the
suppository into feces.
9. Remove finger and wipe patient’s anal area.
10. Ask patient to remain on side for 5 to 10 minutes.
11. Perform hand hygiene and document every thing

33. ADMINISTERING OPHTHALMIC MEDICATIONS
Definition:
Medications are instilled in mucous membranes of eye for
various therapeutic effects.
Purpose:
⚫ To treat infection.
⚫ To relieve inflammation.
⚫ To treat eye disorders such as glaucoma.
⚫ To diagnose such as foreign bodies and corneal abrasions.

34. Preparation Of OPHTHALMIC MEDICATIONS
l. Gather Equipment
⚫ Medication bottle with sterile dropper or ointment tube.
⚫ Small gauze squares or cotton balls.
⚫ Disposable gloves.
2. Explain the need and reason for instilling drops or ointment.
3.Allow the pt to sit with head tilted backward or to lie in a supine position.
4.Ask client to look up .

35. Instill eye drops
. Check prescribed medication order for number of drops (if a liquid) and eye
.Wash Hands
.With dominant hand resting on client’s forehead, hold filled medication eye dropper or ophthalmic
solution approximately 1-2 cm (1/2-3/4 in) above conjunctival sac

36. Instill eye drops
5. pull the lower lid down to expose the conjunctival sac.
have the pt look up and away, then squeeze the
prescribed numbers of drops into the sac. Release the
patient's eyelid, and have him/ her to blink to distribute
the medication.
6. If drops land on outer lid margins, repeat procedure
7. Gently lay a thin strip of the medication along the
conjunctival sac from the inner canthus to the outer
canthus. avoid touching the tip of the tube to the
patient's eye.Then release the eye lid and have the patient
roll his eye behind closed lids .

37. (OTIC) INISTILLATION
Definition:
Instill liquid medication into external auditory canal for
such therapeutic effects.
Purpose:
⚫ To treat infection and inflammation.
⚫ To soften cerumen for removal.
⚫ To produce local anesthesia.
⚫ To aid in removal of foreign body trapped in the ear.

38. Preparation for EAR (OTIC) INISTILLATION
1. Wash hands
2. Gather Equipment:
⚫ 2 or 3 cotton balls or tissue.
⚫ Disposable gloves.
⚫ Medication record or card.
⚫ Medication to be administered.

39. Before instilling eardrops, have the client lie on his or her
side.Then straighten the ear canal to help the medication
reach the eardrum. For adult, gently pull the auricle up and
back. For young child and infant, gently pull down and back

40. Instillation of nasal drugs
• To relieve inflammation , pain, swelling and congestion
• To give local anesthesia
• To arrest hemorrhage
• To diagnose nasal condition
• Spray
• Drop
• Tampon
• Ointment

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THANKS!
You can find me at
Yosra.anvar@komar.edu.iq