6006403 for nursing student qqtv.ppt.ppt

Nursing College

1. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
Drug AdministrationDrug Administration
PowerPoint® presentation to accompany:
Medical Assisting
Third Edition
Booth, Whicker, Wyman, Pugh, Thompson

2. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-2
Learning Outcomes
51.1 Discuss your responsibilities regarding drug
administration.
51.2 Perform dosage calculations accurately.
51.3 Describe how to assess the patient before
administering any drug.
51.4 Identify the seven rights of drug administration.

3. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-3
Learning Outcomes (cont.)
51.5 Describe the various techniques of drug
administration.
51.6 Compare different types of needles and syringes.
51.7 Explain how to administer an intradermal,
subcutaneous, or intramuscular injection.

4. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-4
Learning Outcomes (cont.)
51.8Explain what information you need to teach the
patient about drug use, interactions, and adverse
effects.
51.9Describe special considerations related to drug
administration.
51.10Describe nonpharmacologic ways to manage
pain.

5. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-5
Introduction
Drug administration is
very important and can
be a dangerous duty
Given correctly – restore
patient to health
Given incorrectly –
patient’s condition can
worsen
Medical assistant must
Understand principles of
pharmacology
Understand fundamentals of
drug administration
Routes
Dosage calculations
Techniques for injection
Seven rights
Patient education
You should be familiar with the medications frequently
prescribed in your practice.

6. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-6
Drug Administration and
Scope of Practice
States’ medical
practice acts define
medical assistants’
exact duties
Know your scope of
practice in the state
where you will work

7. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-7
Dosage Calculations
Measurement systems
Metric
Apothecaries
Household
Most doctors use the metric
system

8. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-8
Dosage Calculations (cont.)
Basic units of volume and weight
Metric system
Liter (L) – volume
Grams (g) – weight
Apothecaries’ system
Fluidounces, fluidram, pints, quarts – volume
Pounds – weight
Household system
Drops, teaspoons,
tablespoons, ounces,
cups, pints, gallons,
quarts – volume

9. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-9
Dosage Calculations (cont.)
Conversions between systems
Approximate equivalents
Charts
Calculations
Ratio method
Fraction method

10. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-10
Dosage Calculations:
Formula Method
Desired dose
Dose on hand
The physician orders aspirin, 10 grains
On hand are 5-grain aspirins
10 grains
5 grains
× Quantity of dose on hand
× 1 tablet = 10/5 or 2 tablets

11. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-11
Work these problems:
1.The physician has ordered ampicillin 500
mg, on hand 250 mg capsules. How much
would you give?
2.You have 50 mg metropolol as a scored
tablet on hand and the doctor tells you to
give 25 mg. How much would you give?
2 capsules
½ tablet
Dosage Calculations:
Formula Method (cont.)

12. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-12
1.Doctor orders 500 mg of ampicillin. You have 250
mg on hand.
2.Set up a ratio with the unknown number of capsules
needed and the amount of drug ordered X:500 mg
3.Set up a ratio with a single capsules and the amount
of drug in a single capsule 1 tab:250 mg
4.Create a proportion, multiply the outer and then the
inner parts, and solve for X.
X:500 mg :: 1cap:250 mg
Answer = 2 capsules
Dosage Calculations: Ratio Method

13. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-13
3.Set the second fraction
with the amount of
drug in a capsule
10 mg
1 cap
4.Then use both fractions
in a proportion:
30 mg 10 mg
x = 1 cap
1.The doctor orders 30
mg of Adalat. Each
capsule contains 10 mg.
2.Set up the first fraction
with the dose ordered
and the unknown
number of capsules
30 mg
x
Solve for X = 3 capsules
Dosage Calculations: Fraction Method

14. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-14
Metabolism and absorption altered
Require precise calculations
BSA – body surface area
Weight
Dosage Calculations:
Pediatric and Geriatric

15. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-15
Apply Your Knowledge
1.Which measuring system is used by most physicians?
ANSWER: Most doctors use the metric system
when working with pharmacology principles.
2.Convert 25 grams to milligrams.
ANSWER:
1.Add a decimal point to the measurement: 25. g
2.Add 3 zeros so you can move the decimal point three
places to the right: 25.000 g
3.Move the decimal point to the right three places: 25,000
4.Change the unit: 25,000 mg

16. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-16
Apply Your Knowledge
3.Calculate the dose to give
for 500 mg Augmentin
®.
ANSWER:
20 mL

17. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-17
Preparing to Administer a Drug
Drugs
Local effect – applied
directly to skin, tissue,
or mucous membranes
Systemic effect – given
by routes that allow the
drug to be absorbed or
distributed into the
bloodstream
Pay close attention
Dose
Route
Form of medication
Medical assistant
Close attention to detail
Strong patient
assessment skills
Expert technique

18. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-18
Preparing to Administer a Drug (cont.)
Assessment
Injection site
Drug allergies
Patient condition – be alert
to changes that can affect
drug therapy
Consent forms

19. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-19
Rules for administration
Give only drugs the doctor orders – use drug reference, if
necessary
Wash your hands
Prepare in a well-lit area
Focus on task; avoid distractions
Calculate the dose carefully
Do not leave a prepared drug unattended – never give a
drug that someone else has prepared
Preparing to Administer a Drug (cont.)

20. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-20
Rules for administration
Identify patient properly
Physician should be in the office
Observe patient following administration
Discard any ungiven medications properly
Report error to physician immediately
Document properly
Preparing to Administer a Drug (cont.)

21. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-21
Seven Rights of Drug Administration
1.Right patient
2.Right drug
3.Right dose
4.Right time
5.Right route
6.Right technique
7.Right documentation
Preparing to Administer a Drug (cont.)

22. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-22
Apply Your Knowledge
How do you properly identify the patient before
administering a drug?
ANSWER: To ensure that you have the right patient, you
should check the name and date of birth on the patient record
and ask the patient to state his/her name and date of birth.

23. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-23
Techniques for
Administering Drugs
Oral
Tablets, capsules, lozenges, and
liquids
Slower absorption through GI tract
Buccal or sublingual
Buccal – placed between the cheek and
gum
Sublingual – placed under the tongue
Faster absorption; bypasses GI tract

24. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-24
Parenteral
Administration of substance into a muscle or vein
Fast absorption; bypasses GI tract
Safety risks
Rapid administration; rapid action
Exposure to bloodborne pathogens
Methods of injection
Intradermal (ID)
Subcutaneous (SC)
Intramuscular (IM)
Intravenous (IV)
Techniques for
Administering Drugs (cont.)

25. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-25
Needles
Available in different gauges – the
smaller the number, the larger the
gauge (inside diameter)
Length – long enough to penetrate the
appropriate layers of tissue
Syringes
Barrel
Plunger
With or without needle
Calibrated in milliliters or units
Techniques for
Administering Drugs (cont.)

26. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-26
Parenteral drug packaging
Ampule – glass or plastic container that is sealed
and sterile (open with care)
Cartridge – small barrel prefilled with sterile drug
Vial – small bottle with rubber diaphragm that
can be punctured by needle
Techniques for
Administering Drugs (cont.)

27. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-27
Methods of injection
Intradermal
Into upper layer of skin
Used for skin tests
Subcutaneous
Provides slow,
sustained release and
longer duration of
action
Rotate sites
Intramuscular
More rapid absorption
Less irritation of tissue
Larger amount of drug
Z-track method
Intravenous
Not usually given by
medical assistants
Techniques for
Administering Drugs (cont.)

28. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-28
Inhalation – administered through the mouth or nose
Topical
Direct application of a drug on the skin
Transdermal – use of a medication patch that will release
medication slowly and evenly
Urethral – instill liquid drugs directly into the bladder
Vaginal and rectal
Eye or ear – creams, ointments, drops, or irrigations
Techniques for
Administering Drugs (cont.)

29. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-29
Apply Your Knowledge
Matching:
___ Absorption through GI tract A. Topical drug
___ Under the tongue B. Oral drug
___ Small bottle with rubber diaphragm C. Intramuscular drug
___ Less irritation of tissue D. Subcutaneous drug
___ Direct application to skin E. Sublingual drug
___ Need to rotate sites F. Vial
ANSWER:
F
E
D
C
B
A

30. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-30
Educating the Patient About
Drug Administration
How to read the prescription drug label
Interactions
Drug-drug interactions
Drug-food interactions

31. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-31
Adverse effects
Report changes
Recognize significant
adverse effects
Instructions on taking the
drug
At the right time
In the right amount
Under the right
circumstances
Educating the Patient About
Drug Administration (cont.)

32. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-32
Apply Your Knowledge
What should you instruct the patient about regarding
drug administration?
ANSWER: The patient should be taught how to read the
prescription label, drug-drug and drug-food interactions,
adverse effects, and how to take the drug correctly.
Bravo!

33. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-33
Special Considerations
Pediatric patients
Physiology and immature body systems may
make the drug effects less predictable
Require dosage adjustments and careful
measurements of doses
Observe pediatric patients closely for adverse
effects and interactions
Administration sites and techniques may differ

34. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-34
Pregnant patients
Remember that you are caring
for two patients
Giving the mother a drug also
gives it to the baby
Check drug information sources
for pregnancy drug risk categories
Special Considerations (cont.)

35. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-35
Patients who are breast-feeding
Some drugs are excreted in
breast milk
Ingestion can be dangerous
because baby can’t metabolize
or excrete drugs
Check drug information sources
for contraindication during
lactation
Special Considerations (cont.)

36. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-36
Elderly patients
Age-related changes
affect
Absorption
Metabolism
Distribution
Excretion
May have increased risk of
Drug toxicity
Adverse effects
Lack of therapeutic effects
Special Considerations (cont.)

37. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-37
Patients from different cultures
Can affect a patient’s understanding of drug
therapy and compliance with it
Obtain drug information sheets
in the languages that are commonly
spoken by patients in your office
Special Considerations (cont.)

38. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-38
Apply Your Knowledge
What do children and the elderly have in
common in relation to drug administration?
ANSWER: Both have alterations in metabolism and
absorption of drugs requiring adjustments in
dosages.
Fantastic!

39. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-39
Charting Medications
Progress notes
Administration
Special problems
New symptoms
Patient’s statements
Patient tolerance
Be sure to have the right chart
Be specific and accurate

40. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-40
Nonpharmacologic Pain
Management
Biofeedback – evokes relaxation;
helps block pain perception
Guided imagery – patient
envisions being in a calm,
nurturing place; promotes
relaxation
Relaxation exercises – breathing
techniques

41. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-41
Apply Your Knowledge
1.You administer a medication to Mr. Max. What and where
should you chart?
ANSWER: You should chart in the progress notes the
date, time, dosage, route, and name of the medication, as
well as how well the patient tolerated it.
2.True or false:
___ Biofeedback involves special breathing techniques .
___ Audiotapes can be used with guided imagery.
___ Relaxation exercises are used to relax different muscle
groups.
F
T
T
helps block pain perceptionANSWER:
I
M
P
R
E
S
S
I
V
E
!

42. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-42
In Summary
Medical assistant
Administer drugs safely and effectively
Conversions and calculations
Patient assessment
Observe general rules
Follow seven rights of drug administration
Be aware of patients needing special considerations
Be aware of nonpharmacologic methods for managing
pain control

43. © 2009 The McGraw-Hill Companies, Inc. All rights reserved
51-43
End of Chapter
Words are the
most powerful
drug used by
mankind.
~Rudyard Kipling