給藥英文課件-護(hù)理學(xué)

給藥

(二)Medications(two)

FACTORSAFFECTINGMEDICATIONACTIONAnumberoffactorsotherthanthedrugitselfcanaffectitsaction.Apersonmaynotrespondinthesamemannertosuccessivedosesofadrug.Inaddition,theidenticaldruganddosagemayaffectdifferentclientsdifferently.1.DevelopmentalFactors

·Duringpregnancywomenmustbeverycarefulabouttakingmedications.

·Infantsusuallyrequiresmalldosagesbecauseoftheirbodysizeandtheimmaturityoftheirorgans,especiallytheliverandkidneys.

·Olderadultshavedifferentresponsestomedicationsduetophysiologicchangesthataccompanyaging.

2.Gender

Differencesinthewaymenandwomenrespondtodrugsarechieflyrelatedtothedistributionofbodyfatandfluidandhormonaldifferences.

3.Cultural,Ethnic,andGeneticFactors

Recentresearchhasindicatedethnicityandculturemaycontributetodifferencesinresponsestomedications.

4.Diet

Nutrientscanaffecttheactionofamedication.

5.Environment

Theclient’senvironmentcanaffecttheactionofdrugs,particularlythoseusedtoalterbehaviorandmood.

6.PsychologicFactors

Aclient’sexpectationsaboutwhat

adrugcandocanaffecttheresponse

tothemedication.

7.Illnessanddisease

Illnessanddiseasecanalsoaffecttheactionofdrugs.

8.TimeofAdministration

Thetimeofadministrationoforalmedicationsaffectstherelativespeedwithwhichtheyact.

ROUTESOFADMINISTRATION

Pharmaceuticalpreparationsaregenerallydesignedforoneortwospecificroutesofadministration.Therouteofadministrationshouldbeindicatedwhenthedrugisordered.Whenadministeringadrug,thenurseshouldensurethatthepharmaceuticalpreparationisappropriatefortheroutespecified.

1.Oral

Oraladministrationisthemostcommon,leastexpensive,andmostconvenientrouteformostclients.Inoraladministration,thedrugisswallowed.Becausetheskinisnotbrokenasitisforaninjection,oraladministrationisalsoasafemethod.

Themajordisadvantagesarepossiblyunpleasanttasteofthedrugs,irritationofthegastricmucosa,irregularabsorptionfromthegastrointestinaltract,slowabsorption,andinsomecases,harmtotheclient’steeth.

2.Sublingual

Insublingualadministrationadrugisplacedunderthetongue,whereitdissolves(Figure33-2).Inarelativelyshorttime,thedrugislargelyabsorbedintothebloodvesselsontheundersideofthetongue.Themedicationshouldnotbeswallowed.Nitroglycerinisoneexampleofadrugcommonlygiveninthismanner.

3.Buccal

Buccalmeans“pertainingtothecheek.”Inbuccaladministration,amedication(eg,atablet)isheldinthemouthagainstthemucousmembranesofthecheekuntilthedrugdissolves(Figure33-3).Thedrugmayactlocallyonthemucousmembranesofthemouthorsystemicallywhenitisswallowedinthesaliva.

4.Parenteral

Parenteraladministrationisadministrationotherthanthroughthealimentarytract;thatis,byneedle.Thefollowingaresomeofthemorecommonroutesforparenteraladministration:

·Subcutaneous(hypodermic):intothesubcutaneoustissue,justbelowtheskin

·Intramuscular:intoamuscle

·Intradermal:undertheepidermis(intothedermis)

·Intravenous:intoavein

5.Topical

Topicalapplicationsarethoseappliedtoacircumscribedsurfaceareaofthebody.Theyaffectonlytheareatowhichtheyareapplied.Topicalapplicationsincludethefollowing:?Dermatologicpreparations:appliedtotheskin

?Instillationsandirrigations:appliedintobodycavitiesororifices,suchastheurinarybladder,eyes,ears,nose,rectum,orvagina

?Inhalations:administeredintotherespiratorytractbyanebulizerorpositivepressurebreathingapparatus.Air,oxygen,andvaporaregenerallyusedtocarrythedrugintothelungs.SeeChapter47.EssentialPartsofaDrugOrder

?Fullnameoftheclient

?Dateandtimetheorderiswritten

?Nameofthedrugtobeadministered

?Dosageofthedrug

?Routeofadministration

?Frequencyofadministration

?Signatureofthepersonwritingtheorder

ADMINISTERING

MEDICATIONSSAFELY

Thenurseshouldalwaysassessaclient’shealthstatusandobtainamedicationhistorypriortogivinganymedication.?Themedicationhistoryincludesinformationaboutthedrugstheclientistakingcurrentlyorhastakenrecently.

?Animportantpartofthehistoryisclients’knowledgeoftheirdrugallergies.

?Alsoincludedinthehistoryaretheclient’snormaleatinghabits.

?Anyproblemstheclientmayhaveinself-administeringamedicationmustalsobeidentified.Clinicalguidelinesforadministering

medications

1.Nurseswhoadministermedicationsareresponsiblefortheirownactions.Questionanyorderthatyouconsiderincorrect.

2.Beknowledgeableaboutmedicationsyouadminister.

3.Federallawsgoverntheusesofnarcoticsandbarbiturates.Keepthesemedicationsinalockedplace.4.Useonlymedicationsthatareinaclearlylabeledplace.

5.Donotuseliquidmedicationsthatarecloudyorhavechangedcolor.

6.Beforeadministeringamedication,identifytheclientcorrectlyusingtheappropriatemeansofidentification,suchascheckingtheidentificationbraceletoraskingclientstostatetheirnameorboth.7.Donotleavemedicationsatthebedside,withcertainexceptions(eg,nitroglycerin,coughsyrup).Determineagencypolicy.

8.Ifaclientvomitsaftertakinganoralmedication,reportthistothenurseinchargeorthephysicianorboth.

9.Takespecialprecautionswhenadministeringcertainmedications,forexample,haveanothernursecheckthedosagesofanticoagulant,insulin,andcertainIVpreparation.10.Mosthospitalpoliciesrequirenewordersfromthephysicianfortheclient’spostsurgerycare.

11.Whenamedicationisomittedforanyreason,recordthefacttogetherwiththereason.

12.Whenamedicationerrorismade,reportitimmediatelytothenurseinchargeorthephysicianorboth.ProcessofAdministeringMedications

1.Identifytheclient.

2.Informtheclient.

3.Administerthedrug.

4.Provideadjunctiv