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ORAL MEDICATION
INTRODUCTION:
 The safe and accurate administration of medicine is the nurses most important and prime responsibility.
 Drugs are primary means of therapy for the clients with health problems
MEDICINE:
 A substance that is used in treating disease or reliving pain and that is usually in the form of pill or a
liquid.
CLASSIFICATION OF DRUGS A/C THEIR ACTION:
 Analgesics
 Anaesthetics
 Antipyretics
 Anti inflammatory
 Antibiotics
 Anti-pruritics
 Aseptic
 Antifungal
 Anti- diarrhoeal
 Anti-emetics
 Anti- tubercular
 Coagulants
Common forms of drug preparation:
 Aqueous solution
 Capsule
 Lotion
 Ointment, paste, powder, syrup, water
 Tablet
TYPES OF ORDER:
 Standing order
 PRN order
 On time order or single order(OD)
 Stat order (STAT)
 Telephone verbal order
DOSAGE:
 A drug is the amount of drug administration at one time
 Maximum dose
 Minimum dose
 Lethal dose
 The minimum dose is the smallest quantity of drug that will produce an effect in body.
 The maximum dose is the largest quantity can be administer at once time without producing harm to
the body
 Lethal dose is larger than the maximum dose which will have poisonous effect bon the client (death of
patient)
FACTORS WHICH MODIFY DOSAGE OF DRUG:
  Age
 Weight
 Sex
 Physical condition
 Tolerance
 Route of administration
 Addiction
ROUTES OF ADMINISTRATION THROUGH MOUTH:
 Oral medication
 Sublingual administration
 Buccal administration
ORAL MEDICATION:
Administration of medication through mouth for prophylactic and therapeutic effect.
Purpose:
 To promote health
 To prevent illness
 To help in diagnosis
 To alleviate illness.
 To help in diagnosis
 To alleviate illness
 Therapeutic purpose

Indication:
 Who is not having any swallowing problems.
 Conscious person
 Who is not undergone for any oral surgery
Contraindication:
 Alteration in normal function of GI tract like vomiting.
 Reduce GI motility
 Surgical resection of portion of GI tract
 Inability to swallow
 Patient with gastric suction/ aspiration
 Prior to certain tests/ surgery
 Unconscious/ confused patients
 Patient with gag reflex
 Oral cancer
 Before diagnostic tests operation
Principles:
 Right patient
 Right medication
 Right dose
 Right time
 Right route
  Right education
 Right documentation
 Right to refuse
 Right to assessment
 Right evaluation
General instruction:
 Before administration
 Identification of patient
 Check label of container shake well before use
 Check for any change in colour
After administration:
 Record only medicine which have administered.
 Record date ,time, name, dose
 Never record medicine before it is given
PROCEDURE:
 Wash hands with soap and water.
 Read physicians prescription and enter it in the medicine card.
 To prevent cross infection
 For giving a correct dose to the patient at right time, for convenient administration by staff students
 Take out the medicine from the staff after reading the medicine card.
 Check the medicine from shelf after reading medicine card
 To check the possibility of pouring a wrong medicine
 To ensure the right and valid medicine.
 Do not touch the medicine with hands.
 Pour the syrup from the side of bottle away from the lable. Do not pour excess amount.
 To prevent contamination
 Prevent spoiling of the label.
 Place the card with medicine on tray.
 To prevent mistake in giving drugs.
 Identify the patient.
 Give proper position( sitting)
 Administration medicine
 To prevent error which may occur.
 For easy administration and absorption
 Stay with patient until he has swallowed medicine.
 Provide water for drinking after medicine.
 Ensure that he has taken medicine.
 Help in swallowing the solids medicine.
Drug calculation formulas:
 Amount to administer
 Desired dose(D)/ dose on hand(H) quantity(Q)
CLARKS RULE
 Child dose
  Adult dose(weight/ 150)
YOUNG S RULE
 Child dose
 Adult dose age/(age 12)
Drug excretion:
 It is the process of removing the drug or its metabolites from the body
 Kidney plays a major role in excretion of drug metabolite.
 Lungs intestine also helps in the drug excretion.
 Damage to the kidney can adversely excretion of drug.
Special consideration:
 Administration of medicine which can not irritate the stomach mucosa with light snacks.
 Administration of medicine with a light snacks.
 Administration of medicine with water.
 Do not administer water after giving cough syrup follow 10 rights.
Side effect:
 Allergic reaction
 Skin rash
 Rhinitis
 Urinary system
 Renal damage
 Anuria
 Oliguria
 Haematuria
 Hypertension
 Constipation
NURSING RESPONSIBILITIES:
 Nurses are responsible for their own action regardless of a written order.
 All the nurses must know the minimum and maximum dose of every medicine that they administer.
 The nurses are responsible for ensuring that they have knowledge to ensure the correct administration
of drugs.
 Medication chart are legal documents.
 Follow 10 right of drug administration
 Nurse should check any drug allergy to the patient.
 Check the form of drug available.
 Assist the patient in sitting position
 Stay with the patient until swallow medicine.
 NEBULIZATION
DEFINITION :
o Nebulizer therapy is to liquefy and remove retained secretions from the respiratory tract. A nebulizer is
device that a stable aerosol of fluid and /or drug particles.
o Most aerosol medication have bronchodilating effects and administered by respiratory therapy
personnel.

PURPOSE:

1. To relieve respiratory insufficiency due to brochospasm.

2. To correct the underlying respiratory disorders responsible for bronchospasm.
3. To liquefy and remove retained thick secretion from the lower respiratory tract.
4. To reduce inflammatory and allergic responses the upper respiratory tract.
5. To correct humidity deficit result from inspired air by passing the airway during the used of mechanical
ventilation in critically and post surgical patients.
6. When a child or young person has an acute asthma attack.
7. When a child or young person is in respiratory distress.
8. When a child or young person has stridor.
9. If child or young person is unable to use an inhaler.

TYPES OF NEBULIZER:
I. Inhaler
II. Jet nebulizer
 III. Ultrasonic nebulizer

FACTORS AFFECTING NEBULIZATION:

 Methods of administration/ method of inhalation.

 Viscosity and other physical characteristics of the liquid aerosolized
 Distribution of inspired gas(degree of airflow obstruction)flow rate of gas

PREPARATION OF ARTICLES:

 Nebulizers
 Pressurized gas source
 Flow meter
 Oxygen tubing
 T- piece mouthpiece or mask or other appropriate gas delivery device.
 Sterile normal saline solution or sterile distilled water
 5ml syringe and water
 Prescribed medication
 Suction equipment
 Sputum mug
 Kidney tray
 Stethoscope
 TPR tray
PREPARING SOLUTION:
It is important to use a minimum of 3ml of solution and preferably 4ml in order to deliver an adequate
percentage of prescribed drug.( in an assessment of jet nebulizer when 2ml was used only 50% of dose was
related as aerosol whereas with volume of 4ml 60-80%)
PREPARATION OF PATIENT:
 Explain the procedure to the patient
 The patient should be in a well supported position.
 Breathe slowly and deeply using the lower chest.
PREPARATION OF ENVIRONMENT:
 The environment should be free from draughts of air.
 The bed should be comfortable.
 Verify the order on the patient’s medication record by checking it against doctor’s order.
 Check the label of medication (expiry date)
 Confirm patient’s identity by asking his name and by checking his name, room number, bed no. ,check
gas flow
 Wash hands before procedure
PROCEDURE:

 Explain procedure to patient

 Record patient’s vital signs to establishment a baseline.
 Place patient in sitting or high flowers position to facility lung expansion an aerosol dispersion.
 Attach free end of the oxygen tubing to pressurized gas sources
 Turn on the gas source and check outflow port, usually a setting of 5-6 liters/min is adequate.
 Instruct the patient to breath the slowly deeply and evenly through his mouth
 After about three deep breath he should breath gently using his lower chest breathing control) it
encourage to breath deeply throughout the entire treatment the patient suffer from effect of hyper
ventilation.
 It possible ,remain with the patient during treatment( usually 15- 20 minutes)
 Take vital sign to detect adverse reactions to medications.
 Encourage and assist the patient to cough and expectorate.
 Briefly stop the treatment if he needs rest.
 Instruct patient to report warmth discomfort or hot tubing .check water level frequently to prevent
complications from inhaling drug hot air.
COMPLICATIONS OR NEBULIZATION :
INFECTION :
Due to bacterial growth in the container.
PREVENTION:
 Clean the container every time, fill with fresh sterile solution each time. Increased water absorption
can cause over hydration leading to pulmonary edema in patient with decreased cardiac output.
 Ultra fine particulate can acts as irritant to susceptible patients and cause bronchospasms.
 Monitoring vital sign of ascultate chest for wheezes during procedure. Should be used cautiously in
patients with delicate fluid balance and in asthmatic patients with active or potential bronchospasm.
CARE OF PATIENT:
 make sure the patient is c comfortable.
 Provide a sputum mug for spiting the separation.
DOCUMENTATION:
 Record time date and duration of therapy type, amount of medication added to nebulizer.
 Baseline and subsequent vital sign and +breath sounds.
 Result of therapy such as loosened secretions
 Any complications and nursing action taken.
 Patient’s tolerance of the treatment
 Continuously watch changes.