medicatio

n
WHAT IS MEAN
MEDICATION?
 PURPOSES
To diagnose the disease.
To treat/cure the disease.
 Drugs used to cure specific disease.
 Drugs used to supply a substance which is
deficient in the body.
 Drugs used to help restore normal function.
 Drugs which is given for palliative effect.
To prevent the disease.
PRINCIPLES
OF
MEDICATION
1.Name of the drug(drug
nomenclature)
CHEMICAL NAME
GENERIC NAME
OFFICIAL NAME
TRADE NAME
 CHEMICAL NAME
• It is the name by which a drug
known to the chemist, usually it
indicate the ingredients of the
drug.
• EX: ibuprofen 2-4 (iso butyl
phenyl) propionic acid.
 GENERIC NAME
• It is the name assigned by the
manufacturer that first develops
the drugs. Each drug has only
one generic name, which is
simple than chemical name.
• EX: Morphine sulphate.
 OFFICIAL NAME
• It is the name by which the drug
is identified in the official
publications.
• This name assigned by the FDA
after approval of a drug & is
often the same as the generic
name.
 TRADE NAME
• It is the registered name
assigned by the manufacturer &
is copy righted [marked with
circled R] R C
• EX: Paracetamol (Chemical
Name)
Trade Name - Crocin,
Calpol, Ifimol, Metacin.
DRUG TYPES
&
FORMS
 1.CAPSULE
Powder or gel form of drug encased in
a hard or soft outer casing that
dissolves in the stomach.
 2.ELIXIR
Medication in a clear liquid
containing water, alcohol, sweetness
& flavor.
 3.ENTRIC COATED
Tablet coated with a substance that
blocks absorption of drug, until it
reaches the small intestine, to
prevent stomach irritation.
 4.LINIMENT
Medication mixed with alcohol, oil or
soap which is rubbed on the skin.
 5.LOTION
Drugs in liquid suspension
intended for external use.
 6.LOZENGE
Small oval, round or oblong preparation
containing a drug in a flavored or
sweetened base, which dissolved in a
mouth & release the medication. This
helps to relieve the tickling sensation at
the back of the throat & stops a cough.
 7.OINTMENT
Semisolid preparation containing a
drug to be applied externally.
 8.PILL
Mixture of a powdered drug with
cohesive material, may be round or
oval.
 9.POWDER
Single or mixture of finely ground
drugs.
 10.SOLUTION
Liquid preparation containing one or
more substances completely
dissolved in a solvent OR A drug
dissolved in a another solution.
 11.SUPPOSITORY
An easily melted medication
preparation in a firm base such as
gelatin that is inserted into the
body(Rectum, Vagina, Urethra).
 12.SUSPENSION
Undissolved particles or powder
placed in a liquid that must be
shaken vigorously before use.
 13.SYRUP
Medication combined in a water &
sugar solution.
 14.TABLET
Solid drug that is compressed or
molded into a particular shape, may
be any color, size & shape.
 15.TRANSDERMAL PATCH
Medication contained within semi
permeable membrane, patch which
allows medication to be absorbed
through skin slowly over long
periods.
 Drug
classifications
 1.ANALGESIC.
2.ANAESTHETIC
3.ANTEHELMINTICS
4.ANTIPYRETICS
5.ANTIDOTE
6.ANTI-INFLAMMATORY
7.ANTICOAGULANT
8.ANTI-HISTAMINE
9.ANTACIDS
10.ANTICONVULSANTS
 11.ANTIBIOTICS
12.ANTI-DIARRHOEALS
13.ANTISEPTIC
14.ANTI-FUNGAL
15.ANTISPASMODIC
16.ANTIEMETIC
17.BRONCHODILATOR
18.COAGULANT
19.CORTICO-STERIODS
20.DIURETICS
 21.DIGESTANT
22.EXPECTORANT
23.ANTIHYPERTENSIVE
24.ANTIDIABETIC
25.MUSCLE RELAXANT
26.NASAL DECONGESTANT
27.NARCOTICS
28.SEDATIVES
29.VASODILATORS
 SOURCES
OF
INFORMATION ABOUT
MEDICATION
1.PRINTED MATERIALS
2.PEOPLE
3.COMPUTER BASED
RESOURCES
 PRINCIPLES
OR
MECHANISM OF
DRUG ACTION
PHARMACOKINETICS
 DEFINITION
It is effect of the body on the drug. It
is the movement of drug molecules in
the body in relation to the,
1.Drug’s Action
2.Distribution
3.Metabolism
4.Excretion
 1.ABSORPTION
It is the process by which a drug is
transferred from its site of entry into the
body, to the bloodstream.
It is influenced by many factors,
Route of administration
Lipid solubility
PH
Blood flow
Site of administration
Drug dosage
 2.DISTRIBUTION

It depends on blood flow to the tissues,

the drug’s ability to leave the blood
stream and drug’s ability to enter the
cells.
Circulation
Membrane permeability
Protein binding
 3.METABOLISM

Metabolism or Biotransformation is the

change of a drug form its original
form to new form. The liver is the
primary site for drug metabolism.
 4.EXCRETION

Excretion is the process of removing a

drug from the body. The kidneys
excrete most drugs.
PHARMACODYNA
MICS
 PHARMACODYNAMICS

It refers to the physiological and

biochemical effects of a drug on the
body.
Effects of drugs
on the body
 EFFECTS
Therapeutic Effect
Side Effect
Adverse Effect
Allergic Reaction (Allergic Effect)
Toxic Effect
Idiosyncratic Effect
 FACTORS
INFLUENCING
DRUG ACTION
 FACTORS
Developmental considerations
Weight
Cultural & genetic factors
Gender
Psychological factor
Pathology
Environment
Timing of administration.
 1.Development
al
considerations
Consider the developmental age while
administering the drug.
Child
Old age
Pregnancy period.
 2.weight
Expected responses to drugs are based
largely on the reactions that occur
when the drugs are given to healthy
adults.
 3.Cultural &
genetic factors
Religious restrictions, beliefs or cultural
practices may affect patient acceptance to
drug therapies.
EX: Christian scientist having faith in
spiritual healing.
ETHNOPHARMACOLOGY: It is the study of
the effect of ethnicity on responses to
prescribed medication, especially drug
absorption, metabolism, distribution &
excretion.
 Cont….
PHARMACOGENETICS: It is the study
of genetic variations in responses to
drugs.
Differences in the responses of
patients receiving the same drug may
result from genetic differences.
EX: Lithium usual dose cause toxicity
in Japanese, Taiwanese, African
American.
 4.Gender
The difference in the distribution
of body fat & fluids in men and
women is a minor factor
affecting the action of some
drugs.
 5.Pychological
factor
The patient expectations of the
medication may affect the response
to the medication.
PLACEBO: It is a pharmacologically
inactive drug.
 6.Pathology
The presence of disease can affect
drug action.
EX: Liver diseases affect
metabolism.
Kidney diseases affect
excretion.
7.Environme
nt
The patient environment may
influence their responses to drug.
Sensory perception & overload may
affect drug responses.
Nutritional state can also affect
body’s reaction to drug.
 8.Timing of
administration
The presence of food in stomach can
delay the absorption of oral drug.
So, consider the timing while giving
drug.
Drug interactions
 MEANING
Medication interaction mean when one
medication modifies the action of
another medication.
Interaction can result in 2 way,
1.synergistic effect.
2.antagonist effect.
 Proper
medication
order
 COMPONENTS
Client’s name
Identification or medical number
Medication’s name
Amount & dosage
Routes of administration
Signature of the health care provider
Date & time of the prescription
Use of abbreviations
TYPES OF ORDER
 types
Standing order
PRN order
One time order or single order
Stat order
Telephone, verbal & fax order
Medication
supply
system
 SYSTEM
Stock supply
Unit dose
Computerized automated dispensing
system
Medication cart
Bar code enabled medication
administration(BCMA)
SAM system
1.STOCK SUPPLY
2.Unit dose
3.Computerizes automated
dispensing system
4.Medication cart
 5.Bar code enabled
medication administration
Abbreviations
used
regarding
time of
administratio
ABBREVIAT DERIVATIO MEANING
ON N
a.c Ante cibum Before meals
p.c Post cibum After meals
a.m Ante Before noon
meridiem
p.m Post After noon
meridiem
alt.die Alternis Alternate days
diebus
o.m Omni mane Each morning
o.d Omni die Daily(once a day)
o.n Omni note Each night
ABBREVIATI DERIVATIO MEANING
ON N
c.m Cras mane Tomorrow morning
p.r.n Pro re nata When required
s.o.s Si opus sit If necessary in emergency
b.d (b.i.d) Bis in die Twice a ay
t.i.d (t.d.s) Ter in the die Three times a day
q.i.d Quater in die Four times a day
stat statim At once
Rep. repatatur Repeat
h hora hour
q quaque every
Abbreviations
used
regarding
preparation of
the drug
abbreviation derivation meaning
Aq. aqua Water
Aq.dest Aqua destillata Distilled water
comp compositum Compound
dil dilutis Dilute
et Et. And
fl Fludium Fluid
inf Infusum Infusion
Empl Emplastrum Plaster
lin Linementum Liniment
liq Liquer Liquid
abbreviation derivation meaning
lot Lotio Lotion
mist Mistura Mixture
ol Oleum Oil
pil Pilula Pill
pulv Pulvis Powder
sp Spiritus Spirit
syr Syrupus Syrup
Tr (Tinct.) Tinctura Tincture
ung Unguentum Ointment
inj Injectio Injection
Abbreviations
used
regarding the
amounts
abbreviation meaning
aa Of each
ad Up to
c with
cc Cubic centimeter
gr Grain
gtt A drop
m Minim
kg Kilogram
O A pint
mg or mgm Miligram
Rx Take thou
abbreviation meaning
dist Distilled
qt Quart
R or RR Per rectum
tab Tablet
tbsp, T Tablespoon
MEq Milliequivalent
dd lib As much as desired
Ss, fs half
cm centimetre
g, gm Gram
garg Gargle
abbreviation meaning
L Litre
gal Gallon
tsp Teaspoonful
dr Dram
D/C, dc Discontinue
DS Double strength
qs As much as needed sufficient
quantity
Sol or soln Solution
mcg, ug Microgram
tsp, t Teaspoon
no Number
Abbreviations
used
regarding the
route
ABBREVIATION MEANING
AD Right ear
AS Left ear
AU Each ear
H Hypodermic
IM Intramuscular
INJ Injection
IV Intravenous
IVP Intravenous push
Rx Take, prescription
OD Right eye
abbreviation meaning
sc Subcutaneously
SQ subcutaneous
OS Left eye
OU Both eyes
p or P After, per
Per os, PO By both
EC Enteric coated
elix Elixer
ext External, extract
os Mouth
Abbreviations
used for
hours of
administratio
abbreviation meaning
Q4H Every 4 houes
Q6H Every 6 hours
TDS Thrice a day( 3 doses)
BD Twice a day( 2 doses)
OD Once a day( 1 dose)
HS At bed time
Q8H Every 8 hours( 3 doses)
Q12H Every 12 hours( 2 doses)
alt h Alternate hours
qh Every hour
d Day
 ROUTES OF
ADMINISTRATION
 ROUTES
1.ORAL ROUTE
2.PARENTERAL ROUTE
3.TOPICAL ROUTE
4.INHALATION ROUTE
5.INTRAOCULAR ROUTE
 ORAL ROUTE
It is more common route and most
convenient route for all the patient.
Medications are given by mouth and
swallowed with fluid.
Oral medications have a slower onset of
action & prolonged effect than parenteral
route.
Main disadvantage is unpleasant taste &
irritate the gastric mucosa.
It may administered by many way.
 1.SUBLINGUAL
Placing the medication under the tongue
to dissolve.
Patient should not take a drink until the
medication is completely dissolved.
 2.BUCCAL
placing the solid medication in the mouth
against the mucous membranes of the
cheek until the medication dissolves.
 PARENTERAL
ADMINISTRATION
Parenteral means giving of
therapeutic agents outside the
alimentary tract.( para-beside,
enterone-intestine).
It involves injecting a medication
into body tissues.
 TYPES
Intradermal(ID): Injection into the
dermis just under the epidermis.
Subcutaneous(Sc): Injection into the
tissues just below the dermis of the
skin.
Intramuscular(IM): Injection into a
muscle.
Intravenous(IV): Injection into a vein.
PARENTERAL ROUTE
 ADVANCED
TECHNIQUES
Epidural
Intrathecal
Intraosseous
Intraperitoneal
Intrapleural
intraarterial
 1.Epidural
Medications are administered in the
epidural space via a catheter.
This is mainly for the administration of
analgesia post-operatively.
 2.Intrathecal
Medications are administered
through a catheter that has been
placed into the subarachnoid
space or into one of the
ventricles of the brain.
 3.INTRAOSSEOUS

In this,medication infused directly

into the bone marrow.
It is most commonly used in infants
& toddlers who have poor access to
their intravascular space.
This method is most popular when an
emergency arises & IV access is
impossible.
 4.INTRAPERITONEAL
Medications are administered into
the peritoneal cavity.
One method of dialysis uses the
peritoneal route for the removal of
fluid, electrolytes & waste products.
 5.INTRAPLEURAL
Medications are administered
through the chest wall & directly
into the pleural space.
This may be done through an
injection or through a chest tube.
 6.INTRAARTERIAL
Medications are administered directly
into the arteries.It is very common in
who have arterial clots.
 OTHER METHODS
Intracardiac: medication directly
administered into the cardiac tissue.
Intraarticular: medication directly
administered into the joints.
TOPICAL ROUTE ( INUNCTION)
Inunction is the application of the drug to the
skin usually by a friction. e.g: ointment.
Medications can be applied to the skin in a
variety of ways,
Insertion
Instillation
Irrigation
Spraying
Insufflation
 1.INSERTION
Introducing solid forms of
drugs into the body orifices,
e.g: placing a suppository in
rectum.
 2.INSTILLATION
Instillation is putting a drug in
liquid form into the body cavity(fluid
is retained).E.g: ear drops, nose
drops.
 3.IRRIGATION
Washing out of a cavity or wound with
a stream of lotion or water.
 4.INSUFFLATION
It is the administration of drugs in the
form of powder, vapour or air into a
wound or body cavity by blowing
with an insufflator.
 5.SPRAYING
Spray the gas form drug to the skin.
 INHALATION ROUTE
Medications can be administered
through the nasal passages, oral
passages or endotracheal or
tracheostomy tubes.
Medications are administered by the
inhalation route are readily absorbed
& work rapidly because of rich
vascular alveolar capillary network
present in the pulmonary tissue.
 INTRAOCULAR ROUTE
Inserting a medication similar to a contact
lens into the client’s eye.
The medication disk have a two soft layer
that have medication enclosed in them.
The disk inserted to the client’s eye for up
to 1 week.
Pilocarpine, a medication used to treat
glaucoma, is the most common medication
disk.
Principles of drug
administration
(5 Rights)
 5 RIGHTS
Right Medication
Right Dose
Right Patient
Right Route
Right Time
Right Documentation
 Special
Considerations
 Consideration
A client’s developmental level is a
factor in the way nurses administer
medications. Knowledge of a client’s
developmental needs helps the nurse
to anticipate responses to medication
therapy.
Infants & children
Older adults
Safe administration
Medication error
 Storage
&
Maintenance Of
Drug
 Storage devices
ILR
Deep freezer
Ice pack
Daily carrier
Systems of drug
measurement
 SYSTEMS
Metric system
Apothecary system
Household system
Solutions
 DOSAGE
CALCULATIONS
 Formula
Drug dose in ml = D/A x Q
D – Desirable dose
A – Available dose
Q – Quantity of the drug
dose on hand = dose desired
quantity on hand X(quantity desired)
 DROPS
CALCULATIONS
 Formula
drops per minute = volume to be infused x dropfactor
( drops/mt) Time in minutes

DROP FACTOR = 15 - macro iv set

60 – micro iv set
PEDIATRIC DOSE
CALCULATIONS
 Formula
Young’s Formula = Age x adult dose
Age+12

Dilling’s Formula = Age x Adult dose

20

Clark’s Formula = Wt in pounds x Adult dose

150
( 1 Kg = 2.2 Pounds)
ORAL DRUG ADMINISTRATION

Oral
Sublingual
Buccal
PARENTERAL DRUG
ADMINISTRATION
SYRINGE
PARTS OF THE SYRINGE
 TYPES OF SYRINGE

Hypodermic syringe
Insulin syringe
Tuberculin syringe
 1.Hypodermic syringe
Two scales are marked, ie minim &
milliliter.
3-5ml sizes are available.
The milliliter scale is the one
normally used, minim scale is used
for small dosages.
10,20,50ml syringes not used
directly, can use for mixing.
 2.Insulin syringe
It is similar to hypodermic
syringe, but scale is specially
designed for insulin.
This is only syringe that should
be used administration of
insulin.
 3.Tuberculin syringe
It is designed to administration
of tuberculin solution.
It is narrow syringe, calibrated
in tenths & hundredths of a
mililitre(upto 1ml).
 OTHER TYPES

The tip of a syringe varies and it

is classified,
1.Luer Lok
2.Non Luer Lok
 1.Luer Lok
It has a tip that requires the
needle to be twisted onto it to
avoid accidental removal of the
needle.
 2.Non Luer Lok
It has a smooth graduated tip and
needles are slipped onto it. The
larger 50ml Non Luer Lok
syringe is often used for
irrigation purposes.
 NEEDLE
Needles are made of stainless
steel and most are disposable. A
dull or damaged needle should
never be used.
PARTS OF THE NEEDLE
 CHARACTERISTIC OF THE
NEEDLE

1. Slant or Length of the bevel

2. Length of the shaft
3. Gauge of the shaft(diameter)
1.Slant or length of
the bevel
Longer bevels provide the sharpest
needles & cause less discomfort.
This is used for Sc, IM injections.
Short bevels are used for ID,IV
because a long bevel can become
occluded if it rests against the side
of a blood vessel.
 2.Length of the
shaft
Needle length is chosen according
to client muscle development ,
weight, type of injection.
Commonly used varies from ½ - 2
inches.
 3.Gauge of the shaft
(diameter)
Gauge varies from 18-30 gauge gauge.
Larger gauge - smaller diameter shaft.
Smaller gauge – larger in diameter
( less tissue damage).
 ROUTES OF SIZE OF THE SIZE OF THE
ADMINISTRATION SYRINGE NEEDLE
ID 1ml syringe in 26-27
0.01ml units. 3/8 – 5/8 inch
(Tuberculin length
syringe)
SC Insulin syringe 25 gauge
(1ml) ½ - 5/8 inch
Or
2,3ml syringe in
0.1ml
IM 2,5ml syringe in 21,22,23 gauge
0.2ml 1-2 inch length
IV Size depends 18-21 gauge
upon the fluids
 Routes
of
parenteral
administration
INTRAMUSCULAR
INJECTION
INTRAMUSCULAR INJECTION

Major considerations of IM is selection of

safe site located away from large blood
vessels, nerves and bones.
An adult with well developed muscles can
usually safely tolerate upto 3ml of
medication for gluteal.
Use 3-5ml syringe and use 1 ½ inches with
21 or 22 gauge needle. Angle: 90
 IM site
Deloid
Dorso Gluteal
Ventro Gluteal
Vastus Lateralis
1.Deltoid
Landmark: The deltoid muscle is located in
the lateral aspect of the upper arm.Locate
four fingers on deltoid muscle (palpate
lower edge of acromion process) form a
triangle, injection site is in the centre of
the triangle or about 3-5cm below the
acromion process(1-2 inches).
It is not used often for IM injection because
it is relatively small muscle & is very close
to radial, brachial, ulnar nerves &
brachial artery.
 Cont….
It is easily accessible but the muscle is not
well developed in many adults.
The deltoid area is used to inject very small
quantities of non-irritating drugs.
It is sometimes considered for use in
adults, because of rapid absorption, but no
more than 1ml of solution.
This site can use for HepB vaccine in
adults.
The deltoid muscle is not developed enough
in infants to absorb medication adequately.
2.Dorsogluteal
Landmark: Identify the greater
trochanter of the femur & the
posterior superior iliac spine. Draw
an imaginary line between these two
bony landmarks. Site will be the
upper & outer quadrant or divide the
buttocks into the 4 regions by
imaginary line.
This site is not mostly used for IM
injections.
3.Ventrogluteal
Landmark: place palm of the hand over
the greater trochanter. Place the index
finger on the anterior superior iliac spine
and extend the middle finger dorsally,
palpating iliac crest. The “V” shaped
formed by this two fingers, in center we
can give injection.
The right hand used for patient’s left hip,
the left hand used for patient’s right hip.
It is the safest site for older than 7 month
clients.
The ventrogluteal site involves the gluteal
medius & gluteal minimus muscles in the
hip area.
This site offers a large muscle mass that is
relativly free from major nerves and blood
vessels.This is preferred site for IM
injection.
Position – back, prone or side lying
position.
Suitable is side lying position with knee
bent slightly raised toward the chest.
4.Vastus Lateralis
The vastus lateralis muscle is thick
& well developed, is located on the
anterior lateral aspect of the thigh.
It is suitable for infants & children
because there are no major blood
vessels & nerves in the area, rapid
drug absorption, gluteal muscles are
poorly developed.
The middle third of the muscle is the
suggested site.
Landmark: It is located on the
lateral aspect of the thigh. It is the
area between mid anterior thigh and
mid lateral thigh, one hand’s
breadth from below the greater
trochanter to one hand’s breadth
above knee.
Position- Back lying or sitting
position.
Angle of the Needle
INTRAMUSCULAR
INJECTION
TECHNIQUE
 Z-track technique
Pull the skin down or to one side about
1inch (2.5cm) & hold in this position with
nondominant hand.
Insert the needle & inject the medication
slowly.
Withdraw the needle steadily & release the
displaced tissue to allow it to return to its
normal position.
Don’t massage the site because it may
cause irritation.
 Cont…
This technique reduces pain and
discomfort.
This is the best technique for giving IM
injection.
New needle should be used.
Z-track
SUBCUTANEOUS
INJECTION
SUBCUTANEOUS INJECTION
SITE
Outer aspect of the upper arm
Abdomen(just below the costal
margin of the iliac crest)
Anterior aspect of the thigh
Upper back(scapular area of the
upper back)
Upper ventral or dorsogluteal area.
 Criteria for the
injection site
Any site is acceptable if it meets the
following criteria:
The skin & underlying tissues are
free of abnormalities.
Not over bony prominences.
Free of large blood vessels and
nerves.
Injection
technique
Avoid sites that are bruised, tender, hard,
swollen, inflamed or scarred.
The best & convenient site is abdomen
because it absorbs the medication most
rapidly than other site.
Choose the needle sizes based on the
amount of subcutaneous tissue present,
which is based on the patient’s body
weight and build.
25 – 30 gauge, 3/8 to 1 inch needle can be
used.
Best Method
 Cont…..
The 3/8 inch and 5/8 inch needles are
commonly used.
Only small doses of medication can
use(0.5ml – 1ml).
Sc injections are administered in 45 to 90
angle.
Choose the angle of the needle insertion
based on the amount of subcutaneous
tissue present.
Insulin syringe
Injection Angle
 Cont…
Generally, shorter, 3/8 inch needle should be
inserted at a 90 degree angle and longer, 5/8
inch needle is inserted at a 45 degree angle.
Pinch the muscle for administration of
injection.
If pinching is used, once the needle is
inserted, release the skin to avoid injecting
into compressed tissue.
Aspiration is contraindicated with
administration of heparin because it cause
hematoma formation.
Shorter & Longer Needle
Two Different Angle
Injection technique
 Cont….
Apply gentle pressure to the injecting site,
avoid massaging the site because it cause
underlying tissue damage.
Rotate the site if the patient is to receive
frequent injections. It helps to prevent the
fibrous tissue formation(Lipoatrophy &
Lipohypertrophy).
Use insulin syringe for insulin injection.
select shorter & thinner needle because
they are less painful.
Lipoatrophy & lipohypertrophy
INTRADERMAL
INJECTION
 ID INJECTION
It is the administration of a drug into
the dermal layer of the skin just
beneath the epidermis.
Intradermal injection
 Injection site
Inner aspect of the lower arm
Upper aspect of the anterior
chest
Upper aspect of the posterior
chest.
Criteria for the injection
site
Where the skin is healthy.
Free of any irritation, swelling,
edema and discoloration.
Where the clothing will not irritate
the skin.
 INJECTION TECHNIQUE
Intradermal injections are used for
sensitivity tests, such as tuberculin test,
allergy test and local anesthesia because
it has the longest absorption time of all
the parenteral routes.
Use tuberculin syringe caliberated in
tenths and hundredths of a milliliter.
A ¼ to ½ inch, 26 or 27 gauge needle is
used.
Tuberculin syringe
 Cont….
The dosage given intradermally is small,
usually less than 0.5ml.
Angle-5 to 15 degree.
Bevel of the needle is pointed up while
inserting the needle.
While injecting, notice that small bleb
resembling approximately 6mm in
diameter(resembling mosquito bite)
Apply gentle pressure, do not massage.
Induration
 Special
Considerations
If tuberculin test is done (with p.p.d) ask the client
to report after 48 hours.
If a test dose is given for penicillin injection,
observe the area for reactionary changes after 20
min to 1 hour.
The area will be reddened, the wheel will be
increased in case of reactionary changes.
Any client develops unusual symptoms like itching,
increased pulse rate, respiration rate, giddiness,
vomiting, wheezing, cyanosis etc.., should be
treated immediately.
Give antihistamines as early as possible.
INTRAVENOUS
ROUTE
 INTRAVENOUS
Intravenous administration of medication
delivers the drug directly to the blood
stream. Medications administered
intravenously have an immediate effect.
The intravenous route is the most
dangerous route of administration because
the drug is placed directly into the
bloodstream, it cannot be recalled, and its
actions cannot be slowed.
 VENIPUCTURE
A venipuncture is a technique in which
a vein is punctured transcutaneously
by a sharp rigid stylet partially
covered by a plastic catheter or by a
needle attached to a syringe.
 Purposes
To collect a blood specimen
Instill a medication
Start an iv infusion
Inject a radio-opaque tracer for
special examination
 Criteria for vein
selection
The condition of veins(collapsed or too small)
The characteristics of tissues over the vein
(edematous, injured, diseased, inflamed, etc)
Purpose & duration of infusions
The type & the amount of iv fluid ordered
The diagnosis & the general conditions of the
patient
Age of the client(very young & old patients have
fragile veins)
Mobility of the limb: avoid sites that are easily
moved or bumped such as the the dorsal surface
of the hand
Contraindication
s
Site has signs of infection,infiltration
& thrombosis
A surgically compromised extremity
An AV fistula in the extremity.
EQUIPMENTS
syringe
IV Cannula
Common Types
Parts of the
cannula
 INTRAVENOUS SITES
Veins in the forearm (cephalic & basilic
vein)
Veins in the Antecubital fossa (median
cubital, cephalic and basilic vein)
Veins in the radial area(radial vein)
Veins in the hand (dorsal metacarpal veins)
Veins in the foot
Veins in the thigh (femoral and saphenous
veins)
Veins in the scalp (for infants)
Inner Arm Veins
Dorsal Surface of the Hand
Dorsal Surface of the Foot
IV Sites in Infants & Children
IV Site -Scalp vein
How to insert
needle?
Insertion needle
Angle
Venflon Insertion
Technique
Technique
Step-1
Step-2
Step-3
Step-4
Step-5
Step-6
Step-7
Step-8
Step-9
Step-10
Step-11
Step-12
 Intravenous therapy
1. Intravenous infusion
2. Intravenous bolus or push
3. Intermittent intravenous
infusion
EQUIPMENTS
Iv infusion set
Parts of the
infusion set
Intravenous fluids
Infusion pump
Syringe pump
Intravenous
infusion
 Intravenous Infusion
The introduction of a large amount
of fluid into body via veins is
termed as IV infusions.
 Purpose
To restore the fluid volume that is lost from the
body due to hemorrhage, vomiting, diarrhea,
drainage etc.
To meet the patient’s basic requirements for
calories, water, minerals and vitamins.
To prevent and treat shock and collapse.
To supply the body with adequate amounts of
fluids, electrolytes and other nutrients when the
patient is unable to take in adequate amounts by
mouth or oral intake is contraindicated.
To administer medicines.
 Indications
To save the patient in life threatening situations
e.g. patients having hemorrhage, shock, burns etc.
To supply fluids and nutrients to the patient who
may have nothing by mouth.
To supply fluids and nutrients to the patients who
are unable to digest o absorb a diet administered
by mouth.
To dilute toxins in case of toxemia or septicemia.
To administer medications which are destroyed by
the gastric juices or which will not be absorbed by
the gastro-intestinal tract, if administered orally.
 Intravenous
solutions
Nutrient solutions e.g., dextrose 5%,
10%, 20%, 25%, 50%
Electrolyte solutions ( Isotonic-
310mEq/L, Hypotonic-250mEq/L,
Hypertonic-375mEq/L) e.g., NS, RL.
Alkalinizing and acidifying solutions
e.g, sodium bicarbonate, potassium
chloride.
Blood volume expanders e.g, lomodox
Dextrose solutions
Electrolyte solution
 Alkalinizing &
acidifying solution
Blood volume
expanders
 General Instructions
Follow strict aseptic technique.
IV fluids are administered only with a
clearly written prescription.
Maintain the specific rate of flow to prevent
circulatory overload.
Watch the patient constantly for
unfavorable symptoms and if found any
report them to the doctor or at least to the
senior staff nurse.
The solution used for infusion correspond
to the patient blood osmolarity.
 Cont….
Observe dislodgement of the needle, IV site,
urinary output.
When electrolyte are use (e.g. potassium)
the rate of flow should be very low.
Observe five rights.
Always check the expiry date of the
medicines before use it.
Shake the fluid and look for the suspected
particles.
Make sure the drip set is sterile & is in
good working condition.
 Cont….
Select a proper site for infusion.
If the flow of fluid is slowed or stopped, find
out the cause- spasm of vein, displacement
of the needle, kinking.
Never allow the bottle to get empty
completely to prevent the entry of air into
the tissues.
If IV infusions are to be given immediately
before and after the blood transfusion,
always use physiologic saline(0.9%) to
prevent Hemolysis of the blood cells in the
tubing.
 Cont…
Immobilize the joints with splints
when the needle is placed near a
joint.
Frequent observation of the vital
signs throughout the procedure will
help to detect many complications.
Ask patient to empty the bladder.
How to
start?
1.SPIKING THE SOLUTION
CONTAINER
2.PARTIALLY FILLING THE DRIP
CHAMBER
3.REMOVING AIR FROM
THE TUBE
4.SETTING THE RATE
 Complications
Circulatory overload
Infiltration
Damage to the walls of blood vessels and
hematoma
Thrombophlebitis
Pyrogenic reactions
Air embolism
Allergic reaction
INTRAVENOUS PUSH
OR
BOLUS
 IV Push or Bolus
Administer a single injection of a
concentrated solution directly
into an intravenous line. The
drug is administered very slowly
over at least 1 minute.
Push or Bolus
INTERMITTANT INTRAVENOUS INFUSION
 Intermittent Infusion
The drug is mixed with a small
amount of the intravenous solution,
such as 50 to 100ml, & administered
over a short period at the prescribed
interval (e.g,every 4 hrs).
piggyback delivery system
volume control administration set
syringe pump.
Piggyback delivery system
Working system
Volume control administration
set
Syringe pump
How to load the
medication from
an Ampoule?
1.Tapping ampoule neck
moves fluid down
2.Gauze pad placed around
neck of ampoule
3.Snapping neck away
from hands
 4.Medication
withdrawing technique
How to load the
medication from
a vial?
1.Open the vial
2.Withdrawing air into
the syringe
3.Injecting air into
the vial
4.Withdrawing the
medication
How to mixing
the two drug?
needle stick
injuries
When its
happen?
Incidence
Risk Group
 Prevention
Needle stick injuries present a major risk for
infection with hepatitis-B, HIV & many other
pathogens.
Use appropriate puncture-proof disposal
containers to dispose of uncapped needles &
sharps.
Never throw sharps in buckets. Sharps
include needles, surgical blades, lancets.
Never bend or break needles before disposal.
Never recap the used needle.
Use safety mechanical device.
 Never
Recapping
Washing the
Hands
 Puncture Proof
Disposal Container
Message for all
Role of Nurse