Administering
injections
Introduction:
Parenteral
medications are given through a route other than the alimentary canal,
These routes are
intradermal, subcutaneous, intramuscular, or intravenous.
The angle of
injection and the of penetration will indicate the type of injection.
Principles involved in the administration of injections:
1.
The knowledge of the anatomy
and physiology of the body is essential for the safe administration of the
injection.
a)
to avoid injury to the
underlying tissues
b)
to minimize pain
c)
to aid in absorption of the
drug
2.
If carelessly given,
injection are a means of introducing infection into the body.
3.
Drugs that change the
chemical composition of the blood will endanger the life of the client, if not
given cautiously,
4.
Any unfamiliar situation
produces anxiety
5.
Once a drug is injected, it
is irretrievable. Antidote may be available for particular medications but the
best antidote is prevention.
6.
Organization and planning
results in the economy of time, material and comfort.
General instructions:
·
Give injection only on the
doctor's written orders
·
Follow strict aseptic
techniques
·
Always ensure that the syringes
and needles are in good working condition
·
Change the needle after
withdrawing drug from a rubber capped Vial as the needle become blunt
·
Follow the 10 rights of
medication administration
·
Never use a drug if the expiry
date is over
·
Always have the client relaxed
and placed in a comfortable position
·
Watch the client for some time
after the injection for any reaction
·
Always give a best dose in case
of antibiotics before the first dose is administered to rule out any allergic
reaction
·
Expel any air from the syringe
before injecting the medication
·
Select an appropriate site for
injection
·
Rotate the sites, especially
for clients getting insulin to prevent lipodystrophy ( wasting of subcutaneous
tissue )
·
Use correct technique of
injection
·
After inserting the needle,
always withdraw the piston to make are it is not in a blood vessel. If there is
blood in the syringe, withdraw the needle and give the injection at another
site
·
Solutions for injections should
be clear, sterile, isotonic if possible, non-hemolytic and contain only
substances that are soluble in water when used for IV injections
·
Do not Massage the area at the
site of injection
·
Injection administration should
be charted immediately after it is administered by the person who has given it
along with the signature.
Administering medications by inhalation
Introduction:
Medications
administered by handheld inhalers are dispersed through an aerosol spray, mist
or powder via a metered-dose inhaler or by nebulization so that the medication
is delivered directly to the membranes of the airways. The alveolar-capillary
network absorbs medications rapidly.
Respiratory Inhalation
Medications
administered by inhalation, such as bronchodilators, are frequently given to
clients who have chronic respiratory disease such as asthma, emphysema, or
bronchitis.
A metered-dose
inhaler (MDI) is a handheld nebulizer (HHN) that can be used by clients to self
administer measured doses of an aerosol medication
Metered-dose
inhalers (MDIs) are usually designed to produce local effects such as
bronchodilation.
Clients who have
chronic respiratory disease such as asthma, emphysema or bronchitis often
receive medications by inhalation.
An MDI delivers a
measured dose of medication with each push of a canister.
Spacers are holding
chamber into which the medication is fired and from which the client inhales,
so that the dose is not lost by exhalation.
Using a Metered-Dose Inhaler:
·
Ensure that the canister is firmly
and fully inserted into the inhaler,
·
Remove the mouthpiece cap.
Holding the inhaler upright, shake the inhaler vigorously for 3 to 5 seconds to
mix the medication evenly.
·
Exhale comfortably (as in a normal
full breath).
·
Hold the canister upside down.
a)
Hold the MDI 2 to 4 cm (l to 2
in.) from the open mouth.
Or
b)
Put the mouthpiece far enough
into the mouth with its opening toward the such that the lips can tightly close
around the mouthpiece
An MDI with a
spacer or extender is always placed in the mouth, This method should not be
used for steroid medications via an MDI because it is not considered as
efficient in delivery or the medication. (Bower, 2005).
ADMNISTERING THE MEDICATION
Press down once on
the MDI canister (which releases the dose) and inhale slowly (for 3 to 5
seconds) and deeply the mouth.
Hold your breath
for 10 seconds or as long possible. This allows the aerosol to reach deeper
airways.
Remove the inhaler
from or away from the mouth,
Exhale slowly
through pursed lips. Controlled exhalation keeps the small airways open during
exhalation.
Repeat the
inhalation if ordered. Wait 20 to 30 seconds between inhalations of bronchodilator
medications so the first inhalation a chance to work and the subsequent dose
reaches deeper into the lungs,
Following use of
the inhaler, rinse mouth with tap water to remove any remaining medication and
reduce irritation and risk of infection.
Clean the MDI
mouthpiece after each use. Use mild soap and water, rinse it, and let it air
dry bet-ore replacing it on the device.
EBP
Research Focus:
In acute asthma,
inhaled beta-2-agonists have in the been administered for relief of
bronchospasm using wet nebulisation. More recently, clinicians and researchers
have argued that metered-dose inhalers with a holding chamber (spacer) are just
as effective, easier to use as they do not require a power source or regular
maintenance and less expensive.
A systematic review
of the research comparing the effects of holding chambers compared with nebulisers
for the delivery of beta-2-agonists for acute asthma undertaken. 2295 children
and 614 adults were included from 27 trials from emergency room and community
settings, In addition. six trials on inpatients with acute asthma (213 children
and 28 adults) were also reviewed.
Metered-dose inhalers
with holding produced outcomes that were at equivalent to nebuliser delivery.
Holding chambers
may have some advantages compared with nebulisers for children with acute asthma.
COMMENTS