💊 Forms & Routes of Drug Administration

Common Forms

• Tablets & capsules – most common oral forms
• Liquids – elixirs, emulsions, suspensions
• Transdermal – patches applied to skin
• Topical – creams, ointments
• Instillations – drops & sprays (eye, ear, nose)

Instillations

• Eye drops – pull down lower lid, drop into conjunctival sac, press lacrimal duct.
• Eye ointment – ¼-inch strip inside conjunctival sac.
• Ear drops –
• <3 yrs: pull ear down & back
• 3 yrs & adults: pull ear up & back
• Nose drops/sprays – tilt head, administer as directed.

Other Routes

• Inhalations – metered-dose inhalers.
• NG & G-tubes – confirm placement, elevate HOB, ensure drug can be crushed.
• Suppositories –
• Rectal: Sims position, insert past anal sphincter.
• Vaginal: suppositories, foams, jellies, creams.

Parenteral (Injection) Routes

• Intradermal (ID) – into dermis, used for TB/allergy tests.
• Subcutaneous (SubQ) – into fat tissue (abdomen, thigh, back of arm).
• Intramuscular (IM) – deeper, common sites:
• Ventrogluteal
• Deltoid
• Vastus lateralis (common for children)
• Z-track technique – pull skin to the side before injecting, prevents leakage into skin.
• Intravenous (IV) – directly into vein.

🧑‍⚕️ Nursing Implications for Parenteral Meds

• Choose correct site, equipment, and technique.
• Always dispose of needles/syringes in sharps container.

👶 Special Considerations: Pediatric Patients

• May have stranger anxiety.
• Illness/procedure may feel like punishment.
• Fear of procedures is common → requires extra comfort & education.

🧠 Clinical Judgment in Medication Administration

• Concept: Caring interventions.
• Recognize cues:
• Assess LOC (level of consciousness), swallowing, aspiration risk.
• Get full drug history & allergies.
• Analyze cues: Risks like injury, acute pain, mobility limits.
• Generate solutions: Encourage adherence strategies.
• Take action:
• Triple-check drug labels, expiration dates.
• Apply the 10 rights of medication administration.
• Verify calculations with another RN/pharmacist if needed.
• Use gloves for topical/inhalation meds.
• Discard sharps safely.
• Evaluate outcomes: Monitor if med was effective and safe.