Administration of Parenteral Medications

1
Administration of Parenteral Medications

• Unit 15

2
Objectives

• Give three advantages of the parenteral route of
  drug administration
• List the basic guidelines for administering an
  injection
• Prepare a patient for an injection
• Demonstrate the proper procedure to be used when
  giving a subcutaneous, intramuscular,
  intradermal, and a Z-track intramuscular
  injection.

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Parenteral Route

• Rapid
• Produces a direct result
• Drugs are absorbed directly into the bloodstream
• Types of injections
• Intravenous fastest effects
• Intramuscular next fastest result
• Subcutaneous slower than other two

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Advantages of Parenteral Route

• 3 major advantages include
• Effective route for drug delivery when the
  patients physical or mental state would make
  other routes difficult
• Do not irritate the digestive system
• Can deliver a precise dose to a targeted area of
  the body (i.e. into a joint or within the spinal
  canal)

5
Disadvantages of the Parenteral Route

• Possible disadvantages include
• Patient may have allergic reaction
• Introduction of microorganisms
• Injections can cause injury to tissue, nerves,
  veins, and other vessels
• Needle can strike a bone
• Injections can traumatize a vein and cause a
  possible hematoma

6
Preparing Patient for Injection

• 1. Establish rapport with the patient
• 2. Let the patients ask questions
• 3. Ask the patient to relax the area that is to
  be used for the injection
• 4. Inform the patient that he/she will feel a
  slight stick
• 5. NEVER tell a patient that the injection will
  not hurt (especially children)

7
Patient Assessment

• Before administering any medication, you assess
  the patient. Your assessment should include
• Age
• Physical condition
• Body size
• Sex
• Injection site

8
Injection Site Selection

• Subcutaneous injection given at a 45 degree
  angle, just below the surface of the skin
• Intramuscular injection given at a 90 degree
  angle, passing through the skin and penetrating
  into the muscle tissue
• Intradermal injection given at angle between 10
  and 15 degrees within the epidermal layer of the
  skin

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Guidelines for Administration of Injections

• Adhere to the six rights of drug administration
• Select a needle-syringe that is the appropriate
  size
• Prepare the proper equipment
• Select the correct site for the injection
• Prepare patient for injection
• Inject medication slowly into patient

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Special Methods

• Z-track method used for administering
  medications that can be irritating to
  subcutaneous tissue
• Ex. Iron dextran/hydroxyzine HCL should be
  administered using this method
• Involves pulling the skin in a way that the
  needle track is sealed off after the injection

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Intravenous (IV) therapy

• IV therapy administration of fluids, solutions,
  electrolytes, nutrients, or medications through
  the venous system
• MAs are NOT permitted to administer IV
  medications or to perform IV therapy
• Types of IV infusions include crystalloids,
  colloids, solutions, hypertonic preparations, and
  blood/blood components.

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Types of IV Infusions

• Crystalloids materials capable of
  crystallization or can form crystals usually
  electrolyte solutions
• Types of electrolyte solutions
• isotonic increases extracellular fluid volume
• Hypotonic forces fluid into the cells (water
  intoxication)
• Hypertonic draws fluid out of the cells causing
  cellular dehydration

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Types of IV Infusions

• Colloids gluelike substance whose particles
  remain uniformly distributed and do not form a
  true solution
• Hydrating solutions administered to patients to
  supplement caloric intake and supply nutrients
• Blood/blood components life-sustaining
  constituents

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Advantages of IV therapy

• Some advantages include
• Direct route for immediate delivery
• Reliable route for the unconscious or
  uncooperative patient
• Absorption of the drug is directly into the
  bloodstream

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Disadvantages of IV therapy

• Some disadvantages include
• Fluid overload circulatory system is overloaded
  with excessive fluids
• Air embolism obstruction of a blood vessel by an
  air bubble
• Septicemia pathogenic organisms are introduced
  into the patients bloodstream

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Disadvantages of IV therapy

• Infection local and systemic
• Thrombophlebitis blood clot in the vein
• Hematoma leakage of blood into surrounding
  tissues
• Pain burning or stinging sensation
• Hypersensitivitiy reaction patient may be
  allergic to the IV materials or the medication
  itself anaphylactic shock