Routes of Medication Administration

The first thing to know about medication administration is be safe! I always make a point to educate my patients about the medications I am administering and the potential side effects. I go through all of my "rights" and then I am ready to administer the medication. There are a variety of routes to choose from. It seems that the two most common are either oral or peripheral IV push route. 

Administering an Oral Medication: This is simply having someone swallow a pill or liquid medication. Make sure to bring in a medication cup with you. Ask the patient how many pills they like to take at a time. Make sure to check their orders for their diet order before giving the medications. Sometimes patients are on a dysphagia diet meaning that there are specifications as to what types of liquids or foods they are allowed to swallow. If they are having trouble with swallowing, you can crush the medications and mix them in apple sauce. Word to the wise: make sure they like apple sauce before you mix it! 

Injecting an IV Medication through a Peripheral IV: Be sure to start by vigorously cleaning the IV hub with an alcohol swab. Keep the IV hub clean between all steps of the IV push (IVP). Flush the IV with 5 mLs of normal saline to check patency of the IV and clear the line of any existing medications or fluids. Next attach your syringe with the medication you are administering. Flush the IV with medication over the recommended time period. Lastly, flush the IV with an additional 5 mLs of normal saline to complete the medication administration and clean the IV line. 

How to Administer Opthalmic Medications (found here): 

  1. Wash your hands carefully with soap and warm water.
  2. If the product container is transparent, check the solution before use. If it is discolored or has changed in any way since it was purchased (e.g., particles in the solution, color change), do not use the solution.
  3. If the product container has a depressible rubber bulb, draw up a small amount of medication into the eye dropper by first squeezing, then relieving pressure on the bulb.
  4. Tilt the head back with chin tilted up and look toward the ceiling.
  5. With both eyes open, gently draw down the lower lid of the affected eye with your index finger.
  6. In the "gutter" formed, place one drop of the solution.
    IMPORTANT: The dropper or administration tip should be held as near as possible to the lid without actually touching the eye. DO NOT allow the dropper or administration tip to touch any surface. 
  7. If possible, hold the eyelid open and do not blink for 30 seconds.
  8. You may want to press your finger against the inner corner of your eye for one minute. This will keep the medication in your eye.

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Administering a Medication Via Otic Drops: Start by pulling back the pinna (outside portion) of the ear. Place as many drops as are prescribed in the ear. While administering medications, avoid touching the tip of the dropper to the ear and contaminating the dropper. This container should remain as sterile as possible. 

 

 

Vaginal Medication Administration: The only way I have ever administered vaginal medications is by using an applicator. This is the exact same technique as inserting a tampon:

  1. Hold the applicator by the ribbed end of the barrel and insert the filled applicator into the vagina as far as it will comfortably go.
  2. Slowly press the plunger of the applicator to release the medication into the vagina. 
  3. Remove the applicator from the vagina. 

Rectal or Suppository Medication Administration: This is by far the least glamorous route of administration. Supplies that you will need include lubricant, you medication, and possibly a nursing friend to help you turn your patient on their side. Instruct the patient on how you will be administering the medication. Have the patient roll onto their side with their bottom exposed. Put lubricant onto the suppository. Using your index finger and thumb, grab the suppository and place your fingers into the patient's anus with the medication. This should take a brief second to complete. The main suppository that I have administered is Tylenol for patients who cannot take oral medications to control their fever.