Chapter 6. Non-Parenteral Medication Administration Show
Medication by MouthMedication is usually given orally, which is generally the most comfortable and convenient route for the patient. Medication given orally has a slower onset and a more prolonged, but less potent, effect than medication administered by other routes (Lynn, 2011). Prior to oral administration of medications, ensure that the patient has no contraindications to receiving oral medication, is able to swallow, and is not on gastric suction. If the patient is having difficulty swallowing (dysphagia), some tablets may be crushed using a clean mortar and pestle for easier administration. Verify that a tablet may be crushed by consulting a drug reference or a pharmacist. Medications such as enteric-coated tablets, capsules, and sustained-release or long-acting drugs should never be crushed because doing so will affect the intended action of the medication. Tablets should be crushed one at a time and not mixed, so that it is possible to tell drugs apart if there is a spill. You may mix the medication in a small amount of soft food, such as applesauce or pudding. Position the patient in a side-lying or upright position to decrease the risk of aspiration. Offer a glass of water or other oral fluid (that is not contraindicated with the medication) to ease swallowing and improve absorption and dissolution of the medication, taking any fluid restrictions into account. Remain with the patient until all medication has been swallowed before signing that you administered the medication. Checklist 44 outlines the steps for administering medication by mouth. Checklist 44: Administering Medication by Mouth
Medication via a Gastric TubePatients with a gastric tube (nasogastric, nasointestinal, percutaneous endoscopic gastrostomy [PEG], or jejenostomy [J] tube) will often receive medication through this tube (Lynn, 2011). Liquid medications should always be used when possible because absorption is better and less likely to cause blockage of the tube. Certain solid forms of medication can be crushed and mixed with water prior to administration. Checklist 45 outlines the steps for administering medication via a gastric tube. Checklist 45: Administering Medication via a Gastric Tube
When Auscultating the abdomen of an adult patient the nurse is unable to hear bowel sounds for how many minutes should the nurse listen to the abdomen?Place the diaphragm of your stethoscope lightly over the right lower quadrant and listen for bowel sounds. If you don't hear any, continue listening for 5 minutes within that quadrant. Then, listen to the right upper quadrant, the left upper quadrant, and the left lower quadrant.
What types of percussion notes can be heard during abdominal assessment?As mentioned previously, percussion elicits sounds that have different pitches across various structures—making distinct sounds. In the abdomen, the predominant sounds are either tympany or dullness. Tympany is typically heard over air-filled structures such as the small intestine and the large intestine.
Which organ would the nurse expect to hear dullness upon percussion during the abdominal assessment?Normally, one expects to hear dull sound on percussion of the right anterior chest over the liver, and tympanic sound on percussion of left anterior chest over the gastric air bubble and the splenic flexure of the colon (Figure 1).
Where would the nurse expect to assess tympany when performing percussion on a patient with ascites?Thus, in the supine patient with ascites there should be periumbilical tympany with dullness in the flanks. One should mark the level of dullness on the skin and then turn the patient on one side for a full minute.
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