Techniques for inhaling drugs in various ways. Inhalation route of drug administration. Pros and cons of inhalation administration

Administration of the drug into the rectum (standard)

End of the procedure.

16. help the patient lie down in a comfortable position

17. take off your gloves

18. remove the screen

19. Explain to the patient that he must remain in a supine position for at least an hour

20. Disinfect the gas outlet tube and gloves

Target procedures: Administration of a drug into the rectum for local or resorptive action

Equipment: Janet pear-shaped balloon or syringe; gas outlet pipe; putty knife; petrolatum; medicine (50-100 ml), heated to 37-38°C; toilet paper; gloves; oilcloth; diaper; screen

Inhalation- a method of administering drugs by inhalation. You can inhale gases, easily evaporating liquids and finely dispersed substances (aerosols and powders).

Briefly from history: information about therapeutic inhalations is found in documents from ancient cultures such as China, India, Greece, Rome and the Middle East. Then they treated with aromatic fumes or vapors obtained from natural plant extracts or hot organic materials. Hippocrates was apparently the first to describe an inhaler, namely a damp clay pot for inhaling hot vapors. To this day, in some countries (China, India, etc.), the use of cigarettes as a means of inhalation therapy (anti-asthmatic cigarettes) continues.

Indications:

- acute and chronic diseases of the upper respiratory tract, bronchi and lungs

Occupational diseases of the upper respiratory tract, bronchi and lungs

Tuberculosis of the upper respiratory tract and lungs

Acute and chronic diseases of the middle ear and paranasal sinuses

Bronchospasm in bronchial asthma

Bacillus carriage of the upper respiratory tract

Influenza and other acute upper respiratory tract infections

Hypertension stage 1 and 2.

Through the mouth and nose

BY MOUTH:

Target: medicinal.

Indications: doctor's prescription.

Equipment: pocket inhaler.

I. Preparation for the procedure

1) read the name of the drug.

2) provide the patient with the necessary information about the drug.

3) explain the procedure to the patient.

4) wash your hands.

II. Executing the procedure

5) Demonstrate the procedure to the patient using an inhalation canister without medication.

6) sit the patient down (if the patient’s condition allows, it is better to perform the procedure while standing, since the breathing excursion is more effective).

7) remove the protective cap from the inhaler.

Rice. 24. Inhalation of drugs through the nose (a)

8) turn the aerosol can upside down and shake it.

9) ask the patient to exhale deeply.

10) insert the mouthpiece of the inhaler into the patient’s mouth so that he can tightly wrap his lips around the mouthpiece; The patient's head is slightly tilted back.

11) ask the patient to take a deep breath through the mouth and at the same time press the bottom of the can.

12) remove the inhaler mouthpiece from the patient’s mouth, recommend that he hold his breath for 5 - 10 seconds.

13) ask the patient to exhale calmly.

III. End of the procedure

14) invite the patient to perform this procedure independently with an active inhaler in your presence.

· Remember! The number of inhalations and the time interval between them is determined by the doctor.

15) close the inhaler with the protective cap and put it away.

16) wash your hands.

B c d

Rice. 24. Inhalation of drugs through the mouth (b, c, d)

Parenteral route of drug administration

SET OF MEDICINES FROM AMPOULES AND BOTTLES

Target: performing an injection.

Indications: injection methods of administering drugs.

Equipment: sterile syringe, sterile tray, sterile tweezers, medicine, nail file, pack with sterile dressing material, alcohol 70°, gloves, container for used material, mask, cap.

Algorithm of actions of the nurse:

1. Wash your hands (hygienic level), put on gloves.

2. Read the inscription on the ampoule, make sure the integrity of the ampoule, the expiration date of the medicinal product, as well as the expiration date on the syringe packaging.

3. Lightly shake the ampoule so that all the solution ends up in its widest part.

4. File the ampoule with a nail file, a cotton ball moistened with alcohol, treat the ampoule (in case the needle does touch the outer surface of the ampoule when taking the medicine), break off the end of the ampoule.

5. Take the ampoule as shown in Fig. 25a, carefully insert the needle into it and collect the required amount of solution (while collecting the solution, you can gradually raise the bottom of the ampoule, Fig. 25a).

6. Without removing the needle from the ampoule, release the air from the syringe. Remove the needle used to draw the solution and put on the needle for injection (if it is not a disposable syringe, with which one needle is packaged).

7. Put a cap on the needle (if the needle is single-use), observing universal precautions, put several cotton balls or napkins in the tray to treat the injection field (if you collected the syringe from a sterile table, put the syringe and cotton balls in the tray; if the injection is being performed you in the room - cover the tray with a sterile napkin) (Fig. 26).

Rice. 25 Set of medicines from ampoule and bottles

Rice. 26 Placing a syringe with medication in the tray

(napkin turned away)

INTRADERMAL INJECTIONS

Target: Diagnostic.

Indications: Mantoux test for tuberculosis, Burnet test for brucellosis, diagnostic allergy tests, determination of sensitivity to medications, for local anesthesia.

Places of administration: Anterior surface of the middle third of the forearm.

Equipment: Sterile tray, cotton balls, alcohol, gloves, tuberculin syringe or 1 ml syringe, needle 15 mm long and 0.4 mm cross-section, medicine, sterile tweezers, file for opening ampoules, mask, cap.

Algorithm of actions of the nurse:

I. Preparation for the procedure

1. Check with the patient for information about the drug and his consent to the injection.

II. Executing the procedure

4. Wash your hands and put on gloves.

5. Treat the injection site with a cotton ball moistened with alcohol, then with a dry sterile cotton ball.

6. Stretch the skin at the injection site, grabbing the middle third of the forearm with your left hand from the back (outer) side.

7. Stretch the skin at the injection site.

8. Insert the needle with the cut up almost parallel to the skin so that the cut of the needle disappears into the thickness of the epidermis. Move the thumb of your left hand onto the needle cannula and fix it. Move your right hand to the piston and inject the medicine, or after inserting the needle, move your left hand to the piston and inject the medicine.

9. Remove the needle without pressing the injection site with a cotton ball.

10. Use a dry cotton ball to remove the mark left after removing the needle.

III. End of the procedure

11. Explain to the patient that the area after the injection cannot be washed for a certain time (if the injection was performed for diagnostic purposes).

12. Place the syringe with the needle in the container with the disinfectant solution.

13. Remove gloves and place in a disinfectant solution.

14. Wash (hygienic level) and dry your hands.

SUBCUTANEOUS INJECTION

Target: medicinal.

Indications: doctor's prescription.

Contraindications: individual intolerance.

Places of administration: the middle third of the anterior outer surface of the shoulder and thigh, the subscapular region, the anterior surface of the abdominal wall (lateral to the navel).

Equipment: syringe capacity 1-2 ml, medicine, sterile cotton balls, 70% alcohol, sterile tray, gloves, container with disinfectant. solution, mask, cap.

Algorithm of actions of the nurse:

I. Preparation for the procedure

1. Clarify with the patient the information about the drug and obtain his consent to the injection.

2. Draw the required dose of the drug into the syringe.

3. Help the patient take the desired position.

II. Executing the procedure

4. Wash your hands. Wear gloves.

5. Treat the injection site sequentially with two cotton swabs (wipes) moistened with a skin antiseptic: first a large area, then the injection site itself.

6. Grab the skin at the injection site into the fold as shown.

7. Insert the needle at an angle of 45° into the base of the skin fold to a depth of 15 mm (2/3 of the needle length); Hold the needle cannula with your index finger.

8. Place your left hand on the piston and inject the medicine, fixing the syringe with your right hand (prevention of microtraumas).

9. Remove the needle, continuing to hold it by the cannula; Press the injection site with sterile cotton wool moistened with a skin antiseptic.

III. End of the procedure

10. Give a light massage to the injection site without removing the cotton wool (napkins) from the skin.

11. Ask the patient how he is feeling.

12.Remove gloves, wash hands.

Rice. 27. Subcutaneous injection

INTRAMUSCULAR INJECTION

Target: medicinal.

Indications: doctor's prescription.

Equipment: syringe 5.10 ml, medicine , sterile tray, 70% ethyl alcohol; gloves; container with disinfectant solution, mask, cap.

Required condition: observe injection sites; the patient should be in a supine position.

The eye is an organ sensitive to infection and injury. For external treatment of eye diseases, eye drops are used, as well as eye ointments, which can be applied with a sterile glass rod or directly from a tube for individual use.

Inhalation route of administration

Inhalation route of administration is the introduction of drugs into the body by inhalation (through the respiratory tract - through the mouth, nose). By inhalation, gaseous substances (nitrous oxide, oxygen), vapors of volatile liquids (ether, fluorotane), aerosols (a suspension of tiny particles of solutions of medicinal substances in the air) can be introduced into the body.

For the convenience of using drugs by inhalation, special nozzles are produced for inhalation of these drugs both through the nose and through the mouth. These attachments are included with your aerosol inhaler.

Advantagesinhalation route of administration:

Action directly at the site of the pathological process in the respiratory tract.

It enters the lesion site, bypassing the liver, in an unchanged form, which causes a high concentration of the drug substance.

Flawsinhalation route of administration:

1. In case of severely impaired bronchial obstruction, there is poor penetration of the drug directly into the pathological focus.

2. Possibility of irritation of the mucous membrane of the respiratory tract by medicinal substances.

The nurse must teach the patient how to administer medications by inhalation, since he usually performs this procedure independently.

QUESTIONS FOR SELF-CONTROL

Ways and methods of introducing drugs into the body.

Rules for prescribing medicines.

Rules for obtaining medicines.

Rules for storing medicines.

Rules for recording medicines.

Rules for storage and accounting of narcotic drugs.

Rules for the distribution of medicines.

Features of external and inhalation methods of drug administration.

Literature

Main:

Order Ministry of Health of the Russian Federation dated 12.11.97

№ 330 “On measures to improve the accounting, storage, prescribing and use of narcotic drugs” (as amended on January 9, 2001).

Order Ministry of Health of the Russian Federation dated 08.23.99

№ 328 “On the rational prescribing of medicines, the rules for writing prescriptions for them and the procedure for their dispensing by pharmacies (organizations)” (as amended on January 9, 2001).

Mukhina S.A., Tarnovskaya I.I. Practical guide to the subject “Fundamentals of Nursing”: textbook. – 2nd ed., corrected. And additional – M.: GEOTAR-Media 2013. 512 p.: ill.- 309-339 p.

Lecture by the teacher.

Additional:

1. Educational and methodological manual on “Fundamentals of Nursing” for students, vol. 1.2, edited by Shpirna A.I., Moscow, VUNMC 2003

2. Internet resources: http://www.med-pravo.ru/PRICMZ/SubPric/SubR.htm#Standart

For inhalation of medicines, special nozzles are produced for use both through the nose and through the mouth. They are included with an aerosol inhaler.

Teaching the patient how to inhale the drug through the nose (Fig. 9-17)

Equipment: two empty aerosol medicine cans; medicinal product.

I. Preparation for training

1. Clarify with the patient the information about the medicine, the procedure, and obtain his consent.

3. Wash your hands.

II. Education

4. Give the patient and take an empty aerosol medication can for yourself.

5. Help the patient sit up.

6. Demonstrate the procedure to the patient using an inhalation canister without medication:

a) remove the protective cap from the inhaler;

b) turn the aerosol can upside down and shake it;

c) tilt your head back slightly, tilting it towards your right shoulder;

d) press the right wing of the nose with your finger to the nasal septum;

d) exhale deeply through the mouth;

f) insert the tip of the mouthpiece into the left half of the nose;

g) take a deep breath through your nose and at the same time press the bottom of the can;

h) remove the tip of the mouthpiece from the nose, hold your breath for 5-10 s (focus the patient’s attention on this);

i) exhale calmly;

j) when inhaling into the right half of the nose, tilt your head to your left shoulder and press the left wing of your nose to the nasal septum.

Rice. 9-17. Inhalation of the drug through the nose: a - pressing the right wing of the nose to the nasal septum; b - deep exhalation through the mouth; c - carrying out inhalation; d - holding your breath for 5-10 s

7. Invite the patient to perform this procedure independently, first with an empty inhaler, then with an active inhaler in your presence.

8. Inform the patient: after each inhalation, the mouthpiece must be washed with soap and water and wiped dry.

III. End of the procedure.

9. Close the inhaler with a protective cap and put it in a specially designated place.

10. Wash your hands.

11. Make a record of the training results, the procedure performed and the patient’s reaction to it in the medical record.

ENTERAL ROUTE

Enteral routes of drug administration:

Through the mouth ( per os);

Through the rectum (per rectum);

Under the tongue (sub lingua, in some cases refers to the enteral route).

TAKEN MEDICINES BY ORAL

The use of drugs by mouth is most convenient and widespread, since various dosage forms (powders, tablets, pills, dragees, mixtures, etc.) can be administered in this way.

However, this method of administration has a number of disadvantages:

1) partial inactivation of the drug in the liver;

2) dependence of the action on age, condition of the body, individual sensitivity and pathological processes in the body;

3) slow and incomplete absorption in the digestive tract. In addition, administering medications orally is impossible if the patient is vomiting and unconscious.

The effectiveness of enteral drug therapy in a medical institution largely depends on the adopted methodology for dispensing drugs.

Optimal technique

1. Place containers with solid and bottles with liquid dosage forms, pipettes (separately for each bottle with drops), beakers, a container with water, scissors, and place prescription sheets on the mobile table.

2. Moving from patient to patient, give the medicine directly at his bedside, according to the prescription sheet (the medicine is dispensed from the package in which it was received at the pharmacy).

Before giving the patient the medicine:

Read the appointment sheet carefully;

Make sure that the patient in front of you is the one whose name is indicated on the appointment sheet;

Check the name of the medicine, its dose and method of administration;

Check the label on the package for compliance with the doctor's prescription;

Be especially careful when there are patients with the same last name and/or on the same medications.

3. Never give medicine without packaging. Do not touch the tablets with your hands, as this is not safe for your health.

4. Cut off the packaging of foil or paper tablets with scissors; Gently shake the tablets from the bottle into a spoon.

5. The patient must take the medicine in your presence and also discuss any concerns with you.

6. Liquid medicines should be mixed thoroughly.

7. Bottles with protein preparations must be carefully rotated while mixing to prevent protein denaturation and foam formation; make sure that the drug has not changed color; pay attention to its expiration date.

The benefits of this type of drug distribution are obvious. First, the nurse monitors whether the patient has taken the drug. Secondly, she can answer his questions. Thirdly, errors during the distribution of medicines are excluded. When giving them to the patient, you should warn him about the features of this or that drug: bitter taste, pungent odor, duration of action, change in the color of urine or feces after taking it.

Attention! The patient has the right to know the name, purpose and dose of the drug.

The patient needs to be told how to take the medicine. It is necessary to inform the patient about the peculiarities of the interaction of the drug he is using with food.

Inhalation route of administration is the introduction of drugs into the body by inhalation (through the respiratory tract - through the mouth, nose). By inhalation, gaseous substances (nitrous oxide, oxygen), vapors of volatile liquids (ether, fluorotane), aerosols (a suspension of tiny particles of solutions of medicinal substances in the air) can be introduced into the body.

For the convenience of using drugs by inhalation, special nozzles are produced for inhalation of these drugs both through the nose and through the mouth. These attachments are included with your aerosol inhaler.

Advantages of the inhalation route of administration :

Action directly at the site of the pathological process in the respiratory tract.

It enters the lesion site, bypassing the liver, in an unchanged form, which causes a high concentration of the drug substance.

Disadvantages of the inhalation route of administration:

1. In case of severely impaired bronchial obstruction, there is poor penetration of the drug directly into the pathological focus.

2. Possibility of irritation of the mucous membrane of the respiratory tract by medicinal substances.

The nurse must teach the patient how to administer medications by inhalation, since he usually performs this procedure independently.

QUESTIONS FOR SELF-CONTROL

1. Ways and methods of introducing drugs into the body.

2. Rules for prescribing medicines.

3. Rules for obtaining medicines.

4. Rules for storing medicines.

5. Rules for recording medicines.

6. Rules for storage and accounting of narcotic drugs.

7. Rules for the distribution of medicines.

8. Features of external and inhalation methods of drug administration.

Literature

Main:

1. Order Ministry of Health of the Russian Federation dated 12.11.97

№ 330 “On measures to improve the accounting, storage, prescribing and use of narcotic drugs” (as amended on January 9, 2001).

2. Order Ministry of Health of the Russian Federation dated 08.23.99

№ 328 “On the rational prescribing of medicines, the rules for writing prescriptions for them and the procedure for their dispensing by pharmacies (organizations)” (as amended on January 9, 2001).

3. Mukhina S.A., Tarnovskaya I.I. Practical guide to the subject “Fundamentals of Nursing”: textbook. – 2nd ed., corrected. And additional – M.: GEOTAR-Media 2009.512s: ill.- 309-339s.

4. Lecture by the teacher.

Additional:

1. Educational and methodological manual on “Fundamentals of Nursing” for students, vol. 1.2, edited by Shpirna A.I., Moscow, VUNMC 2003

2. Internet resources: http://www.med-pravo.ru/PRICMZ/SubPric/SubR.htm#Standart