Third part
- Method of giving treatment
Giving treatment orally
The Definition :
These are medications that are given orally (such as tablets and syrup).
The Reasons :
Treating the patient's signs and symptoms.
The person in charge:
Nursing team.
Tools :
Medications dispensed to the patient.
It is important to follow the ten correct matters before giving the medicine (ten (10) Rights):-
1. The correct patient .
2. The correct medication.
3. The correct dose.
4. The correct way.
5. The correct time.
6. Healthy repetition.
7. Correct registration.
8. Required effectiveness.
9. The right to education.
10. Right of refusal.
Steps:
1. Washing hands.
2. Review the doctor’s order for the medication and prepare the treatment, taking into account the time coordination, unless the time at which administration is required is specified.
3. Verify the correct patient through the patient’s file and identification bracelet (full name and medical number).
4. Explain the procedure that will be performed to the patient.
5. Maintaining patient privacy.
6. Ask the patient to sit if possible so that he can take the medicine.
7. In the case of treatment with tablets, take the tablets to the patient with a glass of water, taking care not to touch the tablets with the hand.
Ensure that the patient takes the treatment dose on time in the presence of a nursing team member.
8. Notify the doctor if the patient refuses the medication to be given and write this down in the form designated for that purpose.
9. Securing the patient after giving medications that cause a change in the patient’s consciousness (narcotics, blood pressure medications, etc.) by raising the sides of the bed or warning the patient not to walk without assistance.
10. Notifying the treating physician in the event of any medication error, which is recorded in the form for reporting a medication error or the appearance of side effects of medications in the nursing registration form.
11. Recording the administration of treatment in the treatment implementation form.
Giving the treatment via intramuscular, subcutaneous, and intravenous injections
And allergy testing
The Definition :
These are medications that are given by intramuscular, intravenous, or subcutaneous injection (such as vials, ampoules, and diabetes treatment 'insulin').
The Reasons :
Treating the patient's signs and symptoms.
The person in charge:
Nursing team.
Tools :
Medicines - syringes - cotton - alcohol - solutions - intravenous devices - cannulas of different sizes - medical adhesive - tourniquet.
It is important to follow the ten correct matters before giving the medicine (ten (10) Rights):-
1. The correct patient.
2. The correct medication.
3. The correct dose.
4. The correct way.
5. The correct time.
6. Healthy repetition.
7. Correct registration.
8. Required effectiveness.
9. The right to education.
10. Right of refusal.
Steps:
· Hand washing.
· Verifying the patient (full name and medical number).
· Explaining the procedure that will be performed to the patient.
· Maintaining patient privacy.
Preparing treatment for intramuscular injection:
1. If it is a single ampoule, withdraw the treatment using a sterile syringe and expel the air from the syringe.
2. If the treatment needs to be analyzed, the water ampoule is withdrawn using a sterile syringe, then it is injected into the ampoule containing the powder, the bottle is shaken, then the specified dose is withdrawn using the syringe, then the air is expelled.
3. The site of intramuscular injection is determined.
4. Clean the site designated for the injection with a piece of cotton moistened with 70% alcohol in a circular manner and in one direction from the inside out without going back again.
5. Insert the tip of the syringe perpendicular to the injection site, then pull the syringe plunger out to confirm the injection site (if blood is drawn, the site is considered wrong and is changed, and if nothing is drawn, the site is correct and the treatment is injected).
Preparing treatment for a patient through intravenous injection:
1. Determine the location of the intravenous injection.
2. The place to be injected is tied with a tourniquet.
3. Feel the vein with the tip of the index finger.
4. Clean the site designated for the injection with a piece of cotton moistened with 70% alcohol in a circular manner and in one direction from the inside out without going back again.
5. The tip of the syringe is inserted at an angle slightly raised along a parallel line from the surface of the skin at the site of feeling the vein.
6. The syringe plunger is pulled out to confirm the location (blood flows into the syringe).
7. Loosen the tourniquet and inject the treatment slowly.
8. Press the injection site with a piece of cotton soaked in alcohol until the blood stops at the injection site.
9. Place a small piece of gauze at the injection site and secure it with adhesive tape.
10. Dispose of injection waste in a waste disposal bag.
11. Registration in the treatment description and implementation form.
Preparing treatment for a patient by subcutaneous injection:
1. Stabilize the skin at the injection site and, with a quick pricking motion, insert the needle at an angle of 90 degrees if the skin is thick and 45 degrees if the skin is thin.
2. Injecting the treatment to be given.
3. Remove the needle and press a piece of cotton soaked in alcohol on the injection site.
4. Dispose of all waste in accordance with infection control policy.
5. Recording the administration of treatment in the treatment description and implementation form.
Drug allergy test:
1. Perform the subcutaneous injection steps at a 45 degree angle in the case of a 3 cm syringe and a flat site in the case of an insulin syringe.
2. When injecting, inject only one ml of the drug to be tested.
3. Mark the injection site.
4. Observe the injection site for 10 minutes after the injection.
5. Notify the doctor if any reaction occurs (redness of the skin, visible swelling, tendency to scratch).
6. You record this on the patient’s ticket and allergy card.
7. The syringe containing the medication to be administered is prepared and the patient is injected if no reaction occurs.
8. The remaining steps are completed as usual for subcutaneous injection.
Note: When following these steps, infection control policies for administering treatment should be taken into account.
Transfusion
Definition: Giving a quantity of blood or its derivatives (plasma - platelets - red blood cells) to a patient according to the doctor’s instructions.
Reasons: Compensating blood loss from the patient’s body and treating an imbalance in blood components.
The person performing the work: the nursing team.
Tools: A bag of blood or its derivatives (usable) - a holder for solutions - a blood transfusion device - a spongy cotton with alcohol - medical tape - a large cannula.
Steps:
1. Hand washing (routine).
2. Verifying the patient (full name and medical number)
3. Measure the patient’s vital signs to ensure that they are within normal levels.
4. Explain the procedure that will be performed to the patient.
5. Maintaining patient privacy.
6. Review the patient’s full name - blood types - and match the bag number with the delivery form number.
7. Preparing medications for recovery and incompatibility next to the patient.
8. Wash your hands (hygiene) immediately before installation.
9. Open the blood transfusion device, connect it to a bottle of saline solution, and fill it (to test the efficiency of its work).
10. Connect the device to the blood bag and transfer it to the patient very slowly for the first 15 minutes
11. Measure the patient’s vital signs every 5 minutes for the first 15 minutes.
12. Note the presence of any symptoms of blood incompatibility with the patient’s body (such as: tremors, back pain, headache, vomiting, rapid pulse, low blood pressure, rapid breathing, skin rash).
13. Increase the drip in the absence of signs indicating incompatibility according to the doctor’s instructions on the ticket.
14. Dispose of the empty blood bag after completing the administration of the required amount, connect the blood transfusion device to the salt solution, pass the solution through the device until the blood disappears from it, and dispose of it in hazardous waste.
15. Measuring vital signs after a blood transfusion.
16. Wash hands and record this nursing procedure on the designated form.
Oxygen therapy
The Definition :
Giving an amount of O2 gas at a specific rate according to the patient’s needs and the doctor’s recommendations.
The Reasons :
Replenishing the proportion of oxygen in the body - maintaining the vitality of tissues and cells.
The person in charge:
Nursing team.
Tools :
Oxygen catheter - oxygen connector - oxygen regulator - sterile gauze - water humidifier with distilled water - cup of water.
Steps:
1. Hand washing (routine).
2. Verifying the patient (full name and medical number)
3. Measure the patient’s vital signs to ensure that they are within normal levels.
4. Explain the procedure to the patient.
5. Prepare the necessary tools.
6. Make the patient in a comfortable position.
7. Connect the regulator to the oxygen tube valve.
8. Connect the humidifier to the oxygen cylinder (or if there are central connections).
9. Connect the connector to the humidifier (nasal tube - oxygen mask).
10. Test for the presence of oxygen by placing the tip of the catheter in a cup of water (bubbles appear).
11. Connect oxygen to the patient.
12. Monitor the patient’s breathing condition and implement the doctor’s instructions.
13. Register in the nursing care form to monitor the extent of the patient’s condition improvement.
14. Inform the doctor if any side effects occur.