Introduction medicines through the respiratoryway by inhaling them, called inhalation.

Contact of drugs on the mucous membranes of the respiratory tract in the form of an aerosol is preferable when providing emergency care to a patient. The smaller the aerosol particles, the treatment is more effective.

Inhalers are stationary, portable, or pocket-sized. Using an inhaler, the medicine is administered through the mouth or nose. Before inhalation, both powdered and liquid forms(infusions, decoctions) are diluted with distilled water or saline to the required dose prescribed by the doctor. Pocket inhalers are the most widely used. Ready pharmacological forms in pharmaceutical packaging (powder or liquid) come in ampoules or bottles and are intended for inhalation of the medicine both through the mouth and using a special nozzle - through the nose. The medicine may also be in an inhaler bottle in the form of an aerosol in factory packaging. The number of inhalations and the time interval between them is determined by the doctor.

The advantages of the inhalation route of administration include:

■ ease of use; . . ■ accessibility;

■ direct impact on the affected area: mucous membranes, respiratory tract. It has a local and resorptive effect, and enters the blood very energetically.

For the administration of drugs into Airways Modern equipment and devices are used. These include a portable ultrasonic device, which consists of a compressor and a nebulizer. A SPACER can be attached to a non-bulizer, which is a chamber (plastic or metal) of different sizes that can be attached to any inhaler, including a pocket one. Some

475

Spencer types have valves. With valve spacers, the valve is located in front of the mouthpiece. As you exhale, the valve closes and the medication remains in the spacer. This saves drug consumption.

Advantages inhalation administration with applicationspacer name:

The efficiency of inhalation increases.

The insertion technique is simplified.

The potential risk of developing adverse reactions to treatment is reduced.

Inhalation administration of drugs using a nebulizer

PreparationTo procedure

Stages

1. Check the name, concentration of the drug, dose, expiration date, read the instructions for the drug prescribed by the doctor, make sure that the drug complies with the doctor’s prescriptions - Note. Special medicinal solutions of bronchodilators are used, inhaled using a nebulizer: berodual, salbutamol, Berotek and others.

2. Check the operation of the sky laser device, according to the supplied instructions. hands to him.

3. Explain to the patient the purpose and principle of the procedure, obtain consent.

4. Teach the patient to breathe deeply during the procedure -

5. Wash and dry your hands in a hygienic manner.

6. Fill the removable chamber with the medicinal solution for spraying and introducing solutions in the appropriate dose (with dilution in a glass with saline solution until required). concentration). "

Rationale

Strict implementation of standards. The potential risk of developing adverse reactions to treatment is reduced, and the effectiveness of inhalation is increased.

Ensuring the accuracy of the procedure.

Ensuring the patient’s right to information, informed participation ease in the procedure-

The deeper the aerosol dose is administered, the more effective the treatment.

Ensuring infection safety.

Stages	Rationale
Preparation for the procedure
7. Sit the patient down and offer to take a comfortable position in front of the device.	Creating comfortable conditions.
Execution p	legalities
I. Invite the patient to wrap his lips around the mouthpiece of the nebulizer, inhale, and exhale slowly through the nose.	Achieving effective results.
2. Turn on the apparatus for spraying and introducing the solution. Note. Watch for general condition patient.	Prevention of complications.
3. Keep track of the time of the procedure by setting a timer or an hourglass corresponding to the appointed time.	The time of the procedure is determined by the doctor.
End of the procedure
1. Turn off the device after the procedure time has expired.	By timer or hourglass.
2. Treat the nebulizer mouthpiece with a disinfectant solution using the total immersion, wash the glass for diluting medicines.	Ensuring infection safety.
3. Wash hands and dry.	Ensuring infection safety and personal hygiene.
4. Complete medical documentation.

Using a pocket inhaler with a spacer

Using of a factory-packaged inhaler can, remove the protective cap from the inhaler can, shake the can and attach it to the spacer. We ask the patient to exhale, tightly clasp the mouthpiece of the spacer with his lips, press the bottom of the canister, and take several breaths from the spacer. Then remove the spacer, disinfect it, and store the pocket inhaler closed.

Q ATTENTION! INHAING AND PRESSING ON THE BOTTOM OF THE CAN MUST BE PERFORMED AT THE SAME TIME (SYNCHRONOUSLY).

477

ASTMOPENT

DOSED AEROSOL

Rice. 20. Rules

using a pocket inhaler

478

Terms of use

pocket inhaler

(spray can)

Remove from the can by the protective cap, turning the can upside down.

Shake the aerosol can well.

Take a deep breath. !

Cover the mouthpiece of the can with your lips, lightly for 1 throw back.

Take a deep breath and at the same time press firmly on the bottom of the can: at this moment a dose of aerosol is dispensed.

Hold your breath for 5-10 seconds, then remove the mouthpiece of the canister from your mouth and exhale slowly.

7. After inhalation, put the protective cap on the can.

U

Remember. The deeper the aerosol dose is administered, the more effective it is.

Note. When administering a dose of aerosol into the nose, it is necessary to remember that the head should be tilted towards the opposite shoulder and tilted slightly back. When injecting the medicine into the right nostril, it is necessary to press the left wing of the nose against the septum.

Inhaled oxygen administration through nasal cannulas

Target: reduction of hypoxia of body tissues, reduction of shortness of breath, improvement of general condition.

Equipment: oxygen source with flow regulator, humidifier (Bobrov apparatus), sterile water for a humidifier, sterile items: nasal cannulas, tray; Vaseline, adhesive tape for fixing the nasal catheter; antiseptic for hand treatment, containers for disinfection of waste material.

	Rationale
Preparation for the procedure
1. Check the operation of the oxygen source, connection to the humidifier, filling it 2/3 of the volume with distilled water. Note. If there is foam in the respiratory tract, use an antifoam agent or 96% ethanol.	Strict implementation of the standard.
2. Explain to the patient the purpose and principle of the procedure, inform the time and place of the procedure.	Ensuring the accuracy of the procedure. In emergency situations, these conditions do not need to be taken into account.
3. Sit or lay the patient down and check readiness for the procedure.	The more comfortable the patient's position, the more effective the treatment.
4. Wash and dry your hands in a hygienic manner.
Executing the procedure
1 Inspect nasal passages, if necessary, clean them with a moistened sterile ball.	Achieving effective results.
1- Lubricate the ends of the fork-shaped cannulas with Vaseline and insert them into the nasal passages, securing the tubes with adhesive tape.	Preventing cannulas from sticking to the nasal mucosa.
■*■ Connect to the tube humidifier-U£2^GOING_YU to the cannulas.
1+1 Open the valve of the oxygen source, adjust the speed °Dachi using the oxygen flow regulator	Air bubbles appear in the humidifier.

	Rationale
End of the procedure
1. Turn off the device when the patient’s health improves, hypoxia of body tissues decreases, and the patient’s shortness of breath decreases.	Once the effect is achieved.
2. Treat the cannulas with a disinfectant solution using the full immersion method.	Ensuring infection safety.
" 3. Wash your hands and dry them.	Ensuring infection safety and personal hygiene.
4. Complete medical documentation.	Ensuring continuity in the transfer of information.

Note. When inhaled oxygen is administered through an oxygen mask, instead of cannulas, an oxygen mask is placed over the mouth, nose and chin. It is necessary to ensure that the mask fits tightly. For convenience, cotton balls are placed to relieve pressure on the nose.

Enteral administration of drugs Rules for the distribution of medicines

Medicines prescribed by a doctor in a hospital setting for internal use are distributed by the ward nurse.

Before dispensing medications, the nurse must:

Read carefully the medical prescriptions out loud: the name, dose of administration, and in liquid forms, the concentration of the drug, expiration date, route of administration and frequency of administration.

Read the instructions for the medicine prescribed by your doctor to make sure it is in accordance with the instructions. titles and doses prescribed by the doctor, check the expiration date, production date of the medicine on the packaging, ampoule or bottle.

Evaluate the drug by its appearance.

Wash your hands hygienically and comply! hygiene rules when distributing medicines at the bedside of patients.

Inform the patient in advance about the prescribed drug.

480

T Introduce yourself, explain the rules of administration, ask if the patient has any allergic reactions to this drug.

Give the patient the opportunity to ask questions about the prescribed drug and be able to answer them competently. At the same time, remember the interests and possible emotional reactions of the patient, be able to anticipate and prevent them.

Observe ethics, answer questions politely, and confidently convince of the need for drug therapy.

Give the patient the oral medication indicated in doctor's prescription, give a glass of water and offer to wash it down with enough water. Make sure the patient has taken the medication. Make a note on the medication prescription sheet about the date of administration, put your signature on the prescription sheet, in the “completed” column.

After some time, ask about the reactions to the use of this remedy and the patient’s general well-being. It is important when the patient has complaints, negative reactions immediately inform the doctor about the use of medications, and if necessary, provide pre-medical care.

Sublingual route of administration of nitroglycerin or validol

Target: relieve an attack of pain in the heart area.

Executing the procedure

Drop a solution of nitroglycerin 2-3 drops or validol 5-6 drops onto a small piece of sugar.

Instruct the patient to keep the sugar under the tongue or behind the cheek until completely absorbed.

Instruct the patient to keep nitroglycerin or validol tablets under the tongue or behind the cheek until completely absorbed (the same goes for capsules).

4. To accelerate the effect of action, 1-2 drops of nitroglycerin (1% solution) should be applied under the tongue without sugar, and the patient should be asked to crush the capsule with his teeth, and then keep it under the tongue.

If the patient is forced to constantly carry the tablets with him, then they should be in a hermetically sealed package in a clothing pocket (nitroglycerin decomposes in light and also in air).

The patient should be aware of the start and end times of the drug.

Administration of a suppository with a laxative effect to the patient

Target: have a medicinal effect on the rectal mucosa. Achieve spontaneous bowel movement within 12 hours of using the drug.

Equipment: suppository from the refrigerator, non-sterile gloves, containers for disinfection of waste material, skin antiseptic.

	Rationale
Preparation for the procedure
1. Introduce yourself, explain the purpose and course of the upcoming procedure.	Patient information. Obtaining verbal consent for the procedure.
2. Remove the package of suppositories from the refrigerator, read the name of the suppository with a laxative effect, and clarify best before date, compare the name with the doctor's prescription. Provide the patient with the necessary information about the drug.	Ensuring the accuracy of the procedure.
3. Sit or lay the patient on his left side or back and bend his knees.	The more comfortable the position and preparation of the patient, the more effective the procedure.
4. Wash and dry your hands in a hygienic manner and put on gloves.

	Rationale
Executing the procedure
1. Open the shell in which the suppository is packaged (but do not remove it).	The solid form of the suppository is maintained.
2. Ask the patient to relax.	Relaxation of muscles and sphincter (anus) is ensured.
3. Spread the buttocks with one hand and insert with the other, squeezing the suppository from the package into the anus (the shell from the package remains in your hand).	Ensuring that the procedure is followed.
4. Invite the patient to lie down in a position that is comfortable for him or help him to do so.	Extending the duration of action of the medicine.
End of the procedure
1. Place the casing in a container for class “B” waste.	Ensuring infection safety.
2. Invite the patient to take a comfortable position.	Ensuring a comfortable state.
3. Remove gloves, immerse in disinfectant solution, wash hands, dry.	Ensuring infection safety.
4. Ask the patient after a few hours if he had a bowel movement.	Monitoring and evaluation of the procedure performed.
5. Complete medical documentation.

Parenteralpathintroductionmedicinalfunds

Parenteral administration of drugs and solutions is carried out through intradermal, subcutaneous, intramuscular, intravenous, intraarterial, abdominal, pleural cavity, in the heart, in the spinal canal, in the painful focus, in the bone marrow.

Intradermal, subcutaneous, intramuscular routes of administration are made by injection. Intravenous administration The drug is produced by venipuncture or venesection (dissection of access to the vein and vein, performed by a doctor).

482

483

Benefits parenteral route of administration.| are:

speed of action;

dosage accuracy;

entry of the drug into the blood unchanged.

Flaws:

mandatory participation of trained medical personnel;

compliance with asepsis and antiseptics;

difficulty or impossibility of administering the drug in case of bleeding;

skin damage at the injection site.

Knowledge of the technique and features of parenteral administration in strict accordance with the standards of simple medical services is the key to the successful professional activity of a medical worker. The essential requirements of the standard of professional activity of a paramedical worker - paramedic, midwife, nurse are:

compliance with labor safety requirements (implementation regulatory documents, hand washing standards, use of gloves and protective clothing, etc.);

compliance with the conditions for performing procedures (inpatient, emergency care at home or during transportation ambulance, outpatient- | but polyclinic or sanatorium-resort);

the ability to use material resources, medicines and other consumables within the limits indicated by approved standards and technologies for performing simple medical services.

Average medical worker must not only know and be able to perform skills, he must also understand each action of the standard, think about it, carry it out, observing the moral, ethical and deontological principles of his activities.

Technologies for performing simple medical services require from paramedical workers deep 1

484

knowledge about the peculiarities of performing techniques, the form of informed consent of patients for the procedures performed by them. A feature of informed consent when using medications is that the doctor obtains consent (written or oral) for treatment and informs medical personnel about it. The patient gives written consent to the doctor if a drug is being administered that is undergoing testing or requires special conditions of implementation, such as long-term use. The average medical worker must make sure that the patient has this consent for the procedure and if it does not, and clarify further actions with the doctor.

Pharmacy-prepared parenteral medications have a blue label, making it easier for healthcare professionals to obtain medications from the pharmacy. Unfortunately, at present this rule is not observed, which creates certain difficulties in the work of procedural nurses.

Rules for the use of medicinesfor parenteral administration

Before parenteral use of copper drugsQing sister is obliged:

Read the instructions for the medicinal product on the packaging, ampoule or bottle: name, dose, concentration of the medicinal product and check with the doctor’s prescription, make sure it corresponds to the doctor’s values, check the expiration date, date of preparation of the medicinal product on the packaging or bottle, check the batch (if its availability).

Open the package with ampoules or bottles, read the name, dose, concentration of the drug on the ampoule and check it with the doctor’s prescription, make sure it complies with the doctor’s prescription, check the batch and check for consistency (if any).

485

inquire

Assess the drug by its appearance: presence of turbidity, sediment, any suspicious inclusions. Changes appearance are a contraindication to the administration of this solution, regardless of its expiration date.

Deliver a manipulation table with equipment to the ward if injections and infusions are performed at the patient’s bedside. Preparation for the procedure can be carried out in the treatment room.

Observe ethics, politely answer questions, confidently convince before and after injections, constantly monitor the patient’s condition during the administration of the drug, especially drip administration. You cannot be separated from the patient, since at any moment his condition may change or problems may arise associated with disturbances in the administration of the drug and a large volume of fluids into the body. If these problems are not immediately resolved, the patient develops a feeling of dissatisfaction with a simple medical service. Not achieved therapeutic effect, since complications arise and the procedure can become useless and sometimes life-threatening for the patient.

After some time it is necessary

talking about the patient’s reactions to the use of this remedy, his general well-being. Important when< нии жалоб у пациента, отрицательных реакций применение лекарственных средств, срочно поставит в известность врача, а при необходимости оказат доврачебную помощь.

Assembling a single-use syringe

Target: introduction medicinal substances parenterally.

Equipment: manipulation table (1 pc.); disposable syringes (according to the number of medications prescribed by the doctor).

Required condition: use the assembled syringe immediately after assembly. When stored under sterile conditions - no more than 6 hours. Before opening, check: shelf life, tightness.

486

	Rationale
Preparation for the procedure
1. Wash hands and dry.	Ensuring infection safety. Creating a barrier for microorganisms.
2. Check the sterilization date, expiration dates indicated on the package, and the tightness of the package by carefully squeezing the package. Make sure there is residual air in it.	Quality control of sterilization and tightness.
Executing the procedure
1. Open the package with scissors and use its inner (sterile) surface when assembling the syringe.	The inner surface of the bag is sterile, which provides a sterile workspace when assembling the syringe and economical use of instruments during this procedure.
2. Take the piston by the handle and insert it into the cylinder.	A strictly defined procedure for assembling a syringe develops a quick skill.
3. Take the handle of the piston inserted into the cylinder and put the cylinder cone on the needle cannula without touching the needle tip.	Securing the needle by the cannula prevents infection of the needle shaft and keeps the needle sterile.
4. Secure the needle cannula with your fingers, rubbing it against the needle cone.	A tightness is created, which will prevent air from entering when taking the medicine and performing the injection.
5. Check the patency of the needle by releasing air from the syringe.
End of the procedure
1. Place the assembled syringe on the inner surface of the bag.	Maintaining sterility.

Medicinal solution set from ampoule

Target: parenteral administration of a medicinal substance by injection.

Equipment: medicine in ampoules, disposable syringe, 70% alcohol, cotton balls, tray, gloves, tweezers, pack with sterile wipes, cotton balls.

Required condition: check the name, concentration of the drug, dose, expiration date,

Ampoule with oil solution should first be heated in a water bath to a temperature of 38 °C.

Stages	Rationale
Preparation for the procedure
1. Wash hands, dry, put on
gloves.	danger.
2. Assemble the sterile syringe.
3. Before opening the ampoule, still	Elimination of erroneous entry
	medicine.
medicine, dose,
best before date.
Executing the procedure
1 . Shake the ampoule lightly to	The best conditions for typing
the entire solution ended up in her wide	solution.
2. File the ampoule with a nail file.	Compliance with asepsis rules.
then with a cotton ball moistened	If the needle does touch the
antiseptic, treat the ampoule,	outer surface of the ampoule at
break off the narrow end of the ampoule.	set of medicine.
3. Take the ampoule between 2 and 3 fingers	Condition for collecting the solution.
with the left hand, placing the bottom
ampoules to the back surface, and
the narrow part to the palmar.
4. Carefully insert the needle into the ampoule,	Avoid getting air into
without touching its walls, and dial
the required amount of solution (filled
paradise solution, you can gradually
lift the bottom of the ampoule).
5. Without removing the needle from the ampoule, you	Compliance with technology is safe -
release air from the syringe.	sti: removing air from the syringe
	in any way, we prevent
	ingress of medicinal solution
	ra into the room, which is in the surrounding
	the air that stings you may be
	toxic and dangerous
	ity for health.
End of the procedure
1. Place a cap on the needle, observing	Preparing for injection. Provide
by giving universal measures to prevent	infectious safety is improved
horniness.

Stages	Rationale
End of the procedure
2. Place in a sterile bag	Provides infectious
a few cotton balls or	safety.
wipes for treatment of injections
onny field or put the syringe and
cotton balls in a sterile tray;
if the injection is performed by you in
room, cover the tray with a sterile
napkin.

Notes: if this is a disposable syringe with which the needle is packaged, it is necessary to have a separate needle in a sterile package in case asepsis is broken.

Intradermal administration of drugs

Target: active detection of tuberculosis (Mantoux test), diagnosis of allergic reactions of the body, prevention of tuberculosis (BCG vaccination).

Functional purpose: preventive, diagnostic, therapeutic.

Equipment: non-sterile trays - 2 pcs. (for syringes, medicines), puncture-proof container for waste class “B” or “C” - 2 pcs., disposable syringes with a capacity of 1 to 2 ml with a needle up to 15 mm (including tuberculin, self-destructing: SP-syringe), cross-section 0.4 mm, skin alcohol antiseptic or 70% alcohol (for treating hands and the injection field), sterile cotton balls, napkins - 4 pcs. (for treating the ampoule and injection site twice before administration and once after administration) on a sterile tray; gloves, disposable towel, liquid soap in a dispenser, medication (vaccines, allergens, amount of solution administered from 0.01 to 1 ml), container for disinfecting gloves.

the middle third of the inner surface of the forearm, the upper third of the outer surface of the shoulder.

Required condition: the specialist must have thematic improvement in vaccine prevention. Average

488

489

The medical professional must make sure that the patient has informed consent for the procedure and if there is none, and clarify further actions with the doctor.

	Rationale
Preparation for the procedure
I. Inform the patient (parents)	Ensuring the right to information
necessary information about pre-	tion and participation in the procedure.
worth the injection, make sure
no contraindications.
2, Wash your hands with soap and dry.	Maintain personal hygiene.
3. Prepare equipment.	Compliance with material expenditure standards
	real resources.
4. Draw up the medicine	Fulfilling doctor's orders.
into the syringe, displace the air so	Maintaining asepsis.
so that the exact dose remains,
live syringe in a sterile tray
or sterile packaging from
5. Dispose of ampoules from	SanPiN 2.1.7.728-99.
vaccines, allergens in a separate	MUZ.1.2313-08.
containers, label the container.
6. Offer the patient to occupy	Depends on the patient's condition and
comfortable position.	of the administered drug.
7. Determine the injection site	Execution Features
by palpation, make sure that	injections.
no pain, lumps,
local temperature rise,
rash, itching.
8. Wash hands, dry, put on	Ensuring infectious safety
gloves.	danger.
Executing the procedure
I. Treat the injection site with an-	Prevention of infection
antiseptic, making smears in one	injection sites.
direction, twice, first
large area (approx.
10x1 Osm), then only the injection site
2. Take the syringe in your right hand,	At this position the needle can
holding the cannula needle pointer-	be fixed with finger rest
finger, and a barrel syringe with	about the forearm, while controlling
piston 3, 4, 5 fingers, cut	insertion of the needle cut into the dermis
needles up.	mu (skin).

	Rationale
Executing the procedure
3. Stretch the skin at the injection site (inner surface of the forearm) with your left hand, holding the syringe in your right hand (or vice versa).	Required condition.
4. Quickly insert only the cut of the needle into the skin, holding it with the cut up almost parallel to the skin (insertion angle 10-15°). Fix the needle with your 2nd finger, pressing it to the skin.	Entry into the dermis is controlled, not under the skin.
5. Transfer left hand onto the plunger and inject the medicine slowly until a papule appears.	The appearance of a papule indicates that the drug has entered the dermis.
End of the procedure
1. Remove the needle, continuing to hold it by the cannula, and with your left hand treat the injection site with a skin antiseptic and disinfect the cotton ball (napkin).	Strong pressure may force the medicine out of the wound and the dose will decrease. Ensuring infection safety.
2. Examine the papule and make sure it is formed.	This indicates correct technique intradermal injection.
3. Explain to the patient (parents) that water should not enter the injection site for a certain time (if the injection was performed for diagnostic purposes).	As prescribed by a doctor.
4. Dispose of the syringe with the needle in a container and label the container.	See Rules for using a container for collecting sharp disposable instruments and SanPiN2.1.7.728-99 and MU 3.1.2313-08.
5. Remove and immerse gloves in a container with a disinfectant solution.	Ensuring infection safety.
6. Wash hands and dry.
"■ Record the result of the execution in the medical documentation.	Ensuring continuity in the transfer of information.

Subcutaneousintroductionmedications

Target: introduction of medicinal substances into the subcutaneous tissue. Specific prevention some infectious diseases (preventive vaccinations).

Functional purpose: preventive (including vaccination), therapeutic, rehabilitation.

Equipment: non-sterile trays - 2 pcs. (for syringes, medicines), puncture-proof container “Hazardous waste” of class “B” or “C” - 2 pcs. (for disposal of syringes and needles), disposable syringes with a capacity of 1-5 ml, a needle 20 mm long, cross-section 0.4-0.8 mm, skin alcohol antiseptic or 70% alcohol (for treating hands and the injection field), sterile cotton balls , napkins - 4 pcs. (for processing the ampoule, injection site - twice before administration and once after administration) on a sterile tray; gloves, disposable towel, liquid soap in a dispenser, medication (usually from 0.5 to 5 ml), containers for disinfecting cotton balls, gloves.

Epidermis

Rice. 21. Subcutaneous injection sites

WITH
sedum layer of the dermis, superficial vessels of the dermis Reticular layer of the dermis Subcutaneous fatty tissue Deep vessels of the dermis Muscles

Typical injection sites: outer surface of the shoulder. Outer surface of the thigh. Subscapular region. Anterior abdominal wall.

Required condition: The average medical worker must make sure that the patient has informed consent for the procedure and if it does not, and clarify further actions with the doctor.

	Rationale
Preparation To procedure
1. Provide the patient with the necessary information about the upcoming injection and make sure there are no contraindications.	Ensuring the right to information and participation in the procedure.
2. Wash your hands with soap and dry. .	Maintain personal hygiene.
3. Prepare equipment.
4. Draw the medicine into the syringe, displace the air so that the exact dose remains, place the syringe in a sterile tray or sterile syringe packaging.
5. Invite the patient to take * a comfortable position.	Depends on the patient’s condition and the drug administered.
	Features of injections.
	Ensuring infection safety.
Executing the procedure
1. Treat the injection site with an antiseptic, making smears in one direction, twice, first a large area (approximately W x J0 cm), then only the injection site. (When administering insulin, let it dry).	Prevention of complications.
£■ Take the syringe in your right hand, holding the needle cannula with your index finger, and the syringe cylinder with the piston with your 3rd, 4th, 5th fingers, with the L-cut facing upward.

CorrectpositionsyringeVhand

Rice. 22. Subcutaneous injection technique

	Rationale
Executing the procedure
3. Gather the skin at the injection site into a fold triangular shape with your left hand, holding it with the base down.	Required condition.
4. Insert the needle with the syringe, located in the right hand, quickly under the skin (introduction angle 45°).	Prevention of complications: damage to the periosteum.
	Contact with the skin is controlled.
6. Introduce the drug slowly into the subcutaneous fat.
End of the procedure
1. Remove the needle, continuing to hold it by the cannula, and with your left hand press a cotton ball moistened with a skin antiseptic or a dry sterile cloth (when administering insulin) to the injection site.	Ensuring infection safety. Prevention of complications when administering insulin.
2. Dispose of a cotton ball (napkin) and a syringe with a needle in different containers, label the containers.	See Rules for using a container for collecting sharp disposable instruments YaSanPiN2.1.7.728-99 and MUZ.1.2313-08.
3. Remove and immerse gloves in a container with a disinfectant solution.	Ensuring infection safety.
4. Wash hands and dry.
	Ensuring continuity in the transfer of information.

494

Peculiaritiesapplicationsinsulin

Insulin is a hormone of the pancreas and has a pronounced effect on carbohydrate metabolism. Promotes the absorption of glucose by cells of body tissues (muscle, fat), facilitating the transport of glucose through cell membranes, stimulates the formation of glycogen from glucose and its deposition in the liver.

Insulin is a colorless liquid containing 40, 80 and 100 ED in 1 ml; Available in bottles, usually 5 ml. B therapy diabetes mellitus simple insulin (6-8 hours) and long-acting insulin (12-36 hours) are used.

The effect of insulin is assessed by changes in blood glucose levels, and changes in sugar in urine are also taken into account.

To administer insulin, special syringes with a capacity of 1-2 ml are used, which have additional divisions for precise dosing of the drug. Draw insulin into the syringe 1-2 divisions more than is necessary for administration. Next, when releasing air from the syringe before injection, adjust the amount of insulin to the required amount.

Insulin is injected subcutaneously into the outer area of ​​the shoulder and thigh, subscapular region, lower abdomen, and buttock. The skin is wiped with alcohol, allowing it to dry. The injection needle must be sharp. Insulin injection sites are changed according to the “asterisks >>” rule, clockwise.

Insulin is administered depending on the severity of the disease 1-3 times a day 15-20 minutes before meals. In diabetic coma, the administration of long-acting insulin is contraindicated.

Complications: allergic reactions, lipodystrophy, edema, insulin resistance (insensitivity), hypoglycemic coma.

Allergic reactions: manifested by thickening of the skin at the injection site, urticaria, Quincke's edema, anaphylactic shock.

Help: it is necessary to use another insulin preparation strictly as prescribed by the doctor.

Lipodystrophy: At the injection site, areas of atrophy or hypertrophy of the subcutaneous fat layer form.

495

4. Insert the needle with a quick movement at an angle of 30-45° into the middle of the subcutaneous fat layer to the length needle, holding it cut side up.

2. Disinfect the syringe and cotton balls, remove gloves and place in a container for disinfection. infections.

Resistance: it is necessary to increase the dose of insulin strictly as prescribed by the doctor.

Hypoglycemic coma: occurs when there is an overdose of insulin. Assistance is provided according to the standard of first aid and doctor’s prescription.

Subcutaneous insulin injection

Target: lowering blood glucose levels, administering an exact dose at a specific time. Indications: Attention! Strictly as prescribed by the doctor!

type 1 diabetes mellitus;

hyperglycemic coma.

Contraindications: hypoglycemic coma, allergic reaction to this insulin.

Equipment: a bottle of insulin solution containing 40 IU in 1 ml (80 IU or 100 IU); sterile: tray, tweezers, cotton balls, disposable insulin syringes; alcohol 70%.

	Notes
Preparing for procedure
1. Make sure that there are no contraindications to the use of this insulin.	Contraindications are: hypoglycemic coma, allergic reaction to this insulin.
2. Make sure that insulin is suitable for subcutaneous administration.
3. Warm the bottle of insulin to body temperature 36-37 °C in a water bath.	You can hold the bottle in your hand for 3-5 minutes.
4. Take insulin syringe in the package, check suitability, tightness of the package, open plastic bag.	Determine the price of dividing the syringe.
5. Open the bottle cap covering the rubber stopper.	Further actions require compliance with asepsis rules.
6. Wipe the rubber stopper with cotton balls and alcohol twice, set the bottle aside, and let the alcohol dry.	The presence of alcohol in the insulin solution leads to its inactivation.
7. Help the patient find a comfortable position.

8. Draw the specified dose of insulin in units from the bottle into the syringe and additionally draw 1-2 units of insulin, put on the cap, put it in tray.

An additional 1-2 IU is added so as not to reduce the dose when releasing air from the syringe before injection.

Executing the procedure

1. Treat the injection site sequentially with two cotton swabs moistened with alcohol: first a large area, then the injection site itself. Allow the skin to dry.

Subcutaneous injection sites:

2. Remove the cap from the syringe and let in air.

Upper outer surface of the shoulder.

Upper outer surface of the thigh.

Subscapular region.

Anterior abdominal wall. Do not inject insulin into the same place.

3. Take the skin in a fold with the first and second fingers of your left hand.

Determine the thickness of the subcutaneous fat layer in the fold.

The angle of insulin injection can be changed depending on the thickness of the subcutaneous fat layer (up to 90°).

5. Release your left hand by releasing the fold.

6. Inject insulin slowly.

7. Press a dry sterile cotton ball to the injection site and quickly remove the needle.

End of the procedure

1. Feed the patient.

Disinfection is carried out in accordance with current orders.

Rice. 23. Insulin injection sites (shown by shading)

496

497

Features of the use of heparin

Heparin- direct anticoagulant: inhibits the formation of thrombin, prevents blood clotting.

Used for the prevention and treatment of thromboembolic complications in acute heart attack myocardium, operations on the heart and blood vessels, pulmonary thromboembolism and cerebral vessels, thrombophlebitis of the extremities.

Doses set individually: 5,000 units after 4-6 hours are administered intravenously or intramuscularly, or subcutaneously deep, in the epigastric region - to stimulate the production of endogenous heparin.

Complications. When using heparin, there may be hemorrhagic complications: hematuria (blood in the urine), hemorrhages in the joints, gastrointestinal bleeding, hematomas at the site of subcutaneous and intramuscular injection.

Allergic reactions are possible: urticaria, asthma, rhinitis, lacrimation.

In case of an overdose of heparin, 5 ml of a 1% solution of protamine sulfate, 1-2 ml of dicinone are administered intravenously or intramuscularly as its antagonist.

Treatment with heparin is carried out under the control of a coagulogram (blood test, the main indicator is blood clotting time) for no more than 7 days, strictly as prescribed by the doctor.

Monitor the patient for timely detection of hemorrhagic complications.

It is necessary to do a general urine test every day and monitor its color.

Contraindications to the use of heparin:

1. Peptic ulcer of the stomach and duodenum.

   Diseases accompanied by delayed blood clotting, etc.

Calculation and administration of heparin

Target: reduce blood clotting and administer the exact dose of heparin. Equipment:

bottles with heparin solution containing 5 thousand units in 1 ml;

heparin antagonists: protamine sulfate 1%, diet 1-2 ml IV or IM.

1-2 ml syringe for single use; needle 20 mm, cross-section 0.4 mm, additional needle for taking medicine; sterile tray, covered with a sterile folded napkin V 4 layers, with gauze swabs under the first, and tweezers under the second layer; 70% ethyl alcohol; ampoule with medicine; gloves; container with disinfectant solution.

Stages	Rationale
Preparation for the procedure
Establish a friendly relationship with the patient and assess his condition.
2. Explain to the patient the purpose and progress of the procedure, clarify information about the drug, obtain consent for the procedure.	Make sure that there are no contraindications to this medicine: anemia, peptic ulcer, blood diseases accompanied by a slowdown in blood clotting.
3. Put on a mask, prepare your hands for work, put on gloves.
4. Open the package and collect the syringe.
5. Treat the bottle cap with a swab moistened with alcohol twice.
6. Draw the medicine into the syringe in the required dose, lifting the bottle upside down.	The dose is determined only by the doctor!
7. Remove the needle, throw it into a container with a disinfectant solution.
8. Insert the hypodermic injection needle and release the air.
. "■ Place the cap on the needle.

498

499

Stages	Rationale
Executing the procedure
1 . Place the patient on the couch or lie down.	The position depends on the injection site and the patient's condition.
2. Perform a subcutaneous injection. -
End of the procedure
1. Place the syringe and needles in a container with a 3% chloramine solution.	You must first rinse the syringe of the medicine in washing water or a disinfectant solution.
2. Remove gloves and place in a disinfectant solution.
3. Wash and dry your hands.
4. Help the patient find a comfortable position.
5. Assess the patient's response to the procedure.	Normally, the patient's response to the procedure is adequate.
6. Monitor the color of urine, the color of the skin, pulse, blood pressure, and injection sites. If necessary, as prescribed by a doctor, administer heparin antagonists: protamine sulfate 1%, diet 1-2 ml IV or IM.	If complications occur, immediately inform your doctor. Identify hemorrhagic complications in a timely manner: monitoring the coagulogram is the main indicator (blood clotting time). Complications indicate an overdose of heparin and the occurrence of internal bleeding.
7. Make a note about the procedure performed and the reaction to it on the appointment sheet.	This is a prerequisite for monitoring the number of injections performed and the reaction to it.

Intramuscularintroductionmedications

Target: The medicine prescribed by the doctor was administered intramuscularly. Achieving a therapeutic effect without complications, with minimal discomfort for the patient.

Functional purpose: preventive, therapeutic, rehabilitation.

Equipment: non-sterile trays - 2 pcs. (for syringes, medicines) on the manipulation table, puncture-proof container - 2 pcs. (for disposal of syringes and needles), disposable syringes, capacity 5-10 ml, long needle

1.Epidermis

basement membrane

Subcutaneous fat

Rice. 23. Inserting a needle into the muscle

20 mm, cross-section 0.4-0.8 mm, skin alcohol antiseptic or 70% alcohol (for treating hands and the injection field), sterile cotton balls, napkins - 4 pcs. (for processing the ampoule, injection site - twice before administration and once after administration) on a sterile tray; gloves, disposable towel, liquid soap in a dispenser, medicine (usually from 2 to 10 ml), containers for disinfecting cotton balls, gloves.

Typical injection sites: upper - the outer quadrant of the buttock and the middle third of the outer surface of the thigh.

Required condition: The average medical worker must make sure that the patient has informed consent for the procedure and if it does not, and clarify further actions with the doctor.

	Rationale
Preparation for the procedure
3. Prepare equipment.	Compliance with standards for the consumption of material resources.
4. Draw the medicine into the syringe, displace the air so that the exact dose remains, place the syringe in a sterile tray or sterile syringe packaging.	Fulfilling doctor's orders. Maintaining asepsis.
5. Invite the patient to take a comfortable position.	Depends on the patient’s condition and the drug administered.
6. Determine the injection site by palpation, make sure that there is no pain, compaction, local increase in temperature, rashes, or itching.	Features of injections. Prevention of complications.
7. Wash your hands, dry them, put on gloves.	Ensuring infection safety.
Executing the procedure
1. Treat the injection site with an antiseptic, making smears in one direction, twice, first a large area (approximately 10x10 cm), then only the injection site.	Prevention of injection site infection.
2. Take the syringe in your right hand, holding the needle cannula with your little finger, and hold the syringe cylinder with the piston like a “writing pen”, with the needle down, at an angle of 90° relative to the surface of the patient’s body.	Prevention of complications: damage to the periosteum. The “writing pen” position is recommended to be used in accordance with the approved “Technologies for performing simple medical services”, 2008 (hereinafter referred to as Technologies).
3. Stretch the skin at the injection site with the thumb and forefinger of the left hand (for a child and an old person, gather the muscle into a fold).	A prerequisite for increasing muscle mass.
4. Insert the needle with the syringe, located in the right hand, with a quick movement into the muscle (introduction angle 90°) to 2/3 of the length of the needle.
5. Place your left hand on the piston and pull the piston towards you, make sure that the needle is not in the vessel.	It is necessary to ensure that the needle does not enter the vessel to avoid complications.
b. Inject the medicine slowly into the muscle.

	Rationale
End of the procedure
1. Remove the needle, continuing to hold it by the cannula, and with your left hand press a cotton ball (napkin) moistened with a skin antiseptic to the injection site.	Ensuring infection safety.
2. Dispose of a cotton ball (napkin) and a syringe with a needle in different containers, label the containers.	See Rules for using a container for collecting sharp disposable instruments pSanPiN 2.1.7.728-99 IMU 3.1.2313-08.
3. Remove and immerse gloves in a container with a disinfectant solution.	Ensuring infection safety.
4. Wash hands and dry.
5. Record the result of the implementation in the medical documentation.	Ensuring continuity in the transfer of information.

Additional information: for long courses - one hour after the injection, use a heating pad or make an iodine grid.

Routes of administration of drugs into the body. Methods of external use of medicines. Advantages and disadvantages?

The consequences of desertification in environmental and economic terms are very significant and almost always negative. Agricultural productivity decreases, the diversity of species and the number of animals are reduced, which, especially in poor countries, leads to even greater dependence on natural resources. Desertification limits the availability of basic ecosystem services and threatens human safety. It is an important obstacle to development, which is why the United Nations established World Day to Combat Desertification and Drought in 1995, and subsequently proclaimed 2006 as the International Year of Deserts and Desertification.

Bibliography:

1. Kovda V.A. “Problems of desertification and soil salinization in arid regions of the world”, M: Nauka, 2008

2. Motuzova G.V., Bezuglova O.S. “Ecological monitoring of soils”, M.: Academic Project, Gaudeamus, 2007

3. Ovchinnikova I.N. “Ecological risk and soil pollution”, M., 2003.

4. http://www.geoglobus.ru/ecology/practice2/nature09.php

5. http://www.biodiversity.ru/programs/steppe/bulletin/step-34/vinograd.html

Routes of administration of drugs into the body. Parenteral administration of drugs. Advantages and disadvantages.

outer enteral parenteral

Parenteral administration of drugs and solutions is carried out through intradermal, subcutaneous, intramuscular, IV, intra-arterial, abdominal, pleural cavities, heart, spinal canal, painful focus, bone marrow.

Intradermal, subcutaneous, i/m - done by injection, i/v - by venipuncture or venesection (dissection of access to the vein and the vein itself, done by a doctor).

Advantages: speed of action, accuracy of dosage of the drug in unchanged form.

Flaws: mandatory participation medical staff, compliance with asepsis and antisepsis, difficulty or impossible administration due to bleeding, damage to the skin at the injection site.

Routes of administration of drugs into the body. Methods of external use of medicines. Advantages and disadvantages?

There are several ways to administer drugs: outer(on the skin, through the respiratory tract, on the mucous membranes, in the vagina), enteral(under the tongue, rectally, through the mouth) and parenteral(in\v, s\c, in\m, in\c, into the cavity, into the spinal canal, intracardiac).

External route of drug administration: through skin\ointments, gels\, mucous membranes \eyes\, respiratory tract \nose\.

Advantages: ease of use, availability of direct action on the lesion in case of skin diseases.

Methods of administration: applying ointment to the skin, to the wound surface, rubbing the ointment, inhalation, insertion into the vagina, intestines, using patches, powders, instillation into the eyes, nose, ear.

Disadvantages: inaccurate dose, examine the skin before use, make sure there is no hyperemia, rash, swelling, treat and dry the area of ​​application.

Form: ointments, emulsions, lotions, jellies, pastes, solutions, gels, foam, mash, powders, infusion, aerosols.

17 . Routes of administration of drugs into the body. Inhalation method administration of drugs through the mouth and nose. Advantages and disadvantages ?.

There are several ways to administer drugs: outer(on the skin, through the respiratory tract, on the mucous membranes, in the vagina), enteral(under the tongue, rectally, through the mouth) and parenteral(in\v, s\c, in\m, in\c, into the cavity, into the spinal canal, intracardiac).

The administration of drugs through the respiratory tract by inhalation is inhalation.

Ingestion in the form of an aerosol is preferable when providing emergency care to a patient; the smaller the particle, the more effective the treatment. Inhalers are stationary, portable, or pocket-sized. Using an inhaler, medications are administered through the mouth or nose. Before inhalation, both powder and liquid forms\infusions, decoctions\ are diluted with distilled water or saline. p-th to the required amount prescribed by the doctor. Have wide application pocket inhalers, ready-made pharmacological forms in pharmaceutical packaging, come in ampoules or bottles and are intended for inhalation both through the nose and through the mouth\special nozzle\. Medicines are in an inhaler bottle in the form of an aerosol in factory packaging. The amount and time of use are prescribed by the doctor.

Advantage: ease of use, accessibility, acts directly on the affected area: mucous membranes, respiratory tract, has a local and resorptive effect, and enters the blood very vigorously.

Disadvantages: irritation of the respiratory tract, not always good penetration into the lesion.

18 . Routes of administration of drugs into the body. Administration of drugs per orally, sublingually. The concept of taking medications: “before meals”, “during meals”, “after meals”, “on an empty stomach”, “before bedtime”. Advantages and disadvantages.

Routes of administration:

1. External(skin, mucous membranes, upper respiratory tract).
2. Internal (enteral)(oral, sublingual, rectal)
3. Parenteral(injections: in soft fabrics, vessels, cavities, meninges)

Orally (in the mouth)– the drug is absorbed slowly, absorbing the mucous membranes of the gastrointestinal tract, absorption occurs mainly in small intestine, in the liver, possibly inactivated - entering the bloodstream it has a general systemic effect.

Form: tablets, capsules, drops, powders, tinctures, mixtures, syrups, decoctions.

Advantage: safety and effectiveness, simplicity and accessibility, variety dosage forms.

Disadvantages: inaccurate dosage, absorption effect on the gastrointestinal tract, slow and incomplete absorption, allergic reaction, dependence on pathology (vomiting, convulsions), side effects.

Sublingual (under the tongue) for example nitroglycerin.

Form: capsules, solutions, tablets.

Advantages: urgent Care quickly absorbed into the blood, bypassing the gastrointestinal tract; no professional knowledge is required.

Disadvantages: not knowing the dosage.

Take before meals- this means 15-30 minutes before meals.

“during meals” - with food intake (improves the digestion process)

“after meals” - all irritating drugs (that irritate the gastric mucosa)

“on an empty stomach” - 20 – 60 minutes before breakfast for a shortened therapeutic effect(laxatives, anthelmintics)

“before bedtime” 15-20 minutes before bedtime (sleeping pills)

19 . Routes of administration of drugs into the body. Direct administration of drugs intestine (liquid and solid dosage forms). Advantages and disadvantages.

There are several ways to administer drugs: outer(on the skin, through the respiratory tract, on the mucous membranes, in the vagina), enteral(under the tongue, rectally, through the mouth) and parenteral(in\v, s\c, in\m, in\c, into the cavity, into the spinal canal, intracardiac).

Rectally- this means through the rectum, carried out in the form of liquid dosage forms (decoctions, solutions, mucus) and solid (suppositories), provides local impact on the mucous membrane and resorptive on the body as a whole.

When inserting a suppository into the rectum, we open the package so that the suppository remains in the package, and we press and squeeze it into the anus without touching the suppository itself, because it melts from the heat in your hands and so as not to violate the sterility

Advantages: absorption into the blood unchanged, bypassing the liver, safe alternative way introduction

Disadvantages: before administration you need to give a cleansing enema.

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 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, and treat the ampoule (in case the needle does touch outer surface ampoules 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 thumb left hand on the needle cannula, 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. Using a dry cotton ball, 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: middle third of the anterior outer surface of the shoulder and thigh, subscapular region, anterior surface 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); index finger hold the needle cannula.

8. Place your left hand on the plunger and inject the medicine, fixing the syringe 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. Make light massage injection sites 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.

Inhalation method of drug administration (pocket inhaler). Algorithm for performing the procedure.

(see collection Algorithms for medical services)

The introduction of drugs into the body by inhalation is called inhalation. Medicine is in a bottle in the form of an aerosol. The nurse should teach the patient this procedure, since he usually performs it independently. Through inhalation, medications are administered through the mouth or nose.

Inhalation of a drug by mouth

Inhalation of a drug through the nose

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

Rectal method of administering medications.

Administration of drugs into the rectum:

Liquid - decoctions, solutions, mucus;

Solid candles.

Setting up a therapeutic enema.

Intradermal injection. Places of production. Target. Equipment. Action algorithm. Prevention possible complications

(see collection Algorithms for medical services)

Subcutaneous injection. Equipment. Algorithm of actions. Prevention of possible complications (see the collection Algorithms of medical services)

Intramuscular injection. Places of administration. Action algorithm. Prevention of possible complications (see the collection Algorithms for medical services)

Intravenous injection. Equipment. Action algorithm. Prevention of possible complications (see the collection Algorithms for medical services)

Question 14. Inhalation route administration of medications: types of inhalers, rules for using a pocket inhaler.

Inhalation route of administration - administration of drugs through the respiratory tract. Aerosols, gaseous substances (nitrous oxide, oxygen), vapors of volatile liquids (ether, fluorothane) are introduced.

The medicine in the inhaler bottle is in the form of an aerosol. Used as a vasoconstrictor and anti-inflammatory agent in the nose and mouth.

Advantages:

Local action (in the mouth, nose);

Effect in unchanged form on the pathological focus.

Flaws:

Irritation of the mucous membrane of the respiratory tract;

Poor penetration of drugs directly into the lesion in case of impaired bronchial obstruction.

There are inhalers: stationary, portable, pocket.

Pocket inhalers are used during an attack bronchial asthma. A nurse is teaching a client how to use a personal inhaler.

Using a pocket inhaler

Sequencing:

1. Wash and dry your hands.

2. Remove the protective cap from the can and turn it upside down.

3. Shake the drug.

4. Cover the nozzle with your lips.

5. Take a deep breath, press the bottom of the can and hold your breath for 5-10 seconds.

6. Exhale slowly through your nose.

7. Put on the protective cap.

8. Wash and dry your hands.

The medicine can be administered into the nose using a special nozzle.