Place patient in the Sim’s left lateral position with the upper leg flexed
Open the package of lubricant and remove the foil wrapper from the suppository
Apply a small amount of lubricant to the smooth rounded end of the suppository
Lubricate the gloved index finger
Ask the patient to breathe through the mouth
Insert the suppository into the rectal canal beyond the internal sphincter about 4 inches for an adult and 1 inch for a child
Avoid inserting the suppository into feces
Withdraw the finger and wipe the anal area with tissue
Ask patient to remain in bed for 15 minutes and to resist urge to defecate
Remove glove and wash hand
Record the name of the drug, dosage, route, and time of administration on MAR
Observe the effectiveness of medication
Oral Medications:
Pills
- Can be swallowed directly or sublingual (leave these under the tongue until dissolved)
- Open pack & drop into medicine cup
Granule/ Powders
- Pour into a cup up to correct dosage
Liquids
- Unit dose is a sealed container
- Water based liquid - read meniscus down
- Oil based liquid - read meniscus up
Parentral Meds:
Syringes
- Unit doses and self prepared
- The numbers represent:
1. Volume
2. Gauge of needle (diameter of inside of needle) the higher the number the smaller the needle hole
3. Length of needle
- Insulin syringes and needles
- Tuberculin syringes and needles
- The color of the packaging represents the gauge of the needle
- All needles are interchangeable except for the insulin syringe
- The tuberculin syringe is not lure-locked, needle pulls off- can measure in tenths and hundredths- pediatrics
- 2 types of insulin syringes -
a. 100 U = 1cc - each line = 2 Units
b. 50 U - each line = 1 Unit
- Unit dose syringe comes prefilled by the company - usually use entire contents - discard what
will not be used.
- Tubex syringe - cartridge with holder - prefilled - discard into sharps container.
Administering a Metered Dose Inhaler (self administration)
Equipments:
Medication Administration Record (MAR)
Inhaler
Non-sterile Gloves
Wash basin or sink to rinse mouth
Tissue (optional)
Nursing Actions:
Check any allergies that patient has or any medical condition that is contraindicated with the use of thd drug
Obtain all equipments
Check the written order on MAR
Wash hands
Follow the five right of medication administration
Check the patient identification
Allow the patient o hold and manipulate the canister and explain how the canister fits into the inhaler.
Have the patient demonstrate the insertion of the canister
Discuss the metered-dose concept and frequency of dose to the patient
Explain that the inhaler should be shaken before each use
Remove the mouthpiece and cap from the bottle and insert the stem into the small hole on the flattened portion of the mouthpiece. The patient should grasp the inhaler with thumb and first two fingers
Instruct the patient to exhale, place the mouthpiece into the mouth and tighten the lips (seal) around the mouthpieces
Ask the patient to firmly push the cylinder down against the mouthpiece only once, while slowly inhaling until the lungs feel full
Instruct the patient to remove the mouthpiece while holding the breath for about 10 seconds then exhale slowly through pursed lips
Repeat the doses as prescribed and waiting 1 minute between puffs
A mouthwash can be use by the patient to remove the taste of the medication
Demonstrate to the patient how to wash the mouthpiece under tepid running water to remove secretions
If two or more inhaler medication are prescribed, wait 5-10 minutes between inhalations or as specifically ordered by physician
Record all the drug’s name, dose, date, and time for medication on MAR
Observe for effectiveness of medication and relief of the patient’s symptoms
THE FUNCTIONS OF ARTICLES WITH COMMON NOUNS
The Indefinite Article
§ 2. With countable nouns, both concrete and abstract, the in- definite article is used when we wish to name an object (a thing, a person, an animal or an abstract notion), to state what kind of ob- ject is meant.
e.g. He gave her a cigarette and lighted it.
There came a tap at the door, and a small elderly man en- tered the room, wearing a black cap.
This function may be called the nominating function.
But at the same time, owing to its origin from the numeral one, the indefinite article always implies the idea of oneness and is used only before nouns in the singular.
The idea of oneness may sometimes become quite prominent. It occurs in the following cases:
a) ahundred, a thousand, a minute, a mile, etc.
b) after the negative not — not a word, not a trace, not a thought, etc.
c) in some set phrases — one at a time, at a draught (as in: He emptied his glass at a draught), a stitch in time saves nine, etc.
§ 3. When the speaker uses the indefinite article, he just names an object which is usually new to the hearer. So the indefi- nite article is often used to introduce a new element in the sen- tence. Since the new element is, as a rule, important and attracts attention, the noun with the indefinite article frequently becomes the centre of communication and is marked by strong stress.
e.g. I think he is a stupid fellow.
Presently the Browns arrived. They brought with them a
small child, a governess and a dog. The table was covered with a white cloth.
In contrast to this, the definite article usually indicates that a definite object is meant and that it is not new to the hearer. That is why it often serves to show that the noun is not the centre of communication. Compare the following sentences:
e.g. I bought a book yesterday. I bought the book yesterday.
From the first sentence the hearer learns what object was bought yesterday. So a book is the new element in the sentence. From the second sentence the hearer learns when the book was bought (he already knows that the speaker bought a book). In this case the book is not the centre of communication.
In the Russian language which has no article, the centre of communication is usually marked by word-order and also stress.
Cf.
A boy rushed into the room. The boy rushed into the room. They were sent to a conference
in May. They were sent to the conference
inMay.
 êîìíàòó âáåæàë ìàëü÷èê. Ìàëü÷èê âáåæàë â êîìíàòó. Èõ ïîñëàëè â ìàå íà êîíôå
ðåíöèþ. Èõ ïîñëàëè íà êîíôåðåíöèþ
â ìàå.
This distinction between the two articles is very helpful in most cases but the rule does not always hold good. We may find sentences in which a noun with an indefinite article does not serve as the centre of communication and is not marked by strong stress , (a) and, vice versa, a noun with the definite article marked by strong stress may become the most important element of communi- cation (b).
e.g. a) A camel can carry heavy loads, b) "Shut the door," he ordered.
It follows from the above examples that the use of the indefi- nite article with nouns serving as the centre of communication is i to be regarded as an additional rule.
§ 4. With uncountable nouns, the indefinite article serves to bring out a special aspect of the notion expressed by the noun. In this case its function may be called aspective.
e.g. A dull burning anger rose in his chest. He had almost a supernatural courage.
In this case the noun is usually qualified by an attribute which also brings out a special aspect. In its aspective function the indef- inite article is devoid of the idea of oneness.
The Definite Article
§ 5. When used with countable nouns, either concrete or ab- stract, the definite article has two distinct functions:
1) It may be used with singular and plural nouns to show that the noun denotes a particular object (a thing, a person, an animal or an abstract notion) or a group of objects as distinct from the others of the same kind. In other words, the definite article serves to single out an object or several objects from all the other objects of the same class. This function is called the individualizing func- tion of the definite article.
e.g. The car stopped. Paul got out and stretched himself.
As we stood on the steps, we felt the smell of fallen leaves
coming from the garden. Margot took up the telephone.
2) The definite article may also have the generic function with countable nouns. With nouns in the singular it serves to indicate that the noun becomes a composite image of the class.
e.g. The tiger has always had the reputation of being a man-eater. The linguist is interested in the form and meaning of all pos- sible statements in a language.
§6. With uncountable nouns, the function of the definite arti- cle may be called restricting.
The definite article restricts the material denoted by a concrete uncountable noun to a definite quantity, portion or to a definite locality (a); it also restricts the abstract notion expressed by an uncountable noun to a particular instance (b).
e.g. a) He slowly pulled on his gloves, concentrating on each foldin the leather.
b) The work seemed to consist chiefly of interviewing youngwomen for jobs in department stores.
Absence of the Article (the Zero Article)
§ 7. The absence of the article (the zero article) has only one function with common nouns — the nominating function.
This function of the zero article may be found with countable nouns in the plural; it is parallel to the use of the indefinite arti- cle with singular countable nouns. But while the indefinite article is associated with the idea of oneness, the zero article always im- plies more-than-oneness.
e.g. Marion came round the corner of the house, wearing garden- inggloves and a very old skirt.
My mother gave me some pennies to buy apples or a magazine.
She had a splitting headache and took an aspirin and sleep- ing pills.
The nominating function of the zero article is also found with uncountable nouns, both abstract and concrete (names of materials).
e.g. Last night I felt friendship and sympathy for Henry, but to- day he has become an enemy. Life goes on, changeless and ever changing. Winterbourne asked for water and drank thirstily.