Rules for using a pocket inhaler are necessary for maximum effective application dosed medicines at chronic diseases respiratory organs (most often with bronchial asthma). Pocket inhalation drugs intended for patients with chronic diseases respiratory system, at risk sudden spasm of the airways and forced to use fast-acting aerosol bronchodilators.

Algorithm for using a pocket inhaler

Since a metered dose inhaler is an “ambulance” device, the required dose of the drug that will reach the patient depends on the technique of its use. Airways and will have a bronchodilator effect.

Algorithm for using the inhaler:

1. 1. shake the inhaler;
2. 2. remove the protective cap;
3. 3. take a deep breath;
4. 4. insert the mouthpiece into the mouth;
5. 5. Having started to inhale, press the can;
6. 6. After making sure that the medicinal substance has entered the mouth, continue taking a slow, deep breath;
7. 7. hold your breath;
8. 8. Having taken out the can, exhale through your nose;
9. 9. close the inhaler with the mouthpiece.

A mandatory requirement for the inhalation technique is to inhale simultaneously while pressing the canister, otherwise a significant part of the aerosol substance will dissipate into the surrounding air, bypassing the respiratory tract.

As practice shows, errors in the use of inhalation devices are made by more than half of patients, of which the majority of errors are observed in people over 50 years of age.

Inhalation aids

To make using the inhaler easier, there are spacers - special attachments in the form of a reservoir for an aerosol substance. With their help, even small children can perform inhalations (in this case, a face mask is put on the mouthpiece).

When a person is unable to use an inhaler due to childhood or old age, serious condition or impaired brain function, it is advisable to use nebulizers - electric inhalation devices. Their special feature is spraying under pressure medicinal solution and its delivery to the farthest parts of the respiratory tract, which is indispensable during severe exacerbations of the disease, when it is impossible to take a deep breath and hold your breath. Depending on the spraying method, there are several types of nebulizers:

• compressor;
• ultrasonic;
• membrane

Conditions for inhalation.

· Found quite widespread use in pediatrics this method: carry out inhalations of steam, heat-moist, oil, aerosols of medicines.

· Both stationary and portable inhalers are used.

· Sick child early age wrapped in a blanket and held on your knees, placing a mask (mouthpiece) and a spray bottle on the mouth and nose. The child's cry promotes deeper inhalation of the aerosol.

· Older children cover the mouthpiece of the nebulizer with their lips and periodically take deep breaths.

· For children with asthma, portable inhalers are widely used: to successfully carry out inhalation, a bottle with medicinal substances It must be positioned strictly perpendicularly, bottom up; When inhaling an aerosol mixture from an inhaler, a child must throw back his head, otherwise up to 90% of the medicine remains in the throat.

METHOD OF USING A PORTABLE INHALER

Nurse.

· reads the name of the drug;

· Explains the procedure to the child using an inhalation canister without medication;

· sits the child down, and if his condition allows, it is better to carry out inhalation in the child’s standing position, since in this case a respiratory excursion is more effective;

· removes the protective cap from the inhaler;

· turns the aerosol can upside down and shakes it;

· asks the child to take a deep breath;

· insert the mouthpiece of the inhaler into the child’s mouth, simply wrap it as tightly as possible with your lips and tilt your head slightly back;

· asks the child to take a deep breath through his mouth, while simultaneously pressing on the bottom of the can;

· removes the inhaler mouthpiece from the child’s mouth, asking him to hold his breath for 5-10 seconds;

· forgive the child and then exhale calmly

Invites the child to independently perform this procedure in her presence:

· after completing the procedure, close the inhaler with a sewn cap.

ENTERAL METHOD OF ADMINISTRATION OF MEDICINES

Involves administering medications through the mouth, sublingually, or into the rectum.

METHOD OF ADMINISTRATION OF MEDICINES THROUGH THE ORAL

The nurse should give medications for internal use to children herself, without entrusting this to mothers of young children or children of high school age themselves.

When distributing medicines nurse must comply following rules:

1. Carefully read the label on the package and the entry on the prescription sheet so as not to confuse the medications;

2. Distribute medications at the bedside of a sick child;

3. The child must swallow and wash down the medicine in the presence of a nurse;

4. Products marked “before meals” must be given to the child 15 minutes before meals; with the mark “after meals” - write 15 minutes after taking it: products intended to be taken “on an empty stomach” - give to the child in the morning an hour before breakfast;

5. For older children, solid dosage forms - tablets, capsules, dragees - the nurse places on the root of the tongue and gives them to drink with a small amount of water: sprinkle the powder on the root of the tongue and give to drink with water: liquid dosage forms (infusions, solutions, mixtures, decoctions) Gives you to drink from a spoon or from a beaker and wash it down with water; alcohol tinctures, extracts are prescribed in drops - the nurse measures the required number of drops into a beaker, adds a little water, gives it to the child to drink and wash it down clean water;

6. Special small packages of medications are made for young children; The nurse gives medications in the form of a powder, diluting it in a spoon or in a small bottle in a small amount of water, milk or syrup; It is more convenient to use medicines in solutions for such children, in suspensions with the addition of sugar and fruit syrups;

7. If the child must receive several medications at the same time, the nurse should not mix them, but should give each medication one at a time.

8. In case of persistent vomiting, all medications are administered to the child in the form of suppositories and parenterally.

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

(see collection Algorithms 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 for 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)

External route of administration– the effect of drugs is predominantly local on the skin and mucous membranes, in the eyes, nose, ears, and through the respiratory tract.

Target local application medications:

Improving the absorption of drugs through the skin or mucous membranes;

Providing a local anesthetic effect;

Providing a bactericidal and bacteriostatic effect.

Directions for use: compresses, lotions, powdering, application, rubbing, bandages, instillation of drops, inhalations.

Dosage forms: ointments, emulsions, liniments, lotions, jellies, gels, foams, pastes, solutions, mash, powders, tinctures, aerosols.

Advantages: availability, variety of dosage forms and methods of their use.

Flaws: The method is designed primarily for local effects, since only fat-soluble substances are absorbed through intact skin.

REMEMBER!

When using the medicine on the skin you must:

Inspect the place where the medicine was applied, make sure there is no redness, rash, swelling, or weeping;

Handle warm water or skin antiseptic;

Dry with a towel or gauze pads.

Before exposure to the skin, dosage forms:

Liquid (lotion, mash) - pour onto a gauze napkin;

Soft (ointment, paste, cream, jelly, gel) - apply to the skin area with an applicator, napkins, spatula, hands;

Solid (powders) - apply to the skin area with shaking movements from the packaging.

Application of powder

Sequencing:

2. Wash and dry the skin with a napkin or towel.

3. Apply evenly to the skin (“powder”) using shaking movements.

4. Remove gloves and throw into disinfectant.

5. Treat your hands.

Applying the patch to intact skin

Sequencing:

1. Clean your hands and put on gloves.

2. Open the plaster package with scissors.

3. Remove the protective layer without touching the inner surface with your hands.

4. Fix the patch on the skin.

5. Provide the patient with comfortable conditions.

7. Treat your hands.

Methods of applying ointments, gels, jellies, pastes to the skin:

1. Application.

2. Rubbing.

3.Compresses.

4. Bandages.

Applying ointments to the skin

Sequencing:

1. Examine the area of ​​skin to apply the ointment.

2. Clean your hands and put on gloves.

3. Squeeze the required amount of ointment from the tube onto the applicator.

4. When applying ointment to the skin, apply the ointment in a thin layer;

when rubbing the ointment, rub the ointment with rotational movements until complete absorption (until the skin becomes dry).

5. When applying the ointment to the skin, leave the skin open for 10-15 minutes until completely absorbed;

when rubbing the ointment, cover the patient for warmth or warmth, wrap the area where the ointment was rubbed.

6. Create a comfortable position for the patient.

7. Remove gloves, discard in disinfectant, wash and dry hands.

Notes :

Ointment irritating effect apply to the applicator, indifferent - to the hands.

It is necessary to carefully study the instructions for using ointments.

REMEMBER!

Before administering drugs to the eyes, nose, ears, you must:

1) carry out personal hygiene measures;

2) observe the temperature regime of the drops:

in the eyes, nose - room temperature

in the ears - body temperature.

Drugs are used in the nose for the following purposes:

Ensuring nasal breathing (vasoconstrictors);

Anti-inflammatory therapy;

Immunostimulation.

Putting drops into the nose

Sequencing:

1. Clean your hands and put on gloves.

3. Raise the tip of the nose.

4. Place 3-4 drops of the drug into one nasal passage, press the wing of the nose to the septum and tilt your head in the same direction.

5. After 2 minutes, apply drops in the same sequence to the other nasal passage.

6. Remove gloves and throw into disinfectant.

7. Treat your hands.

Notes: When using oil preparations, tilt the patient's head back and inject 5-6 drops into both nasal passages. In the mouth the patient will feel the taste of drops of the drug flowing down back wall throats.

Before and after the manipulation you should ask to release nasal cavity from mucus using wipes. Blow your nose without straining, alternately from each nostril.

Putting ointment in the nose

Sequencing:

1. Clean your hands and put on gloves.

2. Sit (or lay) the patient down, tilt his head slightly back.

3. Apply a small amount of ointment to the cotton wool.

4. Raise the tip of the nose.

5. Insert the turunda with ointment into the nasal passage with rotational movements to a depth of no more than 1.5 cm.

6. Leave the turunda in the nose for 10-15 MINUTES, then remove.

7. If necessary, insert turunda with ointment into the other nasal passage.

8. Dump the turunda into a special tray.

10. Treat your hands.

Drugs are used in the ear for the following purposes:

· pain relief;

· administration of antibiotics;

· softening of sulfur.

Putting drops in the ear

Sequencing:

1. Clean your hands and put on gloves.

2. Sit (or lay down) the patient, tilt his head to the healthy side.

3. Heat the preparation to body temperature.

5. Introduce 5-6 drops into the external auditory canal.

6. Press lightly on the tragus of the ear to direct the drops inward.

7. Place a cotton ball and do not change the position of your head for 5-10 minutes.

8. Drop the ball into a special tray.

9. Remove gloves and throw into disinfectant.

10. Treat your hands.

Putting ointment in the ear

Sequencing:

1. Clean your hands and put on gloves.

2. Sit (or lay down) the patient, tilting his head to the opposite shoulder.

3. Apply the required amount of ointment to a sterile cotton swab.

4. Pull back auricle upward and posteriorly to straighten the external auditory canal.

5. Insert the cotton wool into the external auditory canal using rotational movements.

6. Leave the turunda in the ear for the duration of the therapeutic effect, and then throw it into the disinfectant.

7. Remove gloves and throw into disinfectant.

Goals administration of ophthalmic drugs:

Local effect of the drug;

Measurement of intraocular pressure;

Pupil dilation for examination.

All medications and dressings must be sterile and medications intended for ophthalmic practice are injected into the lower conjunctival sac so as not to damage the sensitive cornea; It is not recommended to use dry balls. When applying the drug, do not touch the eyelashes, eyelids, or conjunctiva.

The eye is an organ sensitive to infection and injury.

Putting drops into the eyes

Sequencing:

1. Clean your hands and put on gloves.

2. Sit (or lay down) the patient with his head thrown back. Give a sterile ball/napkin into your hands. to ensure personal hygiene.

3. Ask the patient to look up.

4. Pull back thumb left hand lower eyelid downwards.

5. Introduce 1 drop into the lower fornix eyeball without touching the eyelashes and holding the pipette perpendicular to the lower eyelid.

6. Ask the patient to close his eyes.

7. Apply a sterile cotton ball moistened with 0.9% sodium chloride solution to the inner corner to remove part of the medication.

8. Drop the balls into a special tray.

9. Remove gloves and throw into disinfectant.

10. Treat your hands.

11. Create a comfortable position for the patient.

Putting eye ointment from a tube

Sequencing:

1. Clean your hands and put on gloves.

2. Sit (or lay down) the patient with his head thrown back and ask him to look up.

3. Pull the lower eyelid down with your thumb.

4. Apply the ointment into the lower conjunctival fornix from the inner corner of the eye to the outer.

5. Ask the patient to close his eyelids.

6. Remove excess ointment with a sterile cotton ball and perform a light circular massage through closed eyelids,

7. Discard the balls, treat the “nose” of the tube with a ball moistened with alcohol.

8. Remove gloves and throw into disinfectant.

9. Treat your hands.

10. Create a comfortable position for the patient.

Inhalation route of administration

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.

Question 14. Inhalation route of drug administration: 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 to treat an attack of 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.