BAPTIST MEMORIAL HOSPITAL Memphis Campus

PATIENT CARE POLICY AND PROCEDURE MANUAL

Effective Date: 5/02 Last Review/Revision:5/04,5/06 (Header Only: 4/08) Reference #: I-30

MEDICATION ADMINISTRATION: AGE SPECIFIC VARIATIONS

PURPOSE:

To outline age-specific variations for medication administration by the nurse.

PROCEDURE: In addition to the rights of medication administration (right patient, right drug, right dose, right route, right time, right reason, right response) the nurse considers the following: A. Infant 1. When instilling ear drops, pull the auricle down and back. 2. The vastus lateralis muscle of the thigh is used most often for IM injections. B. Child 1. Liquid oral medications are the preferred route of administration for children. Solid preparations are not recommended for children less than 5 years of age. 2. Children may move about, causing topical medication to be wiped off the skin. Cover loosely, if necessary. 3. After a medication has been inserted into the rectum, press the buttocks together for several minutes to prevent expulsion. 4. For injections: a. Demonstrate the procedure on a doll or teddy bear using a syringe without a needle. b. Distracting the child so he does not see the syringe and needle may help relieve anxiety. c. The vastus lateralis muscle of the thigh is used most often for IM injections. d. Use the gluteal muscle for IM injections after a toddler has been walking for one year. 5. Offer carbonated beverages over ice after giving oral medications to help reduce nausea. 6. When instilling ear drops in a child under age 3, pull the auricle down and back. C. Adolescent 1. Provide extra privacy during rectal medication administration. 2. Offer carbonated beverages over ice after giving oral medications to help reduce nausea. D. Adult 1. Offer carbonated beverages over ice after giving oral medications to help reduce nausea. E. Older Adult 1. Because the older patient is more at risk for fluid overload, consider fluid restrictions when giving oral medications. 2. When giving oral medications: a. Encourage patient to take one tablet at a time and not rush. b. Remember the older patient may have a dry mouth due to loss of elasticity in oral mucosa or reduction in parotid gland secretion.
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c. Note any difficulty in swallowing which may increase risk of aspiration. 3. When giving IM injections: a. Locate an area of skin with minimal wrinkles. b. Consider using a shorter and smaller gauge needle due to muscle atrophy. c. Give no more than 2 ml of medication with each injection. 4. A fecal impaction may occur more often, and interfere with suppository placement.

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