Applying Topical Medication, Medicated Patches and Giving Medication by Mouth

As we talk about the methods of giving
medication by different routes, it’s important to remember that you always
need to follow the written instructions from the child’s health care provider.
These instructions will tell you the five rights: the child’s name, the
medication, dose, route, and time so you know what to give and went to give it.
But you may also need to look at the information that comes with the
medication either written on the package or on the pharmacy printout for how to
give the medication. Knowing how to give medication is just as critical as
knowing what to give because each medication has specific instructions
you’ll need to follow. This training will provide you with key principles to keep
in mind as you give medication. Topical medication comes in many forms
including creams, lotions, gels, ointmints, or aerosols. Putting on topical
medication is usually not complicated but follow these principles to make sure
you give the medication safely. You should wear gloves if the skin on
your hands or the child’s skin where the medication is to be applied is cut,
scabbed, or broken; if your skin should not come in contact with the medication;
If you feel more comfortable wearing them; or if you will come in contact with
body fluids such as saliva or naval secretions. When applying creams, gels, or
ointment, squeeze the medication into your hand and then use your other hand
to apply the medication. Don’t put the tube directly on the child’s skin and
squeeze. This helps keep the medication container clean and makes sure you don’t
put too much on the child’s skin. Apply the medication evenly over the child’s
skin. If you need to apply more medication, change gloves and squeeze the
medication into the clean glove. Topical medication can also come as an aerosol
spray. The directions for use on the bottle to tell you how far away from the
child you should hold the spray. You may also need to apply medicated
patches to the skin. Medicated patches are applied to the child’s skin so the
child’s body can absorb the medication slowly. The medicated patch may be left
on the child for different lengths of time so be sure you know if you are
responsible for removing it. Even though medicated patches are applied to the
skin there are different principles for putting them on. Using a waterproof pen,
write the date and time directly on the patch to communicate with others when it
was applied. This helps if anyone other than you is removing it. Choose the area
where you will put the new patch. The place you choose must be free from any
cuts or broken skin. You should alternate sites unless otherwise instructed. Clean
the child’s skin with soap and water and pat the skin dry. Wear gloves if needed.
All medicated patches may be applied differently so be sure to follow the
written instructions. Be sure these instructions include what to do if the
child removes the patch or if it falls off. Even if the parents or other staff
applied the patch, you may be responsible for removing it, so follow these
guidelines. To avoid coming in contact with the medication put on gloves to
remove the old patch. Unless otherwise instructed, wash off the residual
medication. It’s good practice to roll the patch up in the dirty gloves and
throw it away so it’s not accessible. The most common way children get
medication is by mouth, such as tablets, liquids, melts, or medication that is
rubbed on the gums. But no matter what oral medication you give here are a few
principles to follow to be sure you are giving it safely. If you need to get
tablets, capsules, or melts out of a bottle, avoid touching them with your
bare hands by pouring the number you need into the container cap and then
into a small cup. If you pour too many out, return the extra ones to the bottle
without touching them. Even though the medication bottle is not
sterile, this helps to keep the medication as free as possible from
germs. Always protect yourself and the child when giving medication by wearing
gloves. Whether or not you need gloves depends on how the medication is
prepared and if you may be exposed to any body fluids while giving it. Never
crush or split a tablet or capsule unless you have instructions to do so.
You can change the effectiveness of the medication and may possibly harm the
child if the medication has a protective coating. If the instructions tell you to
crush or sprinkle the medication, add the medication to a small amount of food.
This way you can be sure the child will finish and get the entire dose. Be sure
to check the package instructions to see if there are certain types of food you
should not mix the medication with. If a child needs to swallow the medication,
look in the child’s mouth and under the tongue to make sure the child took it. Many medications given by mouth are also
available as a liquid. Liquid medication is often given to children because the
dose can be easily adjusted based on the child’s age and weight and because the
child has an easier time taking it. Giving liquid medication by mouth will
require you to pay careful attention to how you are measuring the correct dose.
When measuring liquid medication always use the tool that comes with the
medication or the one provided by the parent. If the tool is separate from the
medication container, make sure it is labeled with the child’s first and last
names. Remember, the measurement on the
administration tool must exactly match the measurement on the child’s written
medication consent form. Do not convert a dose from one form of measurement to
another. There is too much of a chance to make a mistake. If the instructions tell
you to give one teaspoon and the tool only has measurements in CCs or
milliliters, you will need a new tool with teaspoons on it before you can give
the medication. If you want to mark the correct dose on the tool with a pen, be
sure to mark next to the measurement line instead of on top of it. In addition to following the package
instructions, keep these guidelines in mind when measuring any liquid
medication. Pour the liquid out of the bottle from the side opposite the
pharmacy label to avoid dripping any medication on it. To make sure you have
the right amount of medication, use the lowest point of the liquids curvature,
not the edges when measuring. If you pour too much liquid into the medicine cup or
spoon, pour the excess into a second clean disposable cup. You can now use the
second cup to add or subtract liquid until you’ve reached the correct dose.
Unless otherwise instructed, you can return this leftover medication to the
original container. If you’re using a medicine cup, put the cup on a flat
surface after you have poured the medication and
check it at eye level. If you’re using a dosing spoon, check the medication dose
at eye level and wipe any excess medication that may be on the outside or
in the lip of the dosing spoon to make sure you are giving the correct dose.
Even a little bit on the outside can dramatically change the dose. After
giving the medication, put a little water into the cup or spoon to collect any
residual medication that may be left over. Have the child drink this. If the parent gives you an oral
medication syringe, check to see if it has a cap. If so, be sure to remove it and
throw it away so it does not become a choking hazard. Before you start, make
sure the plunger is pushed all the way down into the syringe.
If the bottle has an adapter, put the syringe in the adapter and pull the
syringe plunger until you get the correct dose. Carefully turn the bottle
upright before removing the syringe in order to avoid spilling medication. If
the bottle does not come with an adapter pour a small amount of medication into a
clean disposable cup. Place the tip of the syringe into the liquid and pull up
on the plunger to draw the medication. The top of the plunger must be level
with a line on the syringe that marks the right dose. You need to make sure the
syringe tip is filled with the medication you need to give in order for
the dose to be correct. There should not be any air bubbles in the syringe. If you
need to remove air bubbles, turn the syringe so the tip is pointing towards
the ceiling, then tap the syringe to move the air bubbles to the top. Push the
plunger to remove the air bubbles. After removing the bubbles, recheck the
syringe at eye level to make sure the dose is correct and wipe off any
medication on the outside of the syringe. Give the medication by placing the tool
in the child’s mouth between the rear gum and cheek. Do not squirt more
medication then the child can swallow at one time. After giving medication by
mouth, be sure to clean any administration tools you use to prevent
buildup of medication. This will help avoid giving a wrong dose and prevent
possible infections. You can wash medicine cups, dosing spoons, oral
syringes, and pill crushers with dishwashing soap in water, but never put
an oral medication syringe in the dishwasher because the rubber can break
down or the measurement markings can become worn
and unable to read. Your trainer will provide you with time to practice
applying topical medications and giving medication by mouth.