What Is This Module About?

It is to understand and acquire knowledge, skills and attitude in instituting nursing

measures including drug administration. You will find out how these are important
in continuing your course. Doing the right and dealing it right with your patient is
well appreciated.

What Will You Learn From This Module?

In this module you will learn the art of administering drugs responsibly, properties
of ideal drug, therapeutic objective of drug therapy, factors that determined how
an individual will respond to a specific drug and dosage.
This module is divided into three lessons. These are:

1. Orientation to Drug Administration

2. Classification/ Types of medication order
3. Routes of administration
4. Drugs and solution

Let’s see what you already know

Before you start reading this module, answer first the questions that follow to
determine how much you already know the topics to be discussed.

1. Study of drugs in humans

a. Pharmacology
b. Drugs
c.Therapeutics
d. Clinical pharmacology
2. Use of the drugs to diagnose, prevent and treat illness
a. pharmacology
b. absorption
c.therapeutics
d. distribution
3. Drugs diffuse across a cell membrane from a region of high concentration to one
of low concentration.
a. Pinocytosis
b. Active transport
c.Passive diffusion
d. Excretion
4. The movement of drug particles from the G.I tract to body fluids.
a. Metabolism
b. Excretion
c.Distribution
d. absorption
5. Liver is the principal site of drug.
a. Absorption
b. Distribution
c.Metabolism
d. Excretion

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 6. The ability of a client to response to a particular dose of drug may diminish after
days or weeks of repeated administration called?
a. Cumulative effect
b. Toxicology
c. Drug to drug interaction
d. Tolerance
7. This term refers with the adverse effect of the drugs.
a. Toxicology
b. Drug to food interaction
c.Placebo effect
d. Adverse effect
8. It is the desired drug effects.
a. Side effect
b. Therapeutic effect
c.Adverse effect
d. Toxic effect
9. The physiologic benefit from harmless compound.
a. Drug tolerance
b. Cumulative effect
c.Placebo effect
d. Adverse effect
10. All of the following are advantages of IV therapy except
a. Rapid response
b. Less discomfort
c.Accurate titration
d. Safest route

Well how was it? Do you think all your answer is correct? Compare your answers with
those in the answer key on last page to find out.

If you got a low score, don’t feel bad because this will help you to comprehend the
important concepts of roles and responsibilities of a health care provider. If you read this
module carefully, you will learn the answers to all the items in the test and a lot more! Are
you ready?

You may go now to next page to begin your lesson.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 2

 Let’s Learn
LESSON 1

ORIENTATION TO DRUG ADMINISTRATION

OBJECTIVES:
• Definition of the four basic terms ( drug, pharmacology, clinical pharmacology,
and therapeutics).
• Properties of ideal drug.
• Therapeutic objective of drug therapy.
• Factors that determined how an individual will respond to a specific drug and
dosage.

Four Basic Terms

1. Drug: any chemical that can affect living processes

2. Pharmacology: the study of drugs and their interactions with living things.
• Physical and chemical properties
• Biochemical and physiological effects
• Knowledge of the history, source, and use of the drugs
• Absorption, distribution, metabolism and excretion
3. Clinical Pharmacology: study of drugs in humans
4. Therapeutics: use of the drugs to diagnose, prevent and treat illness (and/ or
pregnancy) = medical use of drugs

What is pharmacology?

 The word pharmacology is derived from the Greek pharmakon means drug &
logos means study.

 The science that deals with the study of drugs and their interaction with the living
system. Early drugs were derived from plants, animals and minerals. Records of
drugs used date back to 2000 B.C. in the middle east and china. The drugs
commonly used then were laxatives and emetics to induce vomiting.
Drug – is a substance used in the diagnosis, prevention or treatment of disease.

SOURCES OF DRUGS

ANIMAL - ex. Insulin, Epinephrine

PLANT - ex. Digitalis- heart stimulant

Belladonna-

MINERAL - ex. Iron

SYNTHETIC (laboratory made) - ex. Synthetic insulin,
sintocinon/oxytocin

USES OF DRUGS/THERAPEUTIC ACTIONS OF DRUGS

 PREVENTIVE/RESTORATIVE – Returns the body to health ex. Vaccines,

Vitamins and mineral supplements.
 CURATIVE – directed against the cause or curses a disease or a condition.

- ex. Antibiotic/Penicillin for infection

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  PALLATIVE – directed against the symptom/relieves symptoms of a disease but
does not affect the disease itself.

- ex. Morphine sulfate, aspirin for pain.

 DIAGNOSTIC- e x. Barium of x-ray dyes

 Chemotherapeutic – destroys malignant cells

Ex. Busulfan for leukemia

 Substitutive – replaces body fluids or substances

Ex. Thyroxine for hypothyroidism and insulin for diabetes mellitus

 Supportive – supports body function until other treatments or the body’s
response can take over.
Ex. Norepinephrine bitartate for low blood pressure and aspirin for high body
temperature.

HERBAL PLANT

 RA 8423- created the Philippine Institute of Traditional and Alternative Health

Care.

 NEW HERBAL MEDICINES IN THE MARKET

1. Ascof/Clemex- 300mg lagundi tablet, 500mg ascof forte,

syrup(cough & asthma)
2. Re-leaf- 200mg sambong tablet, diuretics that dissolves the kidney
stone
3. Charantia- ampalaya base, antidiabetic
 10 Herbal Plant approved by DOH

HERBAL PLANT USE:

LAGUNDI Cough, asthma, aromatic bath

ULASIMANG-BATO Gout, arthritis

BAYABAS Wound disinfectant, mouth wash

BAWANG Lower the cholesterol level

YERBA BUENA Body pains

SAMBONG Diuretics

AMPALAYA Mild non-insulin dependent diabetic

NIYOG-NIYOGAN Round worm infestation

TSANG GUBAT Stomach pain,

AKAPULKO Fungi infection

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 Two main areas / branches of pharmacology

 The branch of pharmacology dealing with the economic, biological and chemical
aspects of natural drugs and their constituents. Simply the study of natural (plant
& animal) sources.

 Pharmacokinetics – described as what the body does to a drug, refers to the

movement of drug into, through and out of the body; the time of course of its
absorption, distribution, metabolism and excretion (ADME.

 Pharmacodynamics – described as what the drug does to the body. It is the

study of the biochemical, physiologic, and molecular effects of drugs on the body.

Category of pharmacokinetic

1. Absorption

 The movement of drug particles from the G.I tract to body fluids by passive
diffusion & active absorption or pinocytosis.
 Passive diffusion – drug diffuse across a cell membrane from a region of high
concentration to one of low concentration.
 Active transport – is selective, requires energy expenditure, and may involve
transport against a concentration gradient.
 Pinocytosis – fluid or particles are engulfed by a cell.

Factors affecting drug absorption

Blood flow Hunger
Pain Fasting
Stress Food
Gastric Ph Exercise

2. Distribution

 The process by which the drug becomes available to body fluids and body
tissues.

3. Metabolism/ biotransformation

 Drugs are inactivated by liver enzyme and then converted or transformed by

hepatic enzyme to inactive metabolites or water soluble substance for excretion.
 Liver is the principal site of drug metabolism.

4. Excretion/ elimination

 Principal organ responsible for excretion is the kidney.

 Other routes include bile, feces, lungs, saliva, sweat, breast milk.
 The kidneys filter is free from unbound drugs, water soluble drugs and drugs that
are unchanged. Protein bound drugs cannot be filtered in the kidneys.
Factors that modify drug response

• Toxicology/Toxicity – this term refers with the adverse effect of the drugs & also
the study of poisons. Results from over dosage, ingestion of a drug intended for
external use, or buildup of the drug in the blood because of impaired metabolism
or excretion (cumulative effect)

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 i.e. detection, prevention, and treatment of poisoning. (toxicon = poison in
Greek).

• Pharmacogenetics – this term refers to the influence of genetic factors on drug

response.

• Tolerance – the ability of a client to response to a particular dose of drug may

diminish after days or weeks of repeated administration. A combination may be
given to decrease or delay the development of tolerance for a specific drug.

• Cumulative effect – this occurs when the drug is metabolized or excreted more
slowly than the rate at which it is being administered.

• Drug to drug interaction – the effects of combination of drugs may be greater

than, equal to or less than the effect of a single drug.

• Drug to food interaction – the effects of selected foods may speed, delay or
prevent absorption of specific drugs.

LAW AFFECTING DRUG ADMINISTRATION FOR MIDWIVES

RA 7392- Philippine Midwifery Act of 1992

- New Midwifery Law
- IM of Oxytocic's after placental expulsion
- IM of Vitamin K
- Immunization
R.A. 5821 – aka Pharmacy act
R.A. 3573 – law on reporting communicable disease
R.A. 7600 – rooming in and breastfeeding act of 1992
R.A. 7305 – magna-carta for health workers
R.A. 7624 – drug education law
RA 6675- Generic Act of 1988
RA 6425- Dangerous Drug Act

Accountability - being responsible for the quality of work

Implications:

• Always check for the client’s identity before administering drug

• Know your medications. What are the considerations in giving the medication?
Why is the client receiving the medication?
• Only administer medications you have prepared
• Do not eave medications at the bed side
• If unsure, have another midwife or nurse to check the medication calculation

10 GOLDEN RULES IN ADMINISTERING DRUGS SAFELY

• Administer the right drug

• Administer the right drug to the right patient
• Administer the right dose
• Administer the right drug by the right time
• Administer the right drug by the right route
• Document each drug you administer
• Teach your patient about the drug he is receiving
• Take a complete patient drug history
ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 6
 • Find out if the patient has any drug allergies
• Be aware of potential drug – drug or drug – food interactions

UNITS CONVERSION (METRIC SYSTEM)

The metric units most frequently used in drug notation are the following:

• 1 gram – 1000mg
• 1L – 1000ml
• 1mg – 1000mcg
• 1kg – 1000g
COMMON MEDICAL ABBREVIATIONS USED IN DRUG ADMINISTRATION

• DIL – diluted
• BID – two times a day
• GM – gram
• TAB - tablet
• GTTS – drops
• TID – three times a day
• HR – hour
• OD – once a day
• HS – bedtime
• IM - intramuscular
• Q – every
• L - liter
• PRN – as needed or as desired
• OZ – ounce
• STAT – now/immediate
• PO – per Orem
• IV – intra venous
• PC – post cebum (after meal)
• AC – ante cebum (before meal)
• SYR - syrup
COMMON MILD ALLERGIC RESPONSES

SKIN RASH – Either an intra-epidermal vesicle rash or a rash typified by an urticarial

wheal or macular eruption; rash is usually generalized over the body.

PRURITUS – Itching of the skin with or without a rash

ANGICEDEMIA – Edema due to increased permeability of the blood capillaries.

RHINITIS – Excessive watery discharge from the nose

LACRIMAL TEARING – Excessive tearing

NAUSEA & VOMITING – Stimulation of these centers in the brain

WHEEZING & DYSPNEA – Shortness of breath & wheezing on inhalation & exhalation
due to accumulated fluids & swelling of the respiratory tissues.

DIARRHEA – Irritation of the mucosa of the large intestine.

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 LESSON 2

CLASSIFICATION/ TYPES OF MEDICATION ORDER

TABLET – come in different forms and drug strengths. Most tablets are scored and
thus can be readily broken when half of the drug amount is needed.

CAPSULES – sustained and controlled released pellets. Capsules should not be crush or
diluted.

LIQUIDS – are given when the patient has difficulty in taking tablets. they can be either in
a form of syrup, suspension, elixir or tincture.

INJECTABLE DRUGS – Injectable drugs are given when medications cannot be taken
by mouth because of

• Inability to swallow

• Decrease level of consciousness

• Inactivation of drug gastric juices

• A desire to increase the effectiveness of the drug

PRESCRIPTION DRUGS- these are drugs which bear on their labeling the prescription
legend. Ex. “Caution: Law prohibits dispensing without prescription”. Before such drugs
are marketed, the Food and Drug Administration determines its safety and efficacy.

 Descriptive patient information (name, age)

 The date on which the prescription was written by Doctor

 The Rx symbol

 Name and dosages strength of the prescribed medication

 Dispensing instructions for the pharmacist

ex. Dispense 20 tablets

 Directions for the client or signa (sig.) which the psharmacist

will place the label.
- Refill and/or specialized labeling instructions
ex. Refill 5 times
- Prescriber’s signature

NON PRESCRIPTION DRUGS/OVER-THE-COUNTER DRUGS

 Drugs may be legally acquired without a prescription. Such agents are considered
to be relatively safe for the lay person to use when taken according to directions
provided by the manufacturer and when given to treat conditions for which they
are intended. The pharmacist is an excellent source of information concerning use
of OTC products.

ELLICIT/STREET DRUGS – these drugs are used and/or distributed illegally.

ex. Heroin, Cocaine even a single administration of these drugs may be
hazardous because of the possibility of overdose or impaired ability to react
normally to potentially hazardous situations.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 8

 NAMING OF DRUGS

 OFFICIAL NAME- this is the name under which the drug is listed in one of the
official publications. It is often identical to Generic Name.
- ex. United States Pharmacopia
 CHEMICAL NAME- this is systematically derived name which clearly and
precisely identifies the chemical structure of the drug and the exact description
(atom/molecules).
- ex. Benzodiazepine 4-oxide hydrochloride
 GENERIC NAME- the name assigned to drug by laboratory or company that first
develops the drug before it becomes official. NEVER CHANGE AND USE IN ALL
COUNTRIES.
 BRAND/TRADE NAME-the name assigned by the manufacturer that appears
frequently in the literature. This has the sign R at the upper right of the name
indicate that the name is registered and its use is restricted to the manufacturer
who is the legal owner of the name.

TYPES OF MEDICATION ORDER

1. Stat order- indicates that the medication is to be given immediately and only
once. Ex. Morphine 5mg IM stat

2. Single order- is for medication to be given once at a specified time. Ex. Anxionil
5mg HS before surgery

3. Standing order- may or may not have a termination date. A standing order may
be carried out indefinitely. (Ex. Multivitamins daily) until an order is written to
cancel it, or they may be carried out for a specified number of days. (Ex. Demerol
25mg IV q 4hrs x 5days)

4. P.R.N. order- permits the nurse to give a medication when in his or her judgment
the patient requires it (as needed).

PREGNANCY DRUG CATEGORIES

 Category A- no risk factor to the fetus

 Ex. Multivitamins & Prenatal Vitamins

 Category B- no risk in animal but human study is not adequate

 Ex. Penicillin, Macrodantine

 Category C- animal studies shows risk but human study is adequate

 Ex. Mebendazole

 Category D- fetal risk shows in human

 Ex. Defantine for seizure, tetracycline, quinine

 Category E- proven fetal risk and it is contraindicated with pregnancy

 Ex. Isotretinoen(acme drug)- multiple CNS abnormality for fetus

 Category X - Contraindicated in pregnancy: the risk involved in use of the drug in

pregnant women clearly outweigh potential benefits.

 Category N - FDA has not yet classified the drug into a specified pregnancy
category.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 9

 LESSON 3

METHODS/ROUTES OF DRUG ADMINISTRATION

Drugs may be administered by various routes.

 Enteral route (oral ingestion) – the most common, oldest and safest route of
drug administration (GIT, RECTAL, ORAL, NGT).
Disadvantages

• Onset of action is slower as absorption needs time.

• Irritant and unpalatable drugs cannot be administered

• Some drugs may not be absorbed due to certain physical characteristics

• Irritation to GIT may lead vomiting

• Cannot be given to unconscious and uncooperative patients

• Some drugs may undergo extensive first pass metabolism in liver

• Patients may forget to take the tablet

Advantages

• Safest route

• Most convenient

• Most economical

• Drugs can be self-administered

• No- invasive route

ENTERIC COATED TABLET

• Some tablets are coated with substance like cellulose acetate which are not
digested by the gastric acid but get disintegrated in the alkaline juices of the
intestine.

• This will prevent gastric irritation, avoid destruction of the drug by the stomach

ADVANTAGES

• Frequency of administration may be reduced.

• Therapeutic concentration may be maintained for a long time.

DISADVANTAGES

• There may be release of the entire amount of the drug in a short time leading to
toxicity.

 Parenteral route – the drugs are directly delivered into tissue fluids or blood (IM,
SQ, IV, ID). PARENTERAL- involve skin puncture. Thus administration involves
risk of infection, pain, and local irritation.
Advantages

• Action is more rapid and predictable than oral administration

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 10
 • These route can be employed in unconscious or uncooperative patients

• Gastric irritant can be given parentally

• It can be used in patients with vomiting or those unable to swallow

• In emergencies parenteral route are very useful

Disadvantages

• Asepsis must be maintained

• Injection may be painful

• More expensive, less safe and inconvenient

• Injury to nerve and other tissues may occur

 SUBCUTANEOUS INJECTION DISADVANTAGES

• Repeated administration at the same sire can cause lipoatrophy resulting in

erratic absorption

• Irritant drugs cannot be injected

 INTRAMUSCULAR
• Absorption into the plasma occurs by simple diffusion

• Drugs are absorbed faster from the deltoid region

ADVANTAGES

• IM route is reliable

• Absorption is rapid

 Percutaneous – performed through the skin (MUCOUS MEMBRANE, TOPICAL,

OTIC, INHALER, Etc.).
 ORAL- most compatible with drugs that are self- administered. Oral agents must
be able to withstand the acidic environment of the stomach and must permeate
the gut lining before entering the bloodstream.

a) Sublingual- under the tongue

b) Subluteal- gums
 INHALATION- given by the respiratory tract.

Ex. Salbutamol

 INSTILLATION- dropping on the solution into the body cavity.

Ex. Eyes- conjunctival, ears- otic

 TOPICAL- direct application into the skins.

Ex. Ointment

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 EFFECTS OF DRUGS

• Side effect – all drugs have the potential to affect more than 1body system
simultaneously.

• Therapeutic effects – desired drug effects.

• Adverse effect – undesired effects that may be unpleasant or even dangerous

• Toxic effects – overdosed of drug that may result to death

• Drug tolerance – decreased responsiveness over the course of therapy

• Placebo effect – physiologic benefit from harmless compound

IV THERAPY/ Intravenous Fluid Insertion

The drug is injected into one of the superficial veins so that it directly reaches the
circulation and is immediately available for action.

Indications of IV therapy

• Maintenance of hydration and prevention of dehydration to patients who are

unable to tolerate sufficient volumes of oral fluids and medications.

• Parenteral nutrition or fluid and electrolyte replenishment

• Chemotherapy and other drug

• Transfusion of blood and blood components

Methods of proper IV placement

GATHER ALL THE EQUIPMENT

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 IV TUBINGS

IV FLUIDS

 Normal saline and LSS are ideal for patients who need fluid replacement

IV CATHETERS

The larger the gauge, the smaller the diameter.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 13

  Basic components

 The metal needle has a beveled tip and is used to the enter the vein.

 The catheter made of Teflon or other synthetic material, slides over and
off the needle.

 The flash chamber is located behind the needle, and will fill with blood
upon entry into the vein to confirm proper placement.

 Finger grips on the sides of the flash chamber allow the device to be held
securely in the hand.

Drug can be given IV as:

1. A bolus: the drug is dissolved in a suitable amount of vehicle and injected slowly.

2. Slowly: over 15-20 minutes

3. Slow infusion: when constant plasma concentration are required

Administration of IV solutions/ Preparing IV Administration

 Check the patient identification

 Explain the procedure in simple terms to the patient and make her comfortable

 Organize correct and adequate lighting

 Wash hands to prevent infection or cross-contamination

 Wear protective gloves

 Place yourself in a comfortable position; sitting, if possible

Prepare the IV administration set

 Check the type, clarity and expiration of fluid

 “Spike “ the IV bag

 Remove plug from the bottom of the bag.

 Close the flow regulator, remove the protective covering from the spike of
IV tube

 Insert the spike into the port of IVF bag or bottle.

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  Place the fluid bag or bottle higher, squeeze the drip chamber to fill 1/3 of
it

 Open the flow regulator to flush the air and bubbles from the tubing and
close the flow regulator

 Hang the bag on an IV pole. Care should be taken not to contaminate the
end of the tubing

 Maintain strict asepsis

 Watch for sign of extravasation of fluid and thrombophlebitis
 Make sure that there are no air bubbles in syringe and tubing.
CHOOSE THE SITE OF INSERTION
Target a good sized vein with a straight segment at least the length of the catheter.
Use of the non-dominant extremity
Avoiding joint areas
Avoiding use of the lower extremities
Avoid veins irritated by previous use

HAND OR FOREARM VEINS PREFFERED

INSERTING THE IV CATHETER/CANNULA

 Apply a tourniquet above the chosen site to create an adequate venous filling.
 Ask patient to make a fist to maximize vein engorgement.
 Palpate the vein or tap it to help it dilate.

Clean the entry site with alcohol for 60 seconds using a circular motion, working your
way outwards from the site. Allow it to dry. Do not repalpate.
ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 15
  Apply distal traction to the vein by using your non-dominant thumb. Traction
stabilizes the vein and prevents it from "rolling" during the insertion sequence.
 Grip the IV catheter between the thumb and middle finger of the dominant hand.

 Insert the IV catheter into the skin at 15-30º angles with the bevel up and in the
direction of the vein.
 Advance the catheter to enter the vein until blood is seen in the “flash chamber” of
the catheter

 Holding the hub of the plastic catheter with your index finger, withdraw the needle
a few millimeters.
 Advance the plastic catheter on into the vein while leaving the needle stationary,
until the hub of the catheter abuts the skin.

 Once the catheter is fully advanced, release the traction then use the thumb and
index finger of your non-dominant hand to hold the hub of the catheter. The other
fingers are used to tamponade the vein, just beyond the tip of the catheter, to
prevent blood from leaking out.
 Remove the needle

Connect the plastic catheter to the previously-prepared IV tubing set and open the flow
regulator.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 16

  Tape the catheter in place - a loop ("U" shape) should be incorporated to prevent
any tension placed on the line from pulling out the catheter.
 Adjust the flow rate.

ADJUSTING THE FLOW RATE

(Amount to be infused ml) X (drops/ml) = drops

(Time for infusion in minutes) minute
Example:

1000 ml X 20 drops/ml = drops

240 minutes 1 minute

20000 drops = 83 drops/minute

240 min

Advantages of IV therapy

• Rapid response
• Effective absorption
• Accurate titration
• Less discomfort
Disadvantages

• Once injected, the drug cannot be withdrawn.

• Irritation of the vein may cause thrombophlebitis.
• Self-medication is difficult
• The solution should be sterile and strict aseptic measures should be taken.

Complications of IVT

 Infiltration or Swelling at the injection area

 Thrombophlebitis
 Septicemia
 Air embolism
 Fluid overload

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 LESSON 4

DRUGS AND SOLUTION

DRUGS DURING PREGNANCY

 Prescription of drugs to a pregnant woman is a balance between possible adverse

effect on the fetus and the risk to the mother.

Nutritional Supplements

 Iron

• Essential for making hemoglobin, the protein in red blood cells that carries oxygen
to other cells

• Helps you maintain a healthy immune system

• Iron supplements are intended as a supplements to and not as a replacement for

iron rich food

• Pregnancy category N

 Folic Acid

• a type of water soluble vitamin used to prevent miscarriage and neural tube
defects and birth defects

• a deficiency in folic acid may cause megaloblastic anemia

• signs of deficiency includes cracked lips, sore tongue. Fetal effect includes
premature delivery, spontaneous abortion, neural tube defects.

• Pregnancy category A

CONSTIPATION IN PEGNANCY AND CHILDBIRTH

 Accumulation of hard fecal material in the large intestines due to slow bowel.

Important teachings:

• Encourage woman to evacuate her bowels regularly

• Increase amount of fiber in the diet

• Enema should be avoided

• Increase fluid intake

Laxatives – a substance that loosen stools and increase bowel movements.

TYPES OF LAXATIVES AGENT

 Saline laxative agent – are non-absorbable osmotic substances that

attract and retain water in the intestinal lumen, increasing intraluminal
pressure that mechanically stimulates evacuation of the bowel.
• Site of action: small and large intestines

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 • Onset of action: 5min. – 3hours by oral, 2 – 15min. by rectal

 Bulk forming agents – also known as roughage, are substances such as fiber in
food and hydrophilic agents in over-the-counter drugs that add bulk and water to
stools so that they can pass more easily through the intestines (lower part of the
digestive tract).

• Site of action; small and large intestine

• Onset of action: 12 – 72 hours
• Example: Psyllium (pregnancy category N)
•
 Emollient agents (stool softeners)

• Also known as stool softeners, are anionic surfactants that enable additional
water and fats to be incorporated in the stool, making it easier for them to move
through the gastrointestinal tract.

• Site of action; small and large intestines

• Onset of action; 12 – 72 hours
• Example; docusate (pregnancy category B)

 Hyperosmotic agents

• Are substances that cause the intestines to hold more water within and create an
osmotic effect that stimulates a bowel movement.
• Site of action; colon
• Onset of action; 12 – 72 hours by oral and 0.25min – 1hour by rectal
• Examples; lactulose (pregnancy category B)

ANTIMICROBIALS/ ANTIBIOTICS

• Antibiotics are a type of antimicrobial drug used in the treatment and prevention of
bacterial infections.
• Antibiotics are agents made from living microorganisms, synthetic manufacturing
and genetic engineering that are used to inhibit specific bacteria

• They can be bacteriostatic, bactericidal or both.

• The major classes of antibiotics include; aminoglycosides, penicillin and

penicillinase-resistant drugs, sulfonamides, tetracycline’s and antimycobacterials.

ADMINISTRATION

• Antibiotics are usually taken by mouth

• Injection or intravenously can be given in more severe cases.
• Topical used is also one of the treatment options for some skin conditions
including acne and cellulitis.

ADVERSE EFFECT OF ANTI MICROBIALS

• Resistance
• Hypersensitivity or allergic reactions in form of fever and skin rash.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 19

 CLASSES OF ANTIBIOTICS

• Aminoglycosides – Risk of ototoxicity but often used in serious maternal

infection where benefit.

ex. Gentamicin (pregnancy category C)

• Sulfonamides – Risk of “grey baby syndrome” when used in 2nd and 3rd
trimesters

Ex. Co-trimoxazole and chlorampenicol (pregnancy category C)

• Macrolides – Used if woman is penicillin-sensitive. Enhances effect of

anticoagulants

Ex. Erythromycin (pregnancy category B), Clarithromycin (pregnancy category C)

• Penicillin's – Not known to be harmful, traces amount in breast milk (pregnancy

category B)

• Quinolones (FLUOROQUINOLONES) – Risk of athropathy in fetus most of the

evidence for this obtained from animal studies.

EX. Ciprofloxacin (pregnancy category C), Levofloxacin (pregnancy category C and X at

term and breastfeeding).

• Tetracycline's – Risk of discoloration and dysplasia of fetal bones and teeth,

cataracts when used in 2nd and 3rd trimesters.

ex. Doxycycline and tetracycline (pregnancy category D)

ANTI-EMETICS

Is a drug that is effective against vomiting and nausea. Anti-emetics are typically used to
treat motion sickness and the side effects of opioid analgesics, general anesthetics and
chemotherapy directed against cancer

TYPES

• Dopamine Antagonist – act in the brain and are used to treat nausea and
vomiting associated with neoplastic disease, radiation sickness, opioids, cytotoxic
drugs and general anesthetics. Side effects include muscle spasms and
restlessness.

Example; metoclopramide (pregnancy category B)

• Antihistamines – effective in many conditions, including motion sickness,

morning sickness in pregnancy and to combat opioid nausea.

Example; promethazine, hydroxyzine, diphenhydramine

• Phenothiazines – primary use is for sever nausea and vomiting. Secondary use
is to reduce anxiety and tension and for psychosis. Pregnancy category C

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 20

 DRUGS IN LABOR/DELIVERY

 Analgesics vs. anesthetics

 Some drugs given late in pregnancy or during delivery may cause particular
problem, ex. Pethidine is administered as an analgesics can cause fetal apnea.

Anesthetic agents – given during caesarian section may transiently depress

neurological, respiratory and muscular functions.

Analgesics

 Analgesics is any member of the group of drugs used to achieve analgesia, relief
pain.

 Often given as injections into small muscle or vein. It lessen the pain but it will not
lose consciousness.

 Analgesics drugs act in various ways on the peripheral and central nervous
systems.

 Ex. Paracetamol, non steroidal anti-inflammatory drugs, opioids

Anaesthetics

 Is a drug to prevent pain during surgery.

 Anaesthetics are categorized into two classes: general anaesthetics and local
anaesthetics

 General anaesthetics – cause a reversible loss of consciousness

 Inhaled agents – ex. Isofluraine, sevofluraine

 Volatile agents are specially formulated organic liquids that readily into vapor’s
and are given by inhalation for induction and/or maintenance of general
anaesthesia.

 Local anaesthetics – cause a reversible loss of sensation for a limited region of

the body while maintaining consciousness.

 Agents that prevent transmission of nerve impulses without causing

unconsciousness.

 Ex. Lidocaine

 Combination of anaesthetics – are sometimes used for their synergistic and

additive therapeutic effects.

 Intravenous agents (non-opioid) – there are many drugs that can be used
intravenously to produce anesthesia or sedation, the most common are

= Benzodiazepines – ex. Diazepam, midazolam, ketamine, propofol

= Barbiturates – ex. Methohexital

 Spinal block – an injection in the lower back. A small amount of anaesthesia is

injected into the spinal fluid to numb the lower half of the body.

 Epidural anaesthesia – causes some loss of feeling in the lower areas of the
body.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 21

 Drugs Increasing Uterine Contractility

Utero tropic drugs enhance uterine contractility by stimulating the smooth muscle of the
uterus.

 Oxytocin – for induction and augmentation of labor

 Contraindication – CPD, Fetal intolerance labor

 Adverse effect – seizures, water intoxication,asphyxia,hypoxia

 Side effects – hpn, tachysystole, uterine hyperstimulation

 Considerations – not to be used in clients with hpn, sepsis and renal impairment

 Drug to drug interactions – use with caution to hypersensitive people with

vasopressors and anesthetics.

 Pregnancy category X

 METHYLERGOMETRINE MALEATE (METHERGINE)

- Prevention and treatment of postpartum hemorrhage.

 Contraindication – labor induction, hpn

 Side effects – hpn, uterine cramping, palpitations, dyspnea

 Adverse effect – pain in arms, cold hands

 Considerations – continous bp monitoring, check for any bleeding

 Pregnancy category C

TOCOLYTICS

Tocolytic delays the delivery so antenatal corticosteroids can be administered to facilitate

fetal lung maturation.

• Magnesium SO4 (CALCIUM CHANNEL BLOCKER) – it relaxes the smooth

muscle of the uterus through calcium displacement.
 Pregnancy category B.
 Considerations – monitor I & O of the patient, monitor v/s and fht, fetal activity and
uterine activity.

• Betamethasone – when preterm labor occurs before 33wks AOG

betamethasone is required.
 Considerations – monitor v/s & fht and report abnormal findings
 Pregnancy category C

• DEXAMETHASONE – has rapid onset of action and shorter duration of action.

 Considerations – monitor v/s and fetal heart beat
 Pregnancy category C

• ATOSIBAN – an inhibitor of the hormones oxytocin and vasopressin.

 Contraindications – PROM, abnormal fetal heart beat, eclampsia, IUFD, placenta
previa and abruptio placenta
 Side effects – tachycardia, insomnia, headache and dizziness, cardiac disorder,
hypotension, n/v, uterine hemorrhage and uterine atony, pyrexia
 Pregnancy category C
ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 22
TERMS: FUNCTION: DRUGS:
1. ANTIPYRETIC RELIEVES FEVER PARACETAMOL
2. ANALGESICS RELIEVES PAIN NALBUPHINE
3. ANTI-FLATULENCE EXPELS GAS DYSFLATYL
4. ANTI-HISTAMINE RELIEVES ALLERGIC CHLORPHENIRAMINE
REACTIONS
5. ANTISPASMODICS RELIEVES ABDOMINAL PAIN HYOSCINE
6. HASTENS DIURETICS FUROSEMIDE
URINATIONS
7. LAXATIVE PROMOTES DEFACATION BISACODYL
8. ANTACID COUNTERACTS ABDOMINAL ALUM HYDROXIDE
ACIDITY
9. COUNTERACTS ANTI-INFLAMMATORY PREDNISONE
SWELLING
10. PROMOTES MOOD HALLUCINOGENS MORNING GLORY SEED
CHANGES
11. LOWERS BP HYPOTENSIVE HYDRALAZINE
12. PREVENTS ANTI-HEMORRHAGIC AQUAMEPHYTON
BLEEDING
13. FOR INFECTIONS ANTIBIOTIC AMOXYCILLIN
14. STIMULATES OXYTOCICS METHERGIN
UTERINE
CONTRACTIONS
15. PRODUCES STIMULANTS MORNING GLORRY SEED
IRRITABILITY
16. ERADICATES/CONT ANTI-NEOPLASTIC METHOTREXATE
ROLS MALIGNANT
TUMORS
17. PROMOTES EXPECTORANT DEXTROMETHORPAN
EJECTION OF
MUCUS FROM
RESPIRATORY
TRACT
18. ANTI-HELMINTIC EXPELS WORM MEBENDAZOLE
19. TRANQUILIZER RELIEVES ANXIETY BENZEDRINE
20. SEDATIVE INDUCES SLEEP DIAZEPAM

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 23

 Let’s Try This
Analyze the question & write your answer on the given answer sheet.
MULTIPLE CHOICE:
1. Philippine Midwifery Act of 1992
a) RA 7392
b) RA 5821
c) RA 3573
2. law on reporting communicable disease
a) RA 3573
b) RA 6425
c) RA 7600
3. drug education law
a) RA 7624
b) RA 7305
c) RA 6675
4. Dangerous Drug Act
a) RA 6425
b) RA 3573
c) RA 7392
5. aka Pharmacy act
a) RA 5821
b) RA 7600
c) RA 7305
6. rooming in and breastfeeding act of 1992
a) RA 7600
b) RA 6700
c) RA 7392
7. magna-carta for health workers
a) RA 7305
b) RA 5821
c) RA 3573
8. Generic Act of 1988
a) RA 6675
b) RA 1992
c) RA 3425
9. are substances such as fiber in food and hydrophilic agents
a) Bulk forming agent
b) Laxatives
c) Saline laxative agent
10. A substance that loosen stools and increase bowel movements.
a) Laxative
b) Emollients
c) Saline laxative agent
11. It increase intraluminal pressure that mechanically stimulates evacuation
of the bowel movements.
a) Bulk forming agent
b) Saline laxative agent
c) Emollient agents
12. Also known as stool softeners
a) Saline laxative agents
b) Emollient agent
c) Bulk forming agent
13. Animal studies shows risk but human study is adequate.
a) Pregnancy category A
b) Pregnancy category C
c) Pregnancy category B
14. No risk in animal but human study is not adequate.
a) Pregnancy category A
b) Pregnancy category B
c) Pregnancy category C
15. fetal risk shows in human
ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 24
 a) Pregnancy category C
b) Pregnancy category D
c) Pregnancy category E
16. no risk factor to the fetus
a) Pregnancy category E
b) Pregnancy category A
c) Pregnancy category D
17. proven fetal risk and it is contraindicated with pregnancy
a) pregnancy category X
b) pregnancy category E
c) Pregnancy category N
18. Contraindicated in pregnancy
a) Pregnancy category N
b) Pregnancy category X
c) Pregnancy category E
19. Tetracycline’s is pregnancy category?
a) Pregnancy category X
b) Pregnancy category D
c) Pregnancy category N
20. Penicillin is pregnancy category?
a) Pregnancy category X
b) Pregnancy category B
c) Pregnancy category E
21. Risk of athropathy in fetus
a) Macrolides
b) Sulfonamides
c) Quinolones
22. a drug that is effective against vomiting and nausea
a) Antimicrobial
b) Antipyretics
c) Anti-emetics
23. Folic acid is pregnancy category?
a) Pregnancy category B
b) Pregnancy category N
c) Pregnancy category A
24. Iron is pregnancy category?
a) Pregnancy category B
b) Pregnancy category A
c) Pregnancy category N
25. Essential for increasing hemoglobin
a) Phenothiazine
b) Folic acid
c) Iron
26. Drug used in the treatment and prevention of bacterial infections.
a) Anti-emetics
b) Doxycycline
c) Antimicrobial
27. Side effects include muscle spasms and restlessness.
a) Phenothiazine
b) Dopamine antagonist
c) Anesthetics
28. Metoclopramide is pregnancy category?
a) Pregnancy Category N
b) Pregnancy category A
c) Pregnancy category B
29. primary use is for sever nausea and vomiting
a) Phenothiazine
b) Dopamine antagonist
c) Anti-emetics
30. drugs used to achieve analgesia, relief pain
a) anesthetics
b) analgesics

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 25

 c) antibacterial
31. cause a reversible loss of consciousness
a) combination of anesthetics
b) general anesthetics
c) epidural anesthetics
32. Sometimes used for their synergistic and additive therapeutic effects.
a) Spinal block
b) Combination of anesthetics
c) Intravenous agent
33. Cause a reversible loss of sensation for a limited region of the body while
maintaining consciousness.
a) Spinal block
b) Local anesthesia
c) Epidural anesthesia
34. A small amount of anesthesia is injected into the spinal fluid to numb the
lower half of the body.
a) Epidural anesthesia
b) Spinal block
c) Combination of anesthetics
35. Causes some loss of feeling in the lower areas of the body.
a) Epidural anesthesia
b) Spinal block
c) General anesthesia
36. For induction and augmentation of labor
a) Metheylergometrine
b) Barbiturates
c) oxytocin
37. Prevention and treatment of postpartum hemorrhage.
a) Oxytocin
b) Methylergometrine
c) tocolytic
38. Delays the delivery so antenatal corticosteroids can be administered to
facilitate fetal lung maturation.
a) Atosiban
b) Tocolytic
c) dexamethasone
39. Magnesium SO4 (calcium channel blocker is pregnancy category?
a) Pregnancy category B
b) Pregnancy category C
c) Pregnancy category N
40. Drugs that enhance uterine contractility by stimulating the smooth muscle
of the uterus.
a) Tocolytics
b) Utero-tropic
c) Atosiban

41. Liver is the principal site of drug.

a) Absorption
b) Distribution
c) Metabolism
d) Excretion

42. The ability of a client to response to a particular dose of drug may diminish
after days or weeks of repeated administration called?
a) Cumulative effect
b) Toxicology
c) Drug to drug interaction
d) Tolerance

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 26

 43. This term refers with the adverse effect of the drugs.
a) Toxicology
b) Drug to food interaction
c) Placebo effect
d) Adverse effect

44. It is the desired drug effects.

a) Side effect
b) Therapeutic effect
c) Adverse effect
d) Toxic effect

45. The physiologic benefit from harmless compound.

a) Drug tolerance
b) Cumulative effect
c) Placebo effect
d) Adverse effect

46. All of the following are advantages of IV therapy except

a) Rapid response
b) Less discomfort
c) Accurate titration
d) Safest route

47. Described as what the body does to a drug

a) pharmacology
b) pharmacogenetics
c) pharmacodynamics
d) pharmacokinetics

48. Described as what the drug does to the body.

a. Pharmacology
b. Pharmacogenetics
c.Pharmacodynamics
d. Pharmacokinetics

49. Study of drugs in humans

a) Pharmacology
b) Drugs
c) Therapeutics
d) Clinical pharmacology

50. Drugs diffuse across a cell membrane from a region of high concentration to one
of low concentration.
a) Pinocytosis
b) Active transport
c) Passive diffusion
d) Excretion

51. Fluid or particles are engulfed by a cell.

a. Absorption
b.Distribution

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 27

 c. Pinocytosis
d.Active transport

52. The movement of drug particles from the G.I tract to body fluids.
a) Metabolism
b) Excretion
c) Distribution
d) absorption

CONVERSION

1. 150mcg – mg =_____
2. 5ml – l =_____
3. 250mg – g =_____
4. 0.3g – mg =_____
5. 150mg – g =_____
6. 3000mg – kg =_____
7. 1ml – l =_____
8. 500ml – l =_____
9. 0.30mg – mcg =_____
10. 50ml – l =_____

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 28

 Reflective Thinking Activity
RETURN DEMONSTRATION

The purpose of this is to prepare students to know how, when and why vital signs are
taken and how to report and chart these procedures. Students will learn the correct
procedures for measuring temperature, pulse, respirations and blood pressure. They will
learn to recognize and report normal and abnormal findings.

Demonstrate and take a video on the following activity (Blood Pressure, Pulse,
Respiratory Rate and Temperature) then send on my email/gmail
(cabanerosharon@gmail.com & bhabyq_sharon19@yahoo.com).

EVALUATION TOOL IM INSERTION

NAME: ____________________________________ DATE: _______________

PROCEDURE DONE NOT REMARKS

DONE
1. Check physicians order
2. Check relevant laboratory results, allergy and drug history
3. Identify the patient
4. Explain the procedure to the patient
5. Check/prepare all necessary equipment’s
6. Wash hands prior to performing the procedure
7. Select appropriate syringe and needle, considering volume
and type of medication, and patients muscle mass.
a. Usual syringe size is 1-3ml
b. Usual needle is 19-23 gauge
8. Prepare injection. Aspirate into syringe, ensures no air in
syringe
9. Position the patient so the injection site is accessible
10. Do hand gloving
11. Clean injection site with alcohol prep pad in circular motion
12. Ask patient to relax the target muscle
13. With non-dominant hand hold the skin tightly
14. Holding the syringe between thumb and fingers of the
dominant hand
15. Insert the needle swiftly at an angle of 90®angle to the skin
surface
16. Stabilize syringe and aspirate briefly, if blood appears
withdraw the needle and start again, if no blood return,
inject slowly
16. Remove the needle smoothly along the line of insertion
18. Press sterile gauze over the opening with pressure
19. Engage safety needle device, and dispose properly
20. Documents procedure in patient’s chart including contents
and location of injection and any complications
Preceptor’s comment; ____________________________________________________

______________________________________________________________________

SIGNATURE OF C.I.: _____________________ RATING:____________________

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 29

 EVALUATION TOOL SUBCUTANEOUSLY INSERTION

NAME: ______________________________________ DATE: _______________

PROCEDURE DONE NOT REMARKS

DONE
1. Check physicians order
2. Check relevant laboratory results, allergy and drug history
3. Identify the patient
4. Explain the procedure to the patient
5. Check/prepare all necessary equipment’s
6. Wash hands prior to performing the procedure
7. Select appropriate syringe and needle, considering volume
and type of medication, and patients muscle mass.
a. Usual syringe size is 1-3ml
b. Usual needle is 19-23 gauge
8. Prepare injection. Aspirate into syringe, ensures no air in
syringe
9. Position the patient so the injection site is accessible
10. Do hand gloving
11. Clean injection site with alcohol prep pad in circular motion
12. Ask patient to relax the target muscle
13. With non-dominant hand hold the skin tightly
14. Holding the syringe between thumb and fingers of the
dominant hand
15. Insert the needle swiftly at an angle of 45®angle to the skin
surface
16. Stabilize syringe and aspirate briefly, if blood appears
withdraw the needle and start again, if no blood return,
inject slowly
16. Remove the needle smoothly along the line of insertion
18. Press sterile gauze over the opening with pressure
19. Engage safety needle device, and dispose properly
20. Documents procedure in patient’s chart including contents
and location of injection and any complications

Preceptor’s comment; ____________________________________________________

______________________________________________________________________

SIGNATURE OF C.I.: _____________________ RATING: ____________________

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 30

 EVALUATION TOOL ID INSERTION

NAME: ______________________________________ DATE: _______________

PROCEDURE DONE NOT REMARKS

DONE
1. Check physicians order
2. Check relevant laboratory results, allergy and
drug history
3. Identify the patient
4. Explain the procedure to the patient
5. Check/prepare all necessary equipment’s
6. Wash hands prior to performing the procedure
7. Select appropriate syringe and needle,
considering volume and type of medication, and
patients muscle mass.
a. Usual syringe size is 1-3ml
b. Usual needle is 19-23 gauge
8. Prepare injection. Aspirate into syringe, ensures
no air in syringe
9. Position the patient so the injection site is
accessible
10. Do hand gloving
11. Clean injection site with alcohol prep pad in
circular motion
12. Ask patient to relax the target muscle
13. With non-dominant hand hold the skin tightly
14. Holding the syringe between thumb and fingers of
the dominant hand
15. Insert the needle swiftly at an angle of 15®angle
to the skin surface
16. Stabilize syringe and aspirate briefly, if blood
appears withdraw the needle and start again, if no
blood return, inject slowly
16. Remove the needle smoothly along the line of
insertion
18. Press sterile gauze over the opening with
pressure
19. Engage safety needle device, and dispose
properly
20. Documents procedure in patient’s chart including
contents and location of injection and any
complications

Preceptor’s comment; ____________________________________________________

______________________________________________________________________

SIGNATURE OF C.I.: _____________________ RATING: ____________________

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 31

 EVALUATION TOOL INTRAVENOUS INSERTION

NAME: ______________________________________ DATE: _______________

PROCEDURE DONE NOT REMARKS

DONE
1. Check/prepare all necessary equipment’s
2. Identify the patient
3. Explain the procedure to the patient
4. Wash hands prior to performing the procedure
5. Put patient in a sitting or supine position
6. Except in the scalp area, use a tourniquet to produce
venous enlargement
7. Request the patient to make a fist
8. Tap the vein gently until it becomes engorged or place the
part to be used in a related position for several minutes
9. Cleanse the area with antiseptic
10. Grasp the site
11. Rest the thumb on the skin approximately two inches below
the selected side of insertion
12. Exert pressure downward toward the patient’s hand
stretching the skin
13. Hold needle approximately 45˚ and insert with the level
facing the upward about ½ inch below the target vein
14. Careful push the needle into the vein in an upward direction
for approximately ¾ of an inch and observe the backflow of
blood
15. Release the tourniquet
16. Anchor the needle with tape
16. Apply a splint or an arm board
18. Regulate the flow rate as indicated
19. Mark on the infusion bottle the time started, time to
consume, medicine added and rate of flow per minute

Preceptor’s comment; ____________________________________________________

______________________________________________________________________

SIGNATURE OF C.I.: _____________________ RATING: ____________________

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 32

 Medical terminologies

Abstinence: The voluntary self-denial of food, drink, or sex. Today, abstinence most
commonly refers to denial of one's sexual activity.
Acrocyanosis: Blueness of the hands and feet, usually due to inadequate circulation
Abrasion: An abrasion or "excoriation" is a wearing away of the upper layer of skin as a
result of applied friction force. In dentistry an "abrasion" is the wearing away of the tooth
substance
Abruption: A sudden breaking off or away. Abruption of the placenta (abruptio placentae)
is the premature separation of the placenta from the wall of the uterus, a potentially very
serious situation for the mother and baby
Abscess: A local accumulation of pus anywhere in the body. The following are some
examples of abscesses:

Acute: Of abrupt onset, in reference to a disease. Acute often also connotes an illness
that is of short duration, rapidly progressive, and in need of urgent care.
"Acute" is a measure of the time scale of a disease and is in contrast to "subacute" and
"chronic." "Subacute" indicates longer duration or less rapid change. "Chronic" indicates
indefinite duration or virtually no change.

Acupressure is the application of pressure rather than needles on specific points on the
body to control symptoms such as pain or nausea.

Aerophagia: Swallowing too much air, a common cause of gas in the stomach and
belching. Everyone swallows small amounts of air when eating or drinking. However, rapid
eating or drinking, chewing gum, smoking, or ill-fitting dentures may cause a significant
increase in swallowed air. The word "phage" in Greek means "to eat." Aerophagia is
literally to eat air.

Aerophobia: An abnormal and persistent fear of flying. Sufferers experience

severe anxiety even though they usually realize that the flying does not pose a threat
commensurate with their fear. Aerophobia also means an irrational fear of fresh air or
drafts of air. Derived from the Greek "aero-", air or gas + "phobos", fear = literally, fear of
air.
Alphafetoprotein (AFP):
A substance present in the blood of pregnant women, You may need further tests if you
levels appear higher or lower than normal.
Albumin (ALB):
This is a protein. If it's present in your urine, it may be a sign of pre-eclampsia or of an
infection such as cystitis.
Algophobia: An abnormal and persistent fear of pain. The fear is excessive, beyond that
which is expected under the circumstances, producing an anxietyreaction. From the
Greek "algos" (pain) and "phobos" (fear). Note that an "algometer" is an instrument for
measuring pain (it does so by gauging the smallest pressure that produces pain).
Baldness. There are many types of alopecia, each with a different cause. Alopecia may
be localized to the front and top of the head as in common male pattern baldness. It may
be patchy as in a condition called alopecia areata. A variant of alopecia involves the
entire head and is called alopecia capitis totalis. The word "alopecia" comes from the
Greek "alopex" for "fox."
Alzheimer's disease: A progressive degenerative disease of the brain that leads
to dementia. On a cellular level, Alzheimer's disease is characterized by the finding of
unusual helical protein filaments in nerve cells of the brain. These twisted filaments are
called neurofibrillary tangles. In the brain, Alzheimer's disease involves degeneration of
the cortical regions, especially the frontal and temporal lobes. There is currently no cure
for Alzheimer's disease, but new medications and therapies appear to slow its progress
and improve the patient's ability to function
akinesia (akinetic = adj.) - absence or loss of movement.
amenorrhea - the absence of menstrual bleeding.
Amenorrhea: Absence or cessation of menstruation. Amenorrhea is conventionally
divided into primary and secondary amenorrhea.

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 33

Amniotic fluid: The fluid bathing a fetus within the uterus, which serves as
a shock absorber.
Amniotic sac: The amniotic sac and amniotic fluid.
Ampulla: In anatomy, a sac-like enlargement of a canal or duct. The ampulla of Vater is
the enlargement of the ducts from the liver and pancreas at the point where they enter the
small intestine. Ampulla in Latin means flask. An ampulla was a flask used in ancient
Rome to hold ointment, perfume, and wine.
Anasarca: generalized, pronounced swelling (edema) of body tissues due to fluid buildup
in subcutaneous tissues.
Anencephaly: A neural tube defect (NTD) that occurs when the cephalic (head) end of
the neural tube fails to close, usually between the 23rd and 26th days of pregnancy,
resulting in the absence of a major portion of the brain, skull, and scalp.
Anorexia: An eating disorder characterized by markedly reduced appetite or total
aversion to food. Anorexia is a serious psychological disorder. It is a condition that goes
well beyond out-of-control dieting.
Antenatal: Pre-natal check-up before the birth.
APH: Stands for antepartum hemorrhage and means bleeding before the birth.
Apnea - lack of breathing.
Asymptomatic - producing or showing no symptoms
Babinski reflex: A reflex used to determine adequacy of the higher (central) nervous
system. The Babinski reflex is obtained by stimulating the outside of the sole of the foot,
causing extension of the big toe while fanning the other toes.
Bartholin's glands: A pair of glands between the vulva and the vagina that produce
lubrication in response to stimulation. With a second pair of nearby glands called the
lesser vestibular glands, they act to aid in sexual intercourse. Also called the greater
vestibular glands.
Benign: Not malignant. A benign tumor is one that does not invade surrounding tissue or
spread to other parts of the body; it is not a cancer.
Bradycardia: A slow heart rate, usually defined as less than 60 beats per minute.
Bradypnea: Abnormally slow breathing. A respiratory rate that is too slow. The normal
rate of respirations (breaths per minute) depends on a number of factors, including the
age of the individual and the degree of exertion.
Breech presentation – A baby who is lying bottom or feet down in the uterus.
Blood pressure (BP):
It's important to have your blood pressure measured as a rise could mean a problem.

Cephalic – Presentation of the baby with her head in the lower part of the uterus.
Coitus: Sexual intercourse.
Coitus interruptus: A method of contraception, also called withdrawal, in which the man
withdraws his penis from the vagina before ejaculation. Fertilization is prevented because
the sperm do not enter the vagina.

Colic: A cause of crampy abdominal pain in early infancy. Colic is a common condition,
occurring in about 1 in 10 babies. An infant with colic is irritable, cries, and often has a
rigid abdomen and draws up its legs. Overfeeding, undiluted juices, food allergies,
and stress can aggravate colic. Colic usually lasts from early infancy to the third or fourth
month of age

Conception: 1. The union of the sperm and the ovum. Synonymous with fertilization.
2. The onset of pregnancy, marked by implantation of the blastocyst into
the endometrium.
From the Latin conceptio, conceptionis meaning conception, becoming pregnant;
drawing up of legal formulae; and from the Latin conceptus meaning conceiving,
pregnancy; collecting, or a collection.
Congenital: A condition that is present at birth, whether or not it is inherited.
Contagious: capable of being transmitted from one human to another human via direct or
indirect contact.
Contraction: The tightening and shortening of a muscle.
Croup: An infection of the larynx, trachea, and bronchial tubes that occurs mainly in
children. It is usually caused by viruses but sometimes by bacteria.

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Curettage: Removal of tissue with a curette from the wall of a cavity or another surface.
For example, curettage may be done to remove skin cancer. After a local anesthetic
numbs the area, the skin cancer is scooped out with a curette. Curettage may also be
done in the uterus; dilation and curettage (D&C) refers to the dilation (widening) of the
cervical canal to permit curettage of the endometrium, the inner lining of the uterus.

Cyanosis: A bluish color of the skin and the mucous membranes due to insufficient
oxygen in the blood. For example, the lips can develop cynanosis when exposed to
extreme cold. Cyanosis can be present at birth, as in a 'blue baby,' an infant with a
malformation of the heart that permits into the arterial system blood that is not fully
oxygenated.

Cyanotic: Showing cyanosis (bluish discoloration of the skin and mucous membranes
due to not enough oxygen in the blood).
Contusion - a bruise; an injury of a part without a break in the skin, characterized by
swelling, discoloration, and pain.
Dilation: The process of enlargement, stretching, or expansion. The word "dilatation"
means the same thing. Both come from the Latin "dilatare" meaning "to enlarge or
expand."
Dysmenorrhea - painful menstruation.
Dysphagia - painful or difficulty swallowing.
Dysplasia - abnormality of development; in pathology, alteration in size, shape, and
organization of adult cells.
Dyspnea - labored or difficult breathing.
Dysrhythmia - defective heart rhythm;
Ectopic Pregnancy:
A pregnancy that develops somewhere other than the uterus, usually in the fallopian tube,
This pregnancy cannot be allowed to continue as it is dangerous.
Expected date of delivery - when your baby is due. Sometimes called EDC (expected date
of confinement).
Engaged. Means that the widest diameter of the baby's head has passed into the pelvis in
preparation for giving birth.
Episiotomy:
A cut made in the mother's perineum (the area between the vagina and anus) to allow the
baby to be born more quickly and prevent tearing.
Edema - the accumulation of excess fluid in the intercellular or interstitial tissue spaces or
body cavities.
Emesis - the act of vomiting
Fetus: Medical name for the baby before it's born.
Fetal heart (FH): You may see 'FH heard' or 'FHH' on your notes - that means your baby's
heartbeat has been heard.
Fetal movement – It may say 'FM felt' or 'FMF' on your notes. That means your baby had
been felt to move.
Fundus: This is the top of the uterus. The 'fundal' height helps assess the growth of the
baby and how many weeks pregnant you are. It's the length in centimetres between the
top of the uterus and the pubic bone.
Hematoma - a localized mass of blood, usually clotted, trapped in an organ, space, or
tissue, resulting from a break in the wall of a blood vessel.
Hematuria - the presence of blood in the urine.
Hemoglobin - the oxygen carrying pigment of the red blood cells (erythrocytes). It is a
conjugated protein containing four heme groups and globin. A molecule of hemoglobin
contains 4 globin polypeptide chains - designated alpha, beta, gamma and delta. In the
adult, Hemoglobin A predominates
Hemorrhage - to bleed; an escape of blood from the blood vessels.
Hernia - the protrusion of a portion of an organ or tissue through an abnormal opening.
Hypertension - high arterial blood pressure. Various criteria for its threshold have been
suggested, ranging from 140 mm Hg systolic and 90 mm Hg diastolic to as high as 200
mm Hg systolic and 110 mm Hg diastolic.
Hypotension - low blood pressure. hypovolemia - decreased blood volume.
Hypoxia - reduced supply of oxygen to tissues (below physiologic levels) despite normal
blood perfusion.

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Jaundice - yellowness of the skin, sclera, mucous membranes and excretions due to
increased bilirubin in the blood and deposition of bile pigments.
Kyphosis - abnormally increased convexity in the curvature of the thoracic spine as
viewed from the side.
Lanugo - is very thin, soft, usually unpigmented, downy hair that is sometimes found on
the body of a fetal or new-born human. It is the first hair to be produced by the fetal hair
follicles, and it usually appears around sixteen weeks of gestation and is abundant by
week twenty. It is normally shed before birth, around seven or eight months of gestation,
but is sometimes present at birth. It disappears on its own within a few weeks.
Last menstrual period – This date is used to work our how many weeks pregnant you are.
Menarche - the first menstrual period, usually occurring during puberty.
Menorrhagia - hypermenorrhea or profuse menstruation.
Menorrhea - the normal discharge of the menses.
Menses - the monthly flow of blood from the genital tract of a woman.
Metrorrhagia - continuous or non-cyclical uterine bleeding.
Milia - is a small, white bump that typically appears on the nose and cheeks. These cysts
are often found in groups.
Morbidity - the condition of being diseased or sick; the 'sick' rate, i.e. the ratio of sick to well
persons in a community.
Mortality - the quality of being mortal or alive; the 'death' rate, i.e. the number of people
dying in a given population.
Multigravida: A woman who has been pregnant before.
Multipara: Also called a multip - a woman who has given birth at least once before.
Nocturia - excessive urination at night.
Oligohydramnios - too little amniotic fluid.
Oliguria - diminished urine output in relation to fluid intake.
Pap (Papanicolaou) smear - a specimen for microscopic examination of cells for detection
of variuos conditions of the female genital tract (e.g. malignant and premalignant
conditions), prepared by spreading the material across a slide.
Palpation: When the midwife of doctor feels the baby by moving their hands across your
abdomen.
Perineum: The area of skin between your vagina and anus.
PIH: This is pregnancy-induced hypertension, which means that your blood pressure is
high.
Placenta Previa: When the placenta is low down. Sometimes it covers the cervix and
blocks the baby's exit, which would mean you need a caesarean section.
Position: How the baby is lying, for example to the right or left of the pelvis.
Postnatal: Pre-natal check-up after the birth.
Presentation: The part of the baby which is coming first (usually the crown or back of the
baby's head).
Preterm: Born before 37 weeks of pregnancy.
Petechia(e) - a minute red spot(s) due to escape of a small amount of blood.
Primipara - a woman who has born her first child.
Primi-gravida: A woman pregnant for the first time.
Proteinuria - an excess of serum proteins in the urine.

Pruritis - intense itching

Pyrexia - a fever or febrile condition
Quickening: The first movements of the baby that you can feel.
Rhinitis - inflammation of the nasal mucous membrane.
Rhesus (Rh): The rhesus blood group system is a way of categorizing your blood type.
Rooming in: Most maternity units now recommend that babies stay with their mums 24
hours a day. This helps with feeding and bonding. It also reduces the risk of infection.
Skin-to-skin: Skin-to-skin contact with your baby after birth (your baby is dried and put
straight onto your chest).
Syntocinon: Drug given during the third stage of labour to assist with delivery of placenta.
Sclerosis - abnormal hardening of tissue.
Scurvy - a disease caused by insufficient intake of vitamin C.
Seizure - an attack; the sudden onset or recurrence of a disease or of certain symptoms,
e.g. an epileptic attack, convulsion.
Sepsis - the presence of bacteria (pathogenic organisms) or their toxins in the blood or
tissues.

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 Sign - an objective indication or evidence of disease discovered on examination of a
patient. Contrast with symptom.
Stridor - a harsh, high-pitched respiratory sound
Syncope - fainting; temporary loss of consciousness due to reduced oxygen delivery to
the brain.
Tachycardia - abnormally fast heartbeat.
Term: 40 Weeks or thereabouts from the first day of the last menstrual period.
Vertigo - a sensation of spinning or whirling motion.
Vernix caseosa- also known as vernix, is the waxy or cheese-like white substance found
coating the skin of newborn human babies. It is produced by dedicated cells and is
thought to have some protective roles during fetal development and for a few hours after
birth.

MEDICAL ABBREVIATIONS

" seconds ER emergency room

' minutes et and

↓ decreased ETT endotracheal tube

↑ increase F Fahrenheit, gas conc. as a

° hours decimal

a before f frequency

abd abdomen Fx, fx fracture

ABG arterial blood gas g gram

ac before meals GI gastrointestinal

ad lib as needed gtt drop

AFB acid-fast bacillus H &H hemoglobin & hematocrit

AM aerosol mask/morning h hour

amt amount H2O water

anat anatomical HCM high concentration mask

ant anterior Hct hematocrit

approx approximately Hg mercury

AV atrioventricular Hgb hemoglobin

bid twice daily HHN hand-held nebulizer

BP blood pressure HOB head of bed

B/S breath sounds hs at bedtime

BUN blood urea nitrogen hx history

Bx, bx biopsy I&O intake and output

C Centigrade, Celsius ICU Intensive Care Unit

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C &S culture & sensitivity IM intramuscular

ċ with Inf inferior

CA cancer

CBC complete blood count IS incentive spirometer

CCU Coronary Care Unit IV intravenous

Cdyn dynamic compliance kg kilogram

cl clear L, l liter, left

cm centimeter L/min, lpm liters per minute

cmH2O cm water pressure lat lateral

CNS central nervous system lb pound

CO2 carbon dioxide LLL left lower lobe

COPD chronic obstructive LMSB left main stem bronchus

CPPD chest percussion & LUL left upper lobe

postural drainage m meter

CPT chest physiotherapy med medial

CSF cerebral spinal fluid mEq milliequivalent

CSt static compliance mg milligram

CTA clear to auscultation ml milliliter

CV cardiovascular MLT minimal leak technique

CVP central venous pressure mm millimeter

CXR chest x-ray mmHg millimeters of mercury

DC discontinue NC nasal cannula

DOB date of birth no number

Dx, dx diagnosis noc night

ECG (EKG) electrocardiogram NPO nothing by mouth/nothing per orem

NRB nonrebreathing bag

NT nasotracheal

O oxygen

OR operating room

p pulse

P partial pressure AFB acid fast bacilli

AGA appropriate for gestational

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 38

pm afternoon age
AI aortic insufficiency
PAP pulmonary artery pressure AICD Automated Implantable
Cardioverter Defibrillator
pc after meals AIDS Acquired Immunodeficiency
Syndrome
PD postural drainage AJ ankle jerk
AK above knee
PEARL pupils equal reactive to light AKA above knee amputation
AKI Acute Kidney Injury
PO pulse oximeter Alb albumin
ALL acute lymphocytic leukemia
p.o. by mouth ALP Alkaline Phosphatase
ALT (SGPT) alanine aminotransferase
post posterior
AM morning, before noon
AMA against medical advice
postop postoperative
amb ambulate
preop preoperative AMI acute myocardial infarction
AML acute myelocytic leukemia
prn as needed AMML acute myelomonocytic
leukemia
psi pounds per square inch amp. ampule
AMS Altered Mental Status
pt patient amt. amount
ANA antinuclear antibody
PT physical therapy anast. anastomosis
ant. anterior
q every Ant. Tib. anterior tibial
Ao aorta
q2h every 2 hours AOCD Anemia of Chronic Disease
A&O alert and oriented
qd every day Ap apex/apical
a.p. antepartum
qh every hour AP anterior-posterior
APC atrial premature contraction
qid 4 times daily APD Automated Peritoneal
Dialysis
qod every other day APL abductor pollicis longus
approx approximately
qs quantity sufficient AR aortic regurgitation
ARDS adult respiratory distress
Q volume of blood syndrome
AROM artificial rupture of
Q˙ T cardiac output membranes
ARF Acute renal failure
R, RR, resp respiratory rate art. arterial
AS aortic stenosis
Raw airway resistance
ASA Aspirin
RBC red blood cell ASAP as soon as possible
ASCVD arteriosclerotic
RLL right lower lobe cardiovascular disease
A.S.D. atrial septal defect
RLQ right upper quadrant ASHF Acute systolic heart failure
B bilateral or both
RML right middle lobe
BAL blood alcohol level
RMSB right mainstem bronchus
Bal.sus. balanced suspension
rt., ® right
BBB bundle branch block
RUL right upper lobe
BBT basal body temperature

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 39

Rx treatment BCLS Basic Cardiac Life Support

ŝ without BCP birth control pill

S saturation in blood BE. barium enema

SaO2 arterial O2 saturation BF breastfeeding

SM simple mask BGM blood glucose monitoring

SOB short of breath BFR blood flow rate

SpO2 sat. by pulse oximeter bili bilirubin

Stat immediately BIH bilateral inguinal herniorraphy

USN ultrasonic nebulizer BiPAP Bilevel Positive Airway Pressure

V gas volume BJ body jacket

VCO2 CO2 production per min. BK below knee

Ve exp. volume per minute BKA below knee amputation

via by way of Bkfst breakfast

VM venti-mask B.M. bowel movement

VO2 O2 consumption per min. BME biomedical engineering

VQ Scan ventilation-perfusion scan

V/S vital signs

V/T tidal volume

WBC white blood cell

x times

y/o year old

A.S.H.D. arteriosclerotic heart disease

AST (SGOT) Asparate Aminotransferase
A.T. anterior tibial
ATN atubular necrosis
AV atrio-ventricular
A-V arteriovenous

AV Fistula Arteriovenous Fistula

AVI automatic volume infusion pump
AVM arteriovenous malformation
AVR aortic valve replacement
AWOL absence without leave
ax axillary
AXT alternating exotropia

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 40

 References
http://www.acls.net (educational articles/ first aid for emergency situation)

https://radiologykey.com (aseptic technique)

https://www.slideserve.com (fundamental nursing chapter 23 body mechanics, positioning and

moving – power point presentation)

http://passnownow.com (responsible parenthood)

The Better India (10 common medical emergencies and how to deal with them)

Midwife Licensure Exam Reviewer (TOPNOTCHERS REVIEW GROUP/ STAR STL REVIEW CENTER)

https://www.betterhealth.vic.gov.au/health/servicesandsupport/health-assessments

https://www.columbiadoctors.org/condition/vital-signs

https://www.uwhealth.org/health

ODULE IN CLINICAL PRACTICUM 100 (CP100/DRUG ADMINISTRATION)/SCC2020 Pa ge 41