Administering Vaginal Medication

Administering Vaginal Medication

Equipment
■ Medication (foam, jelly, cream, suppository, douche, or irrigating solution).
■ Applicator (if indicated).
■ Washcloth and warm water for perineal care as needed.
■ Water-soluble lubricant.
■ Toilet tissue.
■ Perineal pad.
■ Bath blanket.
■ For irrigation:
■ Waterproof pad.
■ Bedpan.
■ Vaginal irrigation set (may be disposable; consists of a solution container, nozzle, tubing, and clamp).
■ IV pole.

Assessment
■ Assess for:
■ Vaginal burning.
■ Pruritis.
■ Pain.

Post-Procedure Reassessment
■ Assess for:
■ Purulent vaginal discharge.
■ Vaginal burning.
■ Pruritis.
■ Pain.

Key Points
For Vaginal Suppository
■ Position the patient in a dorsal recumbent or Sims’ position.
■ Inspect and cleanse the vaginal area.
■ Apply a water-soluble lubricant to the rounded end of the suppository
and to the gloved index finger on your dominant hand.
■ Separate the labia with your nondominant hand.
■ Insert the suppository or applicator into the vagina along the posterior vaginal wall about 8 cm (3 in.).
■ Instruct the patient to maintain the position for 5 to 15 minutes.

Applicator Insertion of Cream, Foam, or Jelly
■ Position the patient in a dorsal recumbent or Sims’ position.
■ Inspect and cleanse the vaginal area.
■ Separate the labia with your nondominant hand.
■ Insert the applicator approximately 8 cm (3 in.) into the vagina along
the posterior vaginal wall.
■ Depress the plunger on the applicator. Dispose of the applicator. If it is reusable, place it on a paper towel and wash it later with soap and water.
■ Instruct the patient to remain in a supine position for 5 to 15 minutes.

For Irrigation (Douche)
■ Inspect and cleanse the vaginal area.
■ Warm the irrigation solution to approximately 105°F (40.6°C).
■ Hang the irrigation solution approximately 30 to 60 cm (1 to 2 ft)
above the level of the patient’s vagina.
■ Position the patient in a dorsal recumbent position on a waterproof pad and bedpan.
■ Insert the nozzle approximately 7 to 8 cm (3 in.) into the vagina, and start the flow of irrigation solution.

Documentation
■ Document:
■ Medication, time, dose, and route given.
■ Therapeutic and adverse drug effects, nursing interventions, and teaching.
■ Condition of vaginal tissue and perineal area, if abnormalities are present.
■ Any complaints of discomfort outside of the expected range.
■ Length of time the suppository was retained.
■ For vaginal irrigations, chart:
■ Assessment.
■ Type and amount of solution administered.
■ Patient discomfort during the procedure.
■ Patient’s report of decreased vaginal pain, itching, and/or burning following the procedure.

Insert the suppository as far as possible along the posterior vaginal wall