34.3 - Medication Flashcards
How does pressure effect needle size
The a larger the syringe, the lower the pressure flow. The smaller a syringe the higher the pressure flow
How to use an ampule
- Tap the top to bring down any fluid from the neck and into the lower chamber.
- You can either hold the ampule upside down or set it on a flat surface
- Insert the needle without touching the rim of the ampule
- Aspirate the medication in the syringe by gently pulling back on the plunger
- Keep needle tip under the surface of the liquid, tipping ampule if needed
- If air bubbles aspirated, remove from ampule and hold syringe pointing up
- Tap sides of syringe to cause bubbles to rise to needle
- Draw back slightly and then push plunger to eject air carefully without ejecting fluid
- If there is excess fluid, dispose of some and then check fluid level in syringe again
- Replace needle
How to use a vial
- Always clean top of vial with alcohol prior to needle insertion
- Because the vial is a closed system we must inject air equal to the amount of liquid we are removing or there will be a vacuum.
- So if we need to withdraw 2ml of medication, we must push 2ml of air into the vial.
- Vial should be on a flat surface, then insert needle, inject the air (plunger may be forced back by pressure)
- Invert the vial.
- Hold vial between thumb and fingers of nondominant hand
- Hold syringe in dominant hand being sure to counteract the pressure
- Keep needle tip below fluid level and withdraw correct amount.
- Tap syringe to release air bubbles and eject air into vial
- Remove syringe and hold at eye level to ensure correct dose and no air bubbles
- If air bubbles, remove them
- Change needle to one of appropriate guage and length
How to Mix medications
- Mixing compatible medications avoids the need to give a patient more than one injection.
- Determine compatibility of the medications (Consult a compatibility chart or a pharmacist for compatible medications.).
- Do not contaminate one medication with another.
- Ensure that the final dose is accurate.
- Maintain aseptic technique.
- Total dose must be within acceptable limits, may reduce the amount of injections.
- Prior to mixing, you need to calculate the final volumes and dosages. Confirm your calculations are accurate
1) Aspirate and Inject volume of air into vial A equal to being withdraw, don’t touch needle to solution
2) Then aspirate and inject volume of air into volume b and then withdraw the correct volume of medication
3) Insert needle back ito vial A and withdraw the correct amount of medication
4) Replace the needle
How to give insulin
- Before preparing insulin, gently roll all cloudy insulin preparations (Humulin-N) between the palms of your hands to resuspend the insulin.
- Mixing insulin is the same procedure as mixing medications that we already discussed. Draw up clear before cloudy
- Can mix insulins if taking different types, but ensure they are compatible.
- administered within 5 minutes of preparing as longer acting insulins may bind with the short acting and reduce its action
- Patients choose one anatomical area (e.g., the abdomen) and systematically rotate sites within that region; this maintains consistent insulin absorption from day to day.
- Absorption rates of insulin vary on the basis of injection site. Insulin is most quickly absorbed in the abdomen and most slowly in the thighs.
What are some conditions that carry an increased risk for hemorrhage?
Recent childbirth; severe diabetes and renal disease; liver disease; severe trauma; and active ulcers or lesions of the gastrointestinal (GI), genitourinary (GU), or respiratory tract
where to give heparin
heparin given in the abdomen at least 5 cm from umbilicus
Subcutaneous Injection: angle to use
Rule: if you can grasp 5 cm of tissue, insert the needle at a 90-degree angle; if you can grasp 2.5 cm of tissue, insert the needle at a 45-degree angle
Subcutaneous Injection: needle gauge
- 25-27 gauge (10-16mm);
- syringe 1-3ml
- 25-gauge 16-mm needle inserted at a 45-degree angle
- 12-cm needle inserted at a 90-degree angle.
- A child may require only a 12-cm needle
- insulin, needles of 3/16 inch (4 to 5 mm) administered at a 90-degree angle should be used to reduce pain
Subcutaneous Injection: sites to use
- the outer aspect of the upper arms,
- the abdomen from below the costal margins to the iliac crests
- the anterior aspects of the thighs
• Choose an injection site that is free of skin lesions, bony prominences, and large underlying muscles or nerves.
Administering Continuous Subcutaneous Medications
Use a small-gauge (25 to 27) winged butterfly IV needle or a special commercially prepared Teflon cannula.
Use the same anatomical sites for subcutaneous injections and the upper chest.
Requires a computerized pump with safety features.
intramuscular Route: needle gauge
- Use a longer and heavier-gauge needle to pass through subcutaneous tissue and penetrate deep muscle tissue.
- Syringe 2–3 mL for adult, 0.5–1 mL for infants and small children
- Needle, with length corresponding to the site of injection and the age of the patient according to the following guidelines (25-38mm)
- Any site (children):1.6–3.2 cm (depending on the size of the child)
- Vastus lateralis (adults):2.5–3.8 cm
- Deltoid (adults):2.5–3.8 cm
- Ventrogluteal (adults):3.8 cm
intramuscular Route: sites to use
- Vastus lateralis
- Ventrogluteal
- Deltoid
intramuscular Route: angle to use
- Inject at 90°, dart-like, to the hub of the needle and inject at 1 mL per 10 seconds.
- Wait at least 10 seconds before withdrawing the needle.
Intradermal (ID) injections: needle size
- Use a tuberculin (TB) or small syringe with a short 9 mm to 16 mm (⅜- to ⅝-inch), fine-gauge (25 to 27) needle
- Inject only small amounts of medication (0.01 to 0.1 mL) intradermally.
