35 Flashcards
Please list the principal for safe, effective administration of parenteral medication
Know No the medication you will be a administering
Check for a drug allergies
Use only sterile needles
Select appropriate length of the needle
Label the syringe with the patient name, name of the drug, and dose
Obtain assistance if needed with a child
Rotate injection site
Avoid major nerves, blood vessel, and underlining organs
IM- usually 90 degree
Intramuscular
Below the skin usually 45 degree
Subcutaneous
ID-Between the dermis
Intradermal
Routes require a syringe or needle
Injection iv
Parental
Bump
Visible elevation of the epidermis usually 15 degree
Bleb
Thick and sticky
Oil solution
Viscous
Solid material
Solute
Specified fluid to dissolve the solute
Diluent
What are the reasons why medication are given by injection
When the patient can’t Take meds by mouth
To hasten the action of the drug
When a continuous infusion of meds is necessary
When digestive juice would not counteract the effect of the drug if given by the oral route
What are the units of measurement for a needle
Gauges
The more_____the tissue, the____the medication is absorbed
Vascular, quicker
The wrong____or____may cause____to a major nerve or blood vessel or death
Site or route, damage
90°
Intramuscular
Intramuscular syringe
3 mL syringe
Maybe 5 mL
When the dosage is more than 3 mL it is split it into two different muscles
What is the size for intramuscular needle
1 to 1.5 in long
Up to 3 inches needle although that is less common
What size gauge for intramuscular
21 to 23
Sites for intramuscular
Deltoid only 1 mL
VENTROGlUTEAL
VASTUS Laterails for peds
Rectus
Femoris of the thigh
45° to 90° based on the size of the patient then patient gets the smaller angle
Subcutaneous
Types of syringe for subcutaneous
Tuberculin or 3 mL syringe
Size of the gauge and needle for subcutaneous
27 or 25 gauge
1/2–5/8 inches
Site for subcutaneous injection
Lateral surface of upper arm or
anterior lateral surface of the thighs.
abdomen
5° to 15°
Intradermal
Type a syringe for intradermal injection
Tuberculin syringe up to 1 mL
Type of needles and gauges for intradermal injection
1/4 to 1/2 for needles
25–29 gauge
Sites for intradermal injection
forearm
What are the most frequently used IM sites for injection
VENTROGlUTEAL
Dorsogluteal (only if ordered)
Deltoid
Vastus laterails (peds)
How many milliliters can safely be injected into the ventrogluteal, vastus laterails al, and rectus femoris site in most adult patients
1 to 3 mL
Divide larger volume into two syringe and use two sites
Which part of the syringe must be kept sterile
The needle
The Tip
The inside of the barrel
The side of the plunger
Popular because it is large enough for subcutaneous and moles intramuscular injection
Measures 10th of a milliliter 0.1
3 mL
Generally universal use do not use it for injection
10 mL and 12ml
Are 1 mL in size and are calibrated to measure drug doses as small as 0.01 mL it is used to measure doses in hundred
TB syringe
100 calibrated to measure 100 units of
insulin syringe should not be used for anything other than insulin
Insulin unit hundred
For lower doses u-50 Insulin is calibrated for 50 units
Insulin you – 50
Is used for intramuscular injection because it locks and prevent the needle from separating the syringe
Luerlock
For intradermal injection because little pressure is needed
The slip tips
Consist of a vial with an attached needle four use with the carpuject holder
Unit-dose cartilage
Parts of the needle
Bevel,
needle shaft
needle protector
The slanted part of the needle for the tip ending in sharp points with a whole
BEVEL
A safety device that retracts the needle after the use to prevent accidental stick
Needle protector
The length of the needle
Needle shaft
The____the number of gauge the___the needle
Larger, smaller
How would you remove the medication from the neck of an ampule into the body
Tap or flick the stem several times with a finger to Free the trap solution
How can you safely break open a AMPULE
AMPULE breaker or wrap the neck with a gauze or an alcohol swab
Please both times together at the neck and apply outward pressure to snap your neck away from you
What method can be used to recap a clean needle
Use a one hand scoop technique
Place the needle cap on a flat, farm surface, with one hand holding the syringe barrel inside the needle into the needle cat cap
What info should be on a syringe in which you have drawn up medication before taking it into the patient room
Patient name,
the measurement for the medication dosage,
date time and your initial
What type of needle should be used to withdraw the medication from an ampule
A filter needle should be used because small particles of glass may fall into the medication when the AMPULE neck is removed
Should you inject air into the AMPULE before drawing up the medication
No, the medication will bubble up and out of the aMPULE
Where should the tip of the needle be in reference to the solution to withdraw the solution
The bevel of the needle should be below the surface of the solution
Why is air injected into a VIAL before withdrawing the medication
To prevent a vacuum in the VIAL, which may inhibit withdrawal of solution
Two type of insulin economics cannot make
Lantus and Levemir
Why should injection sites be rotated
To promote the best absorption of the medication and to decrease tissue irritation or fibrosis
When should a tuberculin skin test be read
48–72 hours after injection
How do you know if it’s positive or negative tuberculin
Positive is more than 5MM
Negative is less than 5MM
Which route of administration absorbs more quickly subcutaneous or intramuscular
Intramuscular
What are the common site used for subcutaneous injection
Lateral surface of the upper arm or anterior/lateral part of die
What sites are the most commonly Use for heparin injection why
On the abdomen below the costal margin,
because this area is not involved in muscular activities
love handle are 2-3inches away from the umbilicus
Why is this right now massage after administration of heparin
This may cause bruising of the tissue, bleeding are severe ecchymosis
What are some medication that should be checked by two nurses before administration
Insulin
heparin
injectable heart medication
chemo drugs
What is the technique that can be used to find the deltoid site for intramuscular injection
Please four fingers across the deltoid muscle, with the little finger on the acromion process
Why is the dorsogluteal say avoided for intramuscular injection
The high potential for injury to the sciatic nerve in the blood vessel
What is the preferred site for intramuscular injection in infants under 12 months
vastus laterails
What is the Z- track Technique
Why is this technique used
What common medication are given this way
It is a IM injection
Medication can leak upward into the subcutaneous tissue, causing staining, bruising, and significant pain for several weeks or longer with some medication
It must be used whenever a deep IM injection or Iron DEXTRAN and other irritating solution such as hydroxyzine or hydrochloride and several antipsychotic agents are given
What position can be used for I am injection to help relax the muscle
Prone or Sim’s position
When giving a deltoid injection to a child, give the injection in the_____part of the muscle; the needle should point out a slight____ towards the shoulder
thickest, angle
What is the appropriate age for a deltoid side to be used for immunization and in a child
Over 13 months unless the muscle is poorly developed then you avoid it still
How soon after a new medication is given should the nurse assess for side effects
Observe the patient for 30 minutes after the drug has been given for the first time
Is a 29G needle bigger or smaller than a 24G needle
Smaller
Why is the abdomen a good place to administer certain subcutaneous medication
It provides the most reliable, steady absorption
What intramuscular injection can cause SCAIATIC nerve injury if the medication is not a minister correctly
Dorsogluteal
What is the maximum volume for most intramuscular injection site
What would you do if the amount you need to minister is more than the maximum amount
3 mL
It is more than 3 mL divided dose in half and give it into two different large muscle sites
What needle size and length would you use when administering a medication using the truck method
At least a 1 1/2 -3 Inch needle
22 to 23 gauge needle
What should be done with any unused medication from an AMPULE
Waste it and have another nurse witness
What information must be placed on the label for multidose vial
Date, time and initials
How would you know if a drug is compatible with another medication
There will be a different reaction in the medication are not compatible.
The reaction range from color change precipitation, and clouding to to invisible chemical changes rendering the drug inactive
ask pharmacy and look in the drug book
How quickly can IM injection provide Onset action
Within 15 minutes
What is the maximum amount of medication that can safely be injected into deltoid of an adult
1 mL
When administering any parental medication, how long should you observe the patient after a ministration of an anaphylactic reaction
30 minutes after the drug has been given for the first time
Some allergic reaction may occur up to two weeks after the medication has been administer
2.2 pounds = 1 L of retained water
