Anti-Infectives & Injections Flashcards
1
Q
If giving a shot on an angle, the bevel should be _______.
A
Up
2
Q
Vial
A
Rubber topped container for multiple entry
3
Q
Penicillins
(peni-cil-lins)
Drugs to Remember
(2)
A
Penicillin G
-and-
Ampicillin
(am-pi-cil-lin)
4
Q
Principles of Antibiotic/ Anti-Infective Therapy:
Reality:
Give other drugs to ________ the loss of natural flora
A
counter act
5
Q
30 mL syringe
A
Rare
6
Q
General procedure for using vials
A
- Clean the top with alcohol and let it dry a bit
- Inject as much air into the vial as the amount you will take out
-
Turn upside down to draw out medication
- For fewer air bubbles
7
Q
Types of syringes
A
- 3 mL syringe
- Tuberculine syringe
- Insulin syringe
- 5 mL syringe
- 10 mL syringe
- 30 mL syringe
- 60 mL syringe
- Pre-filled syringe
8
Q
Age & Situation Related Side Effects:
Very Young
A
No tetracycline
- Causes malformed/discolored teeth & bones
(tetra-cycl-ine)
9
Q
Principles of Antibiotic/ Anti-Infective Therapy:
Reality:
MD often “________” at the right drug rather than wait to do a _______ (wait 2 days to know what organism is)
-Often uses ____________ medication
A
guesses
culture
-Broad spectrum
10
Q
Penicillins
(peni-cil-lins)
Works mostly on which type of bacteria?
A
Gram (+) bacteria
11
Q
How to Choose a Site & Equipment:
Consider where the ______ was given
A
last injection
12
Q
Sulfonamides Uses:
(Sulf-on-am-ides)
- This drug is often ________________
A
combined with others for best effect
13
Q
Penicillins
(peni-cil-lins)
Bacteriostatic or Bacteriocidal?
A
Bacteriocidal
14
Q
Patient Teaching:
Take the _________. Don’t stop until all doses are gone. At first infection may just be __________ and not gone, although you feel better.
A
whole prescription
suppressed
15
Q
Bacteriostatic
(bacterio-static)
A
Antibiotics that inhibit bacterial growth
16
Q
Parts of the syringe that must be kept sterile:
A
- The needle
- The inside of the barrel
- The end of the plunger
- The barrel tip that the needle hub fits into
17
Q
Age & Situation Related Side Effects:
Pregnant Women
A
Some types of antibiotics will harm fetus
Caused birth defects
ter-a-to-gens
18
Q
Penicillins
(peni-cil-lins)
Action
A
Inhibits bacterial cell wall sythesis
-Causes the bacteria cell to breakdown and die
19
Q
Aspirate or not
A
Depends on hospital policy
20
Q
How to Choose a Site & Equipment:
Site may be determined by________
A
amount of medication
(deltoid- 1 mL only)
21
Q
Penicillins Problems:
(peni-cil-lins)
Combination drugs may be used to _________
beta- lactamase
A
inhibit
22
Q
Patient Teaching:
Don’t ____________, if you do, throw them away. May be _______ when expired.
A
have any leftovers
toxic
23
Q
Disadvantages of administering medications by injection
A
- More expensive than pills
- Takes more than popping a pill
- Hard to get it back if given wrong
- Can’t pump your stomach like a pill
- Painful?
24
Q
Can sulfanomides be combined with other drugs?
A
Yes, sulfanomides are often combined with other drugs for the best effect
25
**Cephalosporins**
## Footnote
(cep-halo-spor-ins)
**Defining Characterisitc**
**Synthetic** antibiotic
26
Minimizing tissue damage & reducing discomfort:
**\_\_\_\_\_\_\_\_ and get the needle in all \_\_\_\_\_\_\_\_\_**
_**\*Don't insert needle in stages**_
Dart quickly
one motion
27
Four **biggest** side effects of antibiotics:
1. Allergy (mild to severe)
2. Resistance
3. Superinfection
4. Gastrointestional upset
28
How to Choose a Site & Equipment:
## Footnote
**Consider the __________ the patient is going to recieve**
of injections
29
Pre-filled syringe
* Already drawn up in **standard dosages**
* Used for **narcotics, saline, emergency meds**
30
Four **biggest** side effects of antibiotics:
## Footnote
**Gastrointestional Upset**
* Nausea
* Vomitting
* Diarrhea
31
_Age & Situation Related Side Effects:_
## Footnote
**Very Old**
May need a **small dose** because of **poor liver** function
\*the liver can't metabolize well
32
**Penicillins Contraindications:**
(peni-cil-lins)
Many people are \_\_\_\_\_\_\_\_\_-especially people with \_\_\_\_\_\_\_\_\_\_
allergic
asthma
33
Where are the acceptable locations for ID injections?
Acceptable ID injection locations:
1. Inside forearms
2. Particulary left arm for TB test
34
Minimizing tissue damage & reducing discomfort:
## Footnote
**Don't ________ once it is in the patient**
move the needle
35
**Penicillins Uses:**
## Footnote
(peni-cil-lins)
Often used for _________ and \_\_\_\_\_\_\_\_\_\_\_
pneumonia
ear infections
36
Advantages of administering medications by injection
* Works quickly- 15 minute
* Pretty easy to do- pt. can learn
* Some medications can only be done this way
37
Acceptable locations for **SQ/SC** injections
1. Out arm "flab"
2. Anterior thigh
3. Lower abdomen
1. Aim for a stretch mark (W)
4. Upper back (scapula area)
38
What is the maximum amount for IM injections
3 mL
39
**Gram (-) cocci**
Bacteria with a more **complex cell wall**
40
What is the **needle** made up of?
Stainless steel
41
General rules for **Z-Track Style IM** injection
* **DON'T PINCH**
* Displace tissue to **side** with side of hand
* Inject at **90 degree angle** into **muscle**
* Pull out needle and release displaced tissue at the same time
* Usually done in a **large muscle**
42
What is the relationship between number of the needle's gauge and its size?
Inverse Relationship
* The smaller the number the larger the diameter of the needle
* The larger the number the smaller the diameter of the needle
43
44
How to Choose a Site & Equipment:
## Footnote
**Consider the patient's \_\_\_\_\_\_\_\_**
Incisions
45
_Protecting Yourself:_
## Footnote
**Dispose of the needle/syringe \_\_\_\_\_\_\_\_\_**
immediately
46
_Boards_
**Do NOT aspirate for _________ & \_\_\_\_\_\_\_\_**
subcutaneous
immunizations
47
**Sulfonamides**
## Footnote
(Sulf-on-am-ides)
**Action**
**Inhibit** the synthesis of **folic acid** used for growth of bacteria
48
_Principles of Antibiotic/ Anti-Infective Therapy:_
## Footnote
**Ideally, the _drug_ should:**
1. Kill the specific organism
2. Not kill the normal flora
3. Have NO side effects
49
General rules for ID injections
1. Not for delivering medication
2. Use a **TB syringe** with **25 gauge** needle or less
3. Insert **bevel up** and make and "bleb" under the skin
4. **DO NOT** massage or press
50
_Patient Teaching:_
If \_\_\_\_\_\_\_\_\_, wear a medical alert tag.
**ALLERGIC**
51
How to Choose a Site & Equipment:
## Footnote
**Syringe: Depends on \_\_\_\_\_\_\_\_\_\_**
amount of medication
52
Minimizing tissue damage & reducing discomfort:
## Footnote
**\_\_\_\_\_\_\_\_: Have band-aids, stickers, kisses from parents**
Kids
53
General rules for SQ/SC injections
1. Give no more than **1 mL** is given in a SQ injection
2. **5/8 inch** needle with small diameter -**25 gauge** is common
3. **Pinch the skin**
4. Enter at a **45 degree angle** with **bevel up**
54
What is the needle's bevel?
* The bevel makes the needle more **pointy** and **easier to use**
55
Where are the acceptable locations for IM injection?
Acceptable IM Locations
1. Ventrogluteal
2. Deltoid (**only 1 mL max**)
3. Vastus lateralis
1. Use this site for kids less than 2
NO, NO - Dorsogluteal site (no longer acceptable!)
56
_Protecting Yourself:_
## Footnote
**Use the needle ________ on the syringe**
shield
57
_Principles of Antibiotic/ Anti-Infective Therapy:_
## Footnote
**Reality:**
**It may be enough to ________ the organism so that body's natural defenses can "\_\_\_\_\_\_\_"**
suppress
catch up
58
**Penicillins Uses:**
## Footnote
(peni-cil-lins)
\_\_\_\_\_\_\_\_\_ drugs
Broad spectrum
59
Anti-infectives
Help fight infections
60
Four **bigges**t side effects of antibiotics:
## Footnote
**Resistance**
Organism **mutates** and **avoids the effects of the medication**
61
Barrel of the needle
* The part of the needle where medication goes into
* Marked off for precise measurement
62
Needle cap
Cap cover of sterile needles
63
_Patient Teaching:_
Antibiotics interfere with \_\_\_\_\_\_\_\_\_\_\_\_\_\_. Use a barrier method.
oral birth control
64
Four **biggest** side effects of antibiotics:
## Footnote
**Superinfection type #2**
_Superinfection type #2_
* When the patient **starts with a viral infection** and now **bacteria have invaded**
* ****Because the immune system is busy fighting the virus
65
Medication containers for syringes
1. Vials
2. Ampules
66
Minimizing tissue damage & reducing discomfort:
## Footnote
**\_\_\_\_\_\_\_\_ the skin**
Pinch
67
Intramuscular injections
**IM**
* Injection into **MUSCLE**
68
**Sulfonamides Uses:**
(Sulf-on-am-ides)
* Excellent antibiotic for \_\_\_\_\_\_\_\_
UTIs
69
The needle shield should be able to be activated with \_\_\_\_\_\_\_\_\_
One hand
70
Tuberculine syringe
* Holds **1 mL** only
* Can measure **1/100th of a mL**
71
**Penicillins**
## Footnote
(peni-cil-lins)
**Made from \_\_\_\_\_\_\_\_\_**
molds
72
Carpuject Syringe Holder
Used for pre-filled medications
73
_Patient Teaching:_
Contact your health care provider if you have the following symptoms when taking anti-infectives:
(4)
1. Rash
2. Respiratory problems
3. Edema around face
4. Diarrhea lasting more than 1 day
74
Insulin syringe
* Holds **1 mL** max
* Some can hold only **1/2 of an mL**
* Measures insulin only
* Insulin comes in units
* **1 unit = 1/100th of mL**
* Needle is **NOT** removable
75
Since many bacteria are not resistant, sulfanomids are useful for treating\_\_\_\_\_\_\_\_\_\_
MRSA
(Methicillin Resistant *Staphyloccus aureus*)
76
**Penicillins Problems:**
## Footnote
(peni-cil-lins)
Many bacterial have ________ and produce _________ which \_\_\_\_\_\_\_\_\_\_\_\_\_.
mutated
beta-lactamase (lact-a-mase)
destroys penicillins
77
Needle shield
* Protective covering used after the needle is used
* Covers the dirty needle
* Cannot be taken off once activated
78
How to Choose a Site & Equipment:
## Footnote
**Needle choice: ___________ to do what you want**
**-and-**
**\_\_\_\_\_\_\_\_\_ not to bend**
long enough
thick enough
79
How to Choose a Site & Equipment:
## Footnote
**Consider if the medication is \_\_\_\_\_\_\_\_\_.**
**If so give in \_\_\_\_\_\_\_\_\_\_\_.**
irritating
large muscle
80
5 mL syringe
* Measures in **1/10th **
* Rare
81
_Principles of Antibiotic/ Anti-Infective Therapy:_
## Footnote
**Reality:**
**\_\_\_\_\_\_\_ the infection without too many \_\_\_\_\_\_\_**
Kill
side effects
82
**Sulfonamides**
## Footnote
(Sulf-on-am-ides)
**Bacteriostatic or Bacteriocidal**
**Bacteriostatic**
-inhibits growth
83
General procedure for using ampules
1. Flick to get all the **fluid to the bottom**
2. **Clean the break area** (neck) with alcohol
3. Break **away**- cover top with alcohol swab package
4. **Dont turn ampule upside down** when you draw med out
5. Use a **filter needle** to a regular needle before injection
84
What are ID injections mostly used for?
1. TB tests
2. Allergy tests
85
General rules for IM injections
1. IM injectins with **larger diameter** needle
1. **20 gauge** is common
2. IM needle length is **1-1 1/2**
3. **Pinch the skin**
4. Enter at a **90 degree angle** (into the muscle)
86
Minimizing tissue damage & reducing discomfort:
## Footnote
**If the medication is _NOT_ heparin, then \_\_\_\_\_\_\_\_\_\_\_**
massage the site
87
_Patient Teaching:_
Don't ___________ with anyone. They may have _______ or it may not be the right medication for their situation.
share your meds
allergies
88
Intradermal Injections
**ID**
* Injections just **under the skin**
89
Contradictions of sulfanomides?
Few
90
Four **biggest** side effects of antibiotics:
## Footnote
**Allergy**
* Mild to severe
* Rash, itching →Constriction of bronchi & **_anaphylactic shock_**
91
**Bacteriocidal**
## Footnote
(bacteri-o-cidal)
Antibiotics that **kill** bacteria
92
**Sulfanomides**
Drug to Remember
**Sulfamethoxazole**
## Footnote
(sulfa-meth-ox-az-ole)
**(Bactrim)**
(bact-rim)
93
_Patient Teaching:_
When taking anti-infectives, you should see improvements in ________ hours after starting
24-48
94
The **bevel** is the needle's\_\_\_\_\_\_\_\_\_?
Sharpest **point**
95
How is the diameter of the needle measured?
Needle's diameter is measured in "gauges"
96
Minimizing tissue damage & reducing discomfort:
## Footnote
**Inject quickly, but not \_\_\_\_\_\_\_\_\_\_\_**
a burst
97
Subcutaneous Injections
**SQ/SC**
* Injection into **FAT**
* **NOT the muscle**
98
_Protecting Yourself:_
## Footnote
**Do _NOT_ _________ the needle after its been in the patient**
recap
99
_Boards_
## Footnote
**DO aspirate for \_\_\_\_\_\_\_\_\_\_\_**
IM injections
100
**Gram (+) cocci**
Round bacterial with **thick cell walls**
101
\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_, _________ and ________ all cause infections, but must be treated differently.
Bacteria, fungi, protozoa, virus
102
Principles of Antibiotic/ Anti-Infective Therapy:
## Footnote
**Reality:**
**Start the medication now, don't wait-Get to the "\_\_\_\_\_\_\_\_\_\_\_\_" ASAP**
therapeutic level
103
What unit of measurement is used for the needle's length?
Inches
104
Plunger of the needle
* Measures at where the plunger scrapes the barrel of the syringe
* Note the **pointy tip in the middle**
105
**Aerobic**
## Footnote
(a-er-ob-ic)
Living in the **presence** of **O2**
106
**Anaerobic**
## Footnote
(ana-er-ob-ic)
Living the the **absence** of **O2**
107
_Principles of Antibiotic/ Anti-Infective Therapy:_
## Footnote
**Prophylactic Use Goal:**
To _prevent infection_ when there is a risk of _contamination_:
1. Before surgery
2. With severe injury
3. With a dirty wound
108
Injection types and sites
1. Subcutaneous injections **(****SQ/SC)**
1. Injection into **FAT**
2. Intramuscular injection **(IM)**
1. ****Injection into **MUSCLE**
3. Intradermals **(ID)**
1. ****Injection just **UNDER the SKIN**
4. **Z-Tack style IM** injection
1. **Push skin** as you inject into **MUSCLE**
109
General rule about used insulin needles and caps?
**Don't recap**
Insulin needles go through the cap
110
Minimizing tissue damage & reducing discomfort:
## Footnote
**\_\_\_\_\_\_\_\_ quickly**
Get out
111
What is the usual amount for ID injections?
**1/10th **is the usual amount
112
**Sulfonamides is used in treating (2):**
(Sulf-on-am-ides)
1. UTIs
2. MRSA
113
Purpose of **Z-Track Style IM** Injection
* Style of injection for **medications too irritating or might stain the skin**
114
Ampules
**Glass** container that must be **broken open**
115
Four **biggest** side effects of antibiotics:
## Footnote
**Superinfection type #1**
_Superinfection type #1_
* Normal flora disturbed (2% change)
* Normal flora has a **function** in the body
* When normal flora is **killed**
* **Other organisms are no longer kept under control**
* ex. fungi, C.diff
116
Hub of the needle
* Comes in **different colors**
* The colors usually corresponds to the **gauge of the needle**
117
3 mL syringe
* Measures in **1/10**th of a mL
* Up to **3 mL**
118
_Protecting Yourself:_
## Footnote
**\_\_\_\_\_\_\_\_\_\_\_ during the injection**
Wear gloves
119
