BLOCK 5: MED ADMINISTRATION

Question 1

what is the insertion of a catheter in to a body cavity, duct, or vessel to allow for blood flow

Answer 1

cannulation

Question 2

what is a bolus

Answer 2

single dose administered by IV

Question 3

what are HRO’s and how are they relevant in medical field

Answer 3

high-reliability organization
focuses on double-checks like cross-checking a medication before administration, etc to ensure a single failure does not lead to patient harm

Question 4

what is medical asepsis

Answer 4

preventing contamination from pathogens by using aseptic technique to prevent contamination of a site when performing invasive procedure

Question 5

what are antiseptics and examples

Answer 5

used to cleanse an area before performing invasive procedure like IVs
examples: rubbing alcohol, iodine, chloraprep

Question 6

difference between antiseptics and disinfectants

Answer 6

antiseptics are not toxic to living tissues, disinfectants are

Question 7

leading cause of disease transmission in healthcare setting

Answer 7

needlesticks

Question 8

how many liters of fluid does a healthy person lose a day

Answer 8

2-2.5L

Question 9

definition of dehydration

Answer 9

inadequate total systemic fluid volume

Question 10

what is the cardinal sign of overhydration

Answer 10

edema

Question 11

what is the benchmark to calculate a solution’s tonicity

Answer 11

sodium

Question 12

what is the concentration of sodium in the cells of the body

Answer 12

0.9%

Question 13

IV solutions are categorized as either ___ or ____ based on their dissolved components

Answer 13

crystalloid or colloid

Question 14

IV solutions are categorized as ___, ___, or ___ based on their tonicity

Answer 14

isotonic, hypotonic, hypertonic

Question 15

what are crystalloid solutions

Answer 15

dissolved crystals in water with ability to cross membranes

Question 16

fluid should be administered to restore ___ not ___

Answer 16

perfusion, normal BP level

Question 17

BP during fluid bolus should be titrated to what

Answer 17

90mm Hg systolic

Question 18

what are colloid solutions

Answer 18

contain molecules too large to pass through membranes, draw fluid from cellular compartments to reduce edema

Question 19

isotonic solutions and their effect on the cell

Answer 19

have same sodium concentration of cell
water does not shift - no cell shape change

Question 20

hypertonic solutions and their effect on the cell

Answer 20

greater sodium concentration than cell
water is drawn out of cell - cell may collapse

Question 21

hypotonic solutions and their effect on the cell

Answer 21

lower sodium concentration than the cell
water flows into the cell - causes cell to swell or burst

Question 22

what is osmolarity

Answer 22

concentration of sodium

Question 23

what common solutions are isotonic

Answer 23

normal saline, lactated ringer, D5W

Question 24

what is third spacing and who is at risk of it

Answer 24

abnormal fluid shift into body’s serous linings

patients with burns, trauma, malnutrition, or liver disease that receive a hypotonic solution

Question 25

what is the best fluid to replace blood loss and why

Answer 25

whole blood because it contains hemoglobin to carry oxygen to cells

Question 26

what is the cannulation of a vein with a catheter to access patient's vascular system called

Answer 26

intravenous therapy

Question 27

once the protective wrap around IV solutions is removed, it must be used ____ once the pigtail is removed from the port, the IV solution, it must be used ____

Answer 27

within 24hrs immediately or discarded

Question 28

two ports of an IV bag

Answer 28

injection port for meds and access port for connecting administration set

Question 29

most common prehospital IV volumes

Answer 29

1,000 and 500mL

Question 30

what is the drip size

Answer 30

how many drops it takes for 1mL to pass into the drip chamber

Question 31

microdrop sets

Answer 31

60drops per mL

Question 32

macrodrip sets

Answer 32

10-15 drops per mL

Question 33

what is a volutrol

Answer 33

microdrip set that allows you to calibrate the drip chamber with a specific amount of fluid to avoid fluid overload

Question 34

what is blood tubing

Answer 34

macrodrip set for rapid fluid replacement with dual piercing spikes

Question 35

how to identify valves and bifurcations in veins

Answer 35

valves: bumps in vein bifurcations: where one vein splits into two

Question 36

why use caution if using IV in leg

Answer 36

can put patient at higher risk of venous thrombosis and pulmonary embolism

Question 37

3 factor's of catheter size selection

Answer 37

purpose of IV, patient's age, location

Question 38

what is an over-the-needle catheter

Answer 38

teflon catheter inserted over the hollow needle and uses automatic needle retraction after insertion

Question 39

what is a butterfly catheter

Answer 39

hollow stainless steel needle with two plastic wings for handling

Question 40

how far up from intended puncture site to place tourniquet

Answer 40

4-8 inches

Question 41

what angle to establish and IV at and what angle to advance the catheter at

Answer 41

35-45 degrees 15 degrees

Question 42

change the IV bag when there is approximately __mL of fluid left

Answer 42

25

Question 43

cannulating the EJ vein comes with what high risks

Answer 43

puncture of carotid artery with rapidly expanding hematoma and air embolism

Question 44

what is infiltration vs. extravasation

Answer 44

infiltration: escape of fluid into surrounding tissues extravasation: escape of irritating agent from vessel which causes blistering

Question 45

what is catheter occlusion

Answer 45

physical blockage of a vein or catheter

Question 46

what are venous spasms caused by

Answer 46

severe reaction to administration of irritating meds or fluids

Question 47

what is phlebitis

Answer 47

vein inflammation

Question 48

what is thrombophlebitis

Answer 48

inflammation of a vein related to a blood clot

Question 49

what is a hematoma

Answer 49

accumulation of blood in the tissues surrounding an IV site from advancement of needle entirely through vein

Question 50

what increases risk for injury to nerves, tendons, and ligaments during IVs

Answer 50

IV site located near joints

Question 51

how to minimize risk of inadvertent arterial puncture

Answer 51

check for a pulse in a vessel before you cannulate

Question 52

what are pyrogenic reactions

Answer 52

foreign proteins in infusion solution or administration set that have abrupt temp elevation (as high as 106)

Question 53

what is circulatory overload

Answer 53

occurs when excessive fluid volume is administered and can lead to pulmonary edema

Question 54

what is speed shock

Answer 54

occurs when medication or solution is rapidly introduced to circulation

Question 55

difference between circulatory overload and speed shock

Answer 55

circulatory overload is a volume problem speed shock is a rate problem

Question 56

air embolism

Answer 56

occurs when air enters the bloodstream

Question 57

what is a vasovagal reaction

Answer 57

syncope due to sight of blood or needles drop in BP, decreased blood flow to brain, and brief LOC

Question 58

what is a catheter shear

Answer 58

needle slices through the catheter creating a free-floating fragment

Question 59

blood-tube top colors red blue green lavender

Answer 59

red: clot activator in PLASTIC tube blue: citrate (reversible anticoagulant) green: heparin lavender: anticoagulant for blood counts

Question 60

which blood tube do you not shake

Answer 60

red topped

Question 61

how many pounds of pressure is required for FAST IO insertion

Answer 61

32lbs

Question 62

what is osteomyelitis

Answer 62

inflammation of the bone and muscle caused by an infection

Question 63

three primary areas for IO needle insertion

Answer 63

proximal tibia, distal tibia, humeral head

Question 64

what is osteogenesis imperfecta

Answer 64

congenital disease resulting in fragile bones

Question 65

meter

Answer 65

basic unit of length in metric system

Question 66

liter

Answer 66

basic unit of volume in metric system

Question 67

gram

Answer 67

basic unit of mass in metric system

Question 68

micro number placement

Answer 68

5 zeros before number 0.000001

Question 69

milli number placement

Answer 69

2 zeros before number 0.001

Question 70

centi number placement

Answer 70

1 zero before number 0.01

Question 71

a

Answer 71

a

Question 72

1 mcg = ___ mg

Answer 72

0.001

Question 73

1mg = __mcg

Answer 73

1,000

Question 74

1g = __ mg

Answer 74

1,000

Question 75

1kg = __ g

Answer 75

1,000

Question 76

1mL = ___ ccs

Answer 76

1

Question 77

100mL = __dL

Answer 77

1

Question 78

1,000mL = __L

Answer 78

1

Question 79

one teaspoon is approximately how many mL

Answer 79

5

Question 80

one tablespoon is approximately how many mL

Answer 80

15

Question 81

one cup is approximately how many mL

Answer 81

240

Question 82

on the celsius scale, water freezes at __ and boils at __

Answer 82

0, 100

Question 83

on the farenheight scale, water freezes at ___ and boils at ___

Answer 83

32, 212

Question 84

normal body temp in F and C

Answer 84

F: 98.6 and C: 37

Question 85

conversion for farenheit to celsius

Answer 85

subtract 32 then multiply by 0.555

Question 86

conversion for celsius to farenheit

Answer 86

multiply by 1.8 then add 32

Question 87

what does a percentage mean in terms of drug concentration

Answer 87

number of grams present in 100mL

Question 88

how far to insert suppository into the rectum

Answer 88

1-1.5 inches

Question 89

what is a parenteral route

Answer 89

any route other than the GI tract

Question 90

what syringe size is most commonly used for injections

Answer 90

3mL

Question 91

what is the hub of a hypodermic needle

Answer 91

plastic piece that houses the needle to fit on syringe

Question 92

what is the shaft or cannula of the needle

Answer 92

length of the needle

Question 93

what is the bevel of a needle

Answer 93

slanted tip at the end of needle

Question 94

what is the opening within the bevel called

Answer 94

lumen

Question 95

what are ampules

Answer 95

breakable sterile glass containers for single doses of meds

Question 96

what are vials

Answer 96

glass or plastic bottles with rubber-stopper top (single or multiple med doses)

Question 97

what is drug reconstitution

Answer 97

removing the sterile water or provided diluent from the vial and injecting it into vial that contains the powder to make a solution for injection

Question 98

what is intradermal injection and how to do it

Answer 98

administering small amount of med (less than 1mL) into the dermal layer just below epidermis at a 10-15 degree angle with the bevel up

Question 99

what is subcutaneous injections and how to do it

Answer 99

given between loose connective tissue between dermis and muscle layer at a 45 degree angle for adult, 90 degree angle for child (2mL or less for adult, 0.5-1mL for kids)

Question 100

what are intramuscular injections and how to do it

Answer 100

insert needle through the dermis and subcutaneous tissue into the muscle layer at 90 degrees (up to 5mL in adult, up to 2mL in kids)

Question 101

most common IM injection sites (4)

Answer 101

vastus lateralis muscle rectus femoris muscle gluteal area deltoid muscle

Question 102

what is the IV administration set that is connected directly to the hub of the IV catheter and what is generally flowed through it

Answer 102

primary line isotonic solution like saline

Question 103

what is the line that is connected to the continuous infusion

Answer 103

"piggyback" or secondary line

Question 104

what is a mechanical device that infuses a precise volume programmed by a clinician called

Answer 104

infusion pump

Question 105

IV infusion pumps deliver fluids or meds via ___

Answer 105

positive pressure

Question 106

3 alarms equipped on infusion pumps

Answer 106

change in flow pressure, presence of occlusions, depletion of medication supply

Question 107

what are percutaneous routes of administration

Answer 107

meds applied to and absorbed through skin and mucous membrains

Question 108

how are transdermal medications applied

Answer 108

topically

Question 109

where to administer ocular medication

Answer 109

on the conjunctival sac

Question 110

what are aural medications

Answer 110

meds administered via mucous membranes of aural (ear) canal

Question 111

intranasal meds require ____ times the dose of IV meds

Answer 111

2-2.5

Question 112

most common inhaled medication

Answer 112

oxygen

Question 113

metered-dose inhalers are also called ___ after the propellant ____

Answer 113

HFAs hydrofluoroalkane

Question 114

which medications can be administered via ET tube

Answer 114

LEAN lidocaine epinephrine atropine naloxone

Question 115

what are nontunneling vascular access devices

Answer 115

inserted direct venipuncture through the skin directly into a selected vein

Question 116

insertion and distal end of peripheral inserted central catheters

Answer 116

insertion: antecubital vein distal: superior vena cava

Question 117

insertion and distal end of midline catheters

Answer 117

insertion: antecubital distal: proximal end of extremity

Question 118

insertion and distal end of central venous catheters

Answer 118

insertion: subclavian, femoral, or internal jugular vein distal: vena cava

Question 119

what are implanted vacsular access devices

Answer 119

implanted surgically and sutured under the skin

Question 120

what is an arteriovenous fistula

Answer 120

connects a vein to an artery

Question 121

when accessing multiple-lumen devices, which ones should be attempted to access first

Answer 121

largest in diameter, if same diameter then the most distal lumen lumen that should be used is usually marked with a #1