Chap 35 Flashcards
Parenteral route
(Not via the gastrointestinal tract) - require the use of 1) a syringe and needle OR 3) an intravenous IV catheter, to introduce medications into the body tissues or fluids.
why are injections given 3
1) when the pt cannot take medication by mouth
2) to hasten the action of the drug
3) when digestive juices would counteract the effects of the drug if given y the oral route
what precautions to observe for with injectable drugs? 3
1) Ensure the dose is accurate
2) select the correct site to prevent damage to the tissue
3) use sterile equipment and aseptic technique to prevent infection and sepsis
the move vascular the tissue..
the quicker the medication is absorbed
the wrong site or route may cause damage to
a major nerve or blood vessel or death
contamination of the equipment or the medication may cause
infection or abscess formation
what routes are used for parenteral medication administration? 4
Intradermal(ID) subcutaneous(subcut) Intramuscular(IM) and Intravascular(IV)
what route is used extensively for skin testing such as tuberculin testing. used at a 5-15 degree angle of inserstion
ID - Intradermal
what route is used for injecting medications into the tissues below the dermal layer? No major vessels or nerves. Inserted at a 45-90 degree angle. Absorption is slower than with IM because lack of blood vessels
Subcutaneous (subcut)
what route is used to inject sites of the deltoid, ventrogluteal, vast us laterals, and rectus femurs of the thigh. 90 degree angle of insertion. aspirates to check for blood. Aqueous solutions are absorbed more rapidly than those in an oil suspension
Intramuscular (IM)
how many mL can safely be injected in the ventrogluteal, vast us laterals, and rectus femurs sites in most adult pts?
3mL
what parts of the syringe must be kept sterile? 4
needle, tip, inside of the barrel, and the sides of the plunger
what syringe is large enough for subcutaneous and most IM injections?
3 mL syringe
what tip would be the choice for an IM injection?
Luer-Lok tip because the locking mechanism prevents a sudden separation of the needle and syringe when pressure is applied to inject medication into the muscle mass.
what tip would be the choice for an ID injection?
non-Luer-Lok slip tip because little pressure is needed to inject the medications into the dermal layer
? minims per mL
16 minims
0.25 mL = ? minims and 0.75 mL = ? minims
4; 12 minims
it is preferable to use a tuberculin syringe for
small doses (under 1 mL)
the larger the number of the gauge..
the smaller the needle
what are common sizes of an ID needle
25-, 27-, or 29- gauge needle works best
what is the common size of a subcutaneous needle?
25-gauge need because its strong enough to puncture the skin and reach below the dermis
what are common size needles to penetrate the large muscle layers when IM injections are given?
20-, 21-, 22-, and 23- gauge needles
the length of the needle is measured from its..
beveled tip to the junction of the shaft and the hub.
most often ? or ? inch needles are used for adult parenteral injections
1 or 1 1/2 inch
Adult Im injections frequently use ? and ? gauge needles. Although ? and ? gauge needles are preferred for viscous solutions or medications in oil suspensions.
22 and 23 ; 20 and 21
viscous
sticky or gummy
when preparing to give an injection, the 1st step is..
to select the appropriate size and type of needles and syringe for the medication to be given and for the pts age and size
3mL syringe and 22-gauge, 1 1/2-inch needle are generally used for what injections?
IM
3mL syringe and a 27-gauge, 3/8- to 1/2-inch, needle is generally used for what injection?
tuberculin
25-gauge, 5/8-inch needle is generally used for what injection?
subcutaneous injection
what contains powder in the base and solution in the top which are mixed together for use
the mix-o-vial
consists of a vial with an attached needle for use with the Carpuject or Tubex holder
unit dose cartridge
what do you need to do before opening an ampule cartridge?
remove the medication from the neck or stem
what kind of needle do you use when withdrawing medication from an ampule and why
filter needle because small particles of glass may fall into the medication
contains a single standard dose of medication
ampules
may contain one or more doses of medication
vial
solute
solid material
diluent
specified fluid to dissolve the solute
typical diluents
sterile water and sterile normal saline
the reaction of incompatibilities can range from…
color change, precipitaion, and clouding to invisible chemical changes rendering the drug inactive
formation of fibrous tissue
fibrosis
scale of measurement
gauge
visible elevation of the epidermis
bleb
interior diameter of a needle
lumen
red, elevated wheals
urticaria
pull back on the syringe plunger to create suction
aspirate
area of hardened tissue
induration
not via the gastrointestinal tract
parenteral
fluid to dissolve solute
diluents
small circular piece at the center
core
slanted part of the needle
bevel
what is the needle size and length determined by?
type of injection to be given and the size of muscle tissue and the amount of fat at the pts injections site.
what is essential for drug absorption?
adequate circulation
needle size for infants
5/8- inch
needle size for older children
5/8- inch or 1- inch need
when giving a deltoid injection to a child, give the injection in the
thickest part of the muscle; the needle should point at a slight angle toward the shoulder
site of choice for infants younger than 12 months for IM injections
vastus lateralis
sites for children older than 13 months of age
vastus lateralis, ventrogluteal or a well developed deltoid muscle
what is the main way to determine the effectiveness of injections?
to assess for signs that the desired effect is taking place. checking to see whether the signs and symptoms of the problem for which the med is being given are subsidding
injection documentation should include? 5
1) medication
2) dosage
3) route
4) site at which the injection was given
