Chapter 22 Flashcards
What are the five rights of drug administration?
Right drug
Right amount
Right patient
Right time
Right route
What is required before adminstering contrast?
Patients consent and history
How to determine right drug?
Do not adminster a drug that you have not seen someone draw up
How many times should you check the drug?
3 times
When are the 3 times you should check the drug?
- Getting off shelf
- When drug is removed from container
- When container is replaced
How to determine right amount?
Measure carefully - use the right size syringe
How to determine right patient?
Verify patient’s name, wristband, birthdate
How to determine right time?
Physician or practitioner determines time
What are the right routes?
Oral
Topical
Parenteral
What is most common drug route?
Oral
How to administer oral drugs?
Make sure patient is conscious and head is elevated
How to administer sublingual drugs?
Under tongue and allowed to dissolve
Never should be swallowed
What is a common sublingual drug?
Nitroglycerin
How to adminster topical drug?
Directly on skin
Unit dose device, such as transdermal patch - precise dose released over specified time
How to adminster parenteral drug?
Injection or route other than digestive tract
What happens if drug is injected incorrectly?
Can cause nerve damage or introduce microorganisms into system
How can injections be administered and what are the absorption rates?
Intramuscular - rapid onset
Subcutaneous - slow constant absorption
Intravenous - immediate onset
How are parenteral injection supplies administered?
In an ampule/vial
IV bag or larger bottle drugs
What is an Ampule?
Sealed glass container; holds a single dose
How to use Ampule?
Hold upright
Flick the top with fingers for contents to go to the bottom
Gauze around top
Break around score
Do not contaminate needle when going into ampule
What is a vial?
Small glass or plastic bottle with sealed rubber top
How to use a vial?
Must pull back plunger to get air in syringe, then put in vial
Vial held in nondominate hand
Syringe in dominant hand
Vial held upside down
Alochol swipe vial before putting needle in
Flip off tab, don’t peel back
What is a luer-lok syringe?
Holds tip and needle in place
What are the 3 parts to a syringe?
Tip - where needle attaches
Barrel - calibration scales
Plunger - inside part that fits into the barrel
What are tuberculin and insulin syringes?
Used for precise measurement of small amount of drug
What exam are tuberculin and insulin syringes used for?
To inject glucagon in barium enemas
What are the 3 parts of the needle?
Hub
Cannula
Bevel
What does guage refer to?
Diameter of the needle
Relationship between guage size and diameter?
The larger the guage size, the smaller the diameter
What is 18 guage needle used for?
Draw up drugs
What are smaller guage needles used for?
Inject
What is the length range of needles?
.25 to .5 inches
What are shorter needles used for?
Subcutaneous injections
What are longer needles used for?
Intramuscular injections
What is a bevel?
Angled surface at the tip of the needle
What is a long bevel used for?
Subcutaneous
What is a short bevel used for?
Intravenous
What are angiocath needles?
Leave the catheter behind so drugs are administered into the catheter
Why are angiocaths safer?
When you pull needle out, the needle is drawn into a protective sheath
What is a butterfly needle?
Used for small veins - larger guage size, thinner needle
Other parenteral supplies needed:
Tourniquet
Alcohol swipe
Betadine
Cotton balls
Gauze
Latex free gloves
Hypo allergenic tape
Arm board
What should be done to contrast media before injection?
Warmed
What is viscosity?
The ability or inability of a fluid solution to flow easily - high viscosity means it flows slowly
Method for subcutaneous injection
25 guage
45 degree angle
Common sites - anterior thigh, upper back, outer surface of upper arm and lower abdomen
Method for intramuscular injection
90 degree angle
1-3 inches in the body
19-25 gauge
Common sites - deltoid muscle, vastis lateralis in lateral thigh, gluteus maximus
Intravenous injection methods
- Single administration - drug injected slowly
- Drug administered by IV bolus or push
- Infusion
What IV bolus?
Fluids injected through IV
What is IV push?
Rapid injection
What is a drip infusion?
Delivery of a certain amount of medication over a period of time
What should you do if drip stops during an infusion?
Check site for infiltration - if severe swelling and inflammation -stop infusion and apply warm cloth
What should you document when adminstering a drug?
Name of drug
Dosage
Route of adminstration and where on the body
Time administered
Expiration date
Lot #
Common IV sites
Basilic vein - medial side of anterior surface of forearm or elbow
Cephalic vein - upper outer arm
Posterior surface of hand
What is extravasation (infiltration)?
The escape of a drug out of the blood into the surrounding tissue
What to do in an extravasation incident?
Remove the needle
Apply pressure
Hold warm compress to sit
Most common contrast used for MRI?
Gadolinium based contrast - Gadolinium Oxysulfide
Characteristics of Gadolinium contrast
Shorten relaxtion times of atoms within body tissues
Can be administered orally or IV
Magnevist, omniscan, Optimark
Contradicted in patients with kidney disease
ac
Before meals
bid
Twice a day
et
And
g
gram
gtt
drops
h
hour
hs
at bedtime
Hypo
hypodermically
IV
intravenous
IM
intramuscular
mg
miligram
mL
mililiter
mm
milimeter
od
in right eye
os
in left eye
pc
after meals
po
by mouth
prn
as needed
qh
every hour
q2h
every 2 hours
q3h
every 3 hours
qid
4 times a day
sc
subcutaneous
Stat
immediately
tid
three times a day
