Class 5 - Medication Admin and Parenteral Medication Admin Flashcards
define parenteral route
medication that is administered into the body other than through the GI tract.
ex: intravenous (into a vein)
subcutaneous (under the skin)
intramuscular (into muscle)
define ampoule
small glass container for individual medication doses
define intramuscular
into the muscle
define intravenous
into the vein
define subcutaneous
beneath the layers of skin
define u-100 syringe
specifically designed syringe for insulin injections
define vial
a glass medication container with a sealed rubber cap for single or multiple doses
what are the parts of the syringe
tip
barrel
plunger
what are the parts of a needle
bevel
shaft
hub (the gauge # is on the hub)
Identify the parts that must be sterile
syringe - the plunger, tip and inside of barrel
needle - the bevel and the shaft
what are the ways in which infection can be prevented when giving injections
- swabbing the injection site with 70% alcohol or a mixture
of alcohol and cholorohexidine - don’t contaminate the tip of the syringe
- don’t touch the plunger other the the top part to push
- dont’ touch the needle shaft or bevel
apply standard precautions when administering injections by
- doing hand hygiene
- wearing gloves
- doing 3 checks and 10 rights
- using medical aseptic practices btw needle and pt
how can i prevent needle stick injuries
- never bend or break needles prior to disposal
- never recap a needle that has ben inserted into a client
- when recapping a needle:
*use a safety mechanical device that firmly grips the
needle cap and holds it in place
*use the scoop method
*use safety syringes that require no contact
where on the body can you use subcutaneous injections
what sites
- abdomen (heparin, insulin)
- back side of the upper arm
- front part of the thigh
- scapular area of upper back
- top part of the buttocks
why do we rotate subcutaneous sites
- to minimize tissue damage
- aid in absorption
- to avoid discomfort
what are the guidelines for mixing short and intermediate acting insulin in one syringe
- mix insulins from clear to cloudy (cloudy insulins have an
added protein that cannot contaminate the clear
insulins) - when insulins are mixed administer within 5 minutes
- ensure accurate dosing
- only use an insulin syringe to administer insulin!!!
where are the injections sites for administering intramuscular injections
- ventrogluteal (top of the buttocks)
- vastus lateralis (middle of the thigh)
- deltoid (shoulder)
what are the special considerations for injections whe dealing with infants and children
- infants: vastus lateralis is better b/c there are no major
blood vessels or nerves, and it is the largest muscle in
an infant - children: deltiod is recommended b/c of the smaller
muscle mass and to minimize discomfort
why is the z track method of injection used
- less painful that putting the neddle in straight
- decrease leakage of irritatind and discoloring medications
into the subcutaneous tissue - enables the medication to become trapped in the muscle
for better effectiveness
what are the needle size and lengths for subcutaneous injections
generally 13 to 16 mm long; using a #23 to #25 gauge or #28 to #30 for insulin
what is the maximum volume of medication that can be administered by subcutaneous injection
doses of 1mL
what are the advantages/disadvantages of subcutaneous injections
advantages:
- no large blood vessels to hit
- minimal bleeding
- rapid absorption
- less pain
- lots of sites to choose from
- lower risk of infection from injection
disadvantages:
- only small doses can be done
- more risk of lipoatrophy b/c of site rotation
- increased sensitivity from being close to the surface of
skin
what are the advantages/disadvantages of intramuscular injections
advantages:
- large volume for doses of medication
- minimal discomfort
disadvantages:
- greater risk of infections
- potential to hit blood vessels or structures beyond the
muscle
what are the needle size and lengths for intramuscular injections
standard is 2.5 or 3.8 cm needle length which equates to #21 to #25 gauge needle
*remember the size of the patient is what dictates the length of the needle used (ex: the larger the persons muscle mass is the longer the needle needs to be)
what is the volume of medication that can be administered by intramuscular injection
- usually 1 to 2mL to a max of 3mL in well developed
muscles - for deltoids 0.5 to 1mL is the maximum dose
- if you have more than 3mL you need to do two needles
what are percutaneous routes
routes that medications are absorbed through the skin or mucuous membranes
ex: inhalers
transdermal patches
topicals
nasal sprays
eye/ear drops
buccal (cheek)
sublingual (under the tongue)
vaginal
rectalprimary advantage of percutaneous drugs are
- the action of the drug is localized to the site it is applied
and side effects are reducedb/c there is no systemic
issues
some exceptions to this though are: some inhalers, patches, sublingual and buccal can produce some systemic effects
what does topical med administration mean
- applied to the skin
ex: creams, ointments, lotions, powders
what can topical medications do
- relieve local signs and symptoms - i.e.: itching
- reduce inflammation
- rehydrate skin
- clean and debride wounds
the amount of medication absorbed through the skin depends on what
- the size of the area covered by medication
- concentration or strenght of the medication
- lenght of time the medication remains on the skin
- general condition of the skin
percutaneous administration of opthalmic (eye drops) means what
to apply medication to the eyes directly
why do we apply pressure to the inner canthus when applying eye drops
to prevent a systemic reaction with the medication
how long should you hold the inner canthus after applying the medication
1 to 2 minutes
what should you do when applying eye drops
- clean eye from inner canthus out prior to administering
- wear gloves
- tell patient to look up and to not blink
- hold the inner canthus with a tissue or gauze immediately
after application of meds to reduce systemic reaction
what should you NOT do when administering eye drops
- do not clean from outer to iner canthus
- do not share eye medication amongst patients
- do not touch the tip of the medication bottle to the
patients eye
what is a transdermal patch
a controlled relaese of medications through a semipermeable membrane for several hours to 3 weeks
what are sublingual/buccal administrations of medications
Sublingual: medications administered under the tongue
Buccal: medications given btw the cheek and the molars
- advise patient not to swallow medication
- primary advantage is rapid absorption and onset
of the medication
- the action of the medication is systemic
what do metered dose inhalers (MDIs) do
delivers medication directly to the mucous membranes of the respiratory tract (lungs)
what are some things to remember when giving inhaled medications
- if dexterity is an issue use a spacer to deliver medications
- wait 30 secs btw inhalations
- if using 2 different inhalers always use the bronchodilator
(short acting) before the corticosteroid (long acting)
*ventolin - dilates bronchioles
*flovent - relaxes smooth muscle, decreases
inflammation - allow 5 mins for bronchodilator towork before
administering a long acting corticosteroid
what is the angle of injection for intramuscular and subcutaneous injections
intramuscular = 90 degree angle subcutaneous = 30-45 degree angle
what are intradermal injections
it is an injection of medication into the dermal layer (just below the epidermis, outer most layer of skin)
what reason are intradermal injections done
usually for allergy testing and tuberculosis screening
where are intradermal injections done
usually on the inside of the forearm (left for TB screening)
define lipohypertophy
lump inder the skin caused by an accumulation of extra fat at the site of many subcutaneous injections
when do you aspirate a needle
you aspirate everywhere except in the deltoid and if you see any blood in the needle remove the injection and start over this means that you have hit a blood vessel
