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PNUR 154 - Integrated Nursing Practice > Class 5 - Medication Admin and Parenteral Medication Admin > Flashcards

Class 5 - Medication Admin and Parenteral Medication Admin Flashcards

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1
Q

define parenteral route

A

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)

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2
Q

define ampoule

A

small glass container for individual medication doses

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3
Q

define intramuscular

A

into the muscle

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4
Q

define intravenous

A

into the vein

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5
Q

define subcutaneous

A

beneath the layers of skin

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6
Q

define u-100 syringe

A

specifically designed syringe for insulin injections

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7
Q

define vial

A

a glass medication container with a sealed rubber cap for single or multiple doses

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8
Q

what are the parts of the syringe

A

tip
barrel
plunger

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9
Q

what are the parts of a needle

A

bevel
shaft
hub (the gauge # is on the hub)

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10
Q

Identify the parts that must be sterile

A

syringe - the plunger, tip and inside of barrel

needle - the bevel and the shaft

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11
Q

what are the ways in which infection can be prevented when giving injections

A
  • 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
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12
Q

apply standard precautions when administering injections by

A
  • doing hand hygiene
  • wearing gloves
  • doing 3 checks and 10 rights
  • using medical aseptic practices btw needle and pt
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13
Q

how can i prevent needle stick injuries

A
  • 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
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14
Q

where on the body can you use subcutaneous injections

what sites

A
  • abdomen (heparin, insulin)
  • back side of the upper arm
  • front part of the thigh
  • scapular area of upper back
  • top part of the buttocks
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15
Q

why do we rotate subcutaneous sites

A
  • to minimize tissue damage
  • aid in absorption
  • to avoid discomfort
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16
Q

what are the guidelines for mixing short and intermediate acting insulin in one syringe

A
  • 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!!!
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17
Q

where are the injections sites for administering intramuscular injections

A
  • ventrogluteal (top of the buttocks)
  • vastus lateralis (middle of the thigh)
  • deltoid (shoulder)
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18
Q

what are the special considerations for injections whe dealing with infants and children

A
  • 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
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19
Q

why is the z track method of injection used

A
  • 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
20
Q

what are the needle size and lengths for subcutaneous injections

A

generally 13 to 16 mm long; using a #23 to #25 gauge or #28 to #30 for insulin

21
Q

what is the maximum volume of medication that can be administered by subcutaneous injection

A

doses of 1mL

22
Q

what are the advantages/disadvantages of subcutaneous injections

A

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

23
Q

what are the advantages/disadvantages of intramuscular injections

A

advantages:

  • large volume for doses of medication
  • minimal discomfort

disadvantages:
- greater risk of infections
- potential to hit blood vessels or structures beyond the
muscle

24
Q

what are the needle size and lengths for intramuscular injections

A

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)

25
Q

what is the volume of medication that can be administered by intramuscular injection

A
  • 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
26
Q

what are percutaneous routes

A 
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
      rectal
27
Q

primary advantage of percutaneous drugs are

A
  • 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

28
Q

what does topical med administration mean

A
  • applied to the skin

ex: creams, ointments, lotions, powders

29
Q

what can topical medications do

A
  • relieve local signs and symptoms - i.e.: itching
  • reduce inflammation
  • rehydrate skin
  • clean and debride wounds
30
Q

the amount of medication absorbed through the skin depends on what

A
  • 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
31
Q

percutaneous administration of opthalmic (eye drops) means what

A

to apply medication to the eyes directly

32
Q

why do we apply pressure to the inner canthus when applying eye drops

A

to prevent a systemic reaction with the medication

33
Q

how long should you hold the inner canthus after applying the medication

A

1 to 2 minutes

34
Q

what should you do when applying eye drops

A
  • 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
35
Q

what should you NOT do when administering eye drops

A
  • 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
36
Q

what is a transdermal patch

A

a controlled relaese of medications through a semipermeable membrane for several hours to 3 weeks

37
Q

what are sublingual/buccal administrations of medications

A

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

38
Q

what do metered dose inhalers (MDIs) do

A

delivers medication directly to the mucous membranes of the respiratory tract (lungs)

39
Q

what are some things to remember when giving inhaled medications

A
  • 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
40
Q

what is the angle of injection for intramuscular and subcutaneous injections

A 
intramuscular = 90 degree angle
subcutaneous = 30-45 degree angle
41
Q

what are intradermal injections

A

it is an injection of medication into the dermal layer (just below the epidermis, outer most layer of skin)

42
Q

what reason are intradermal injections done

A

usually for allergy testing and tuberculosis screening

43
Q

where are intradermal injections done

A

usually on the inside of the forearm (left for TB screening)

44
Q

define lipohypertophy

A

lump inder the skin caused by an accumulation of extra fat at the site of many subcutaneous injections

45
Q

when do you aspirate a needle

A

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

PNUR 154 - Integrated Nursing Practice (4 decks)

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