Drug Forms and Routes- Administering Meds

Question 1

General procedure guidelines

Answer 1

know why giving med;
check MAR against ordered meds 3x;
check for allergies; check labs;
know when med was last given;
ask self if this is correct time and route;
check math calculations and high alert meds with another RN;
complete needed assessments;
open meds before about to admin;
2 pt identifiers

Question 2

Determining route selection

Answer 2

1. desired rate of absorption
2. absorptive qualities of med
3. how drug is supplied
   - determined by prescriber order

Question 3

Advantages of Oral Route

Answer 3

convenient, noninvasive, can admin multiple drugs, is usually pt preference

Question 4

Disadvantages of Oral Route

Answer 4

takes longer, risk for aspiration, may require meals, less potent, pocketing of meds

Question 5

suspension

Answer 5

liquid formulation with drug particles suspended, not dissolved

Question 6

emulsion

Answer 6

liquid formulation; oils and fats in water

Question 7

elixir

Answer 7

liquid formulation with alcohol base

Question 8

syrup

Answer 8

sweet liquid formulation

Question 9

Advantages of NG/Enteric Tube Route

Answer 9

used when pt unconscious, can’t swallow, avoids use of injections

Question 10

Disadvantages of NG/Enteric Tube Route

Answer 10

discomfort of tube, risk of aspiration, tube can get occluded

Question 11

Topical Route; what increases absorption?

Answer 11

larger surface area, thicker skin and pt hydration = inc absorption

Question 12

Topical Drug Forms

Answer 12

cream, ointments, paste, lotions, liniments, powder, dermal patches

Question 13

Advantages of Dermal Patches

Answer 13

systemic effect; constant even release of med over long period of time; consistent blood levels; easy application

Question 14

Disadvantages of Dermal Patches

Answer 14

skin sensitivity; difficulty with adherence to adhesives

Question 15

Advantages of Parenteral Route

Answer 15

more rapid absorption and effect compared to other routes; bypasses GI-tract and 1st pass (liver)

Question 16

Disadvantages of Parenteral Route

Answer 16

risk of local tissue, nerve and bone damage;

risk for admin drug into vascular system

Question 17

Parenteral drug forms

Answer 17

solutions;

powders (must be reconstituted with suitable sterile solvents)

Question 18

parts of a syringe

Answer 18

plunger, barrel, tip

Question 19

parts to a needle

Answer 19

bevel, shaft, hub;

know gauge #

Question 20

reducing risk of infection

Answer 20

prevent contamination of solution;
prevent syringe/needle contamination;
site selection;
skin prep–> wash with soap and water. clean 2 inch diameter for 15 secs with alcohol swab

Question 21

Mixing parenteral meds

Answer 21

determine compatibility of meds;
do not contaminate one med with another;
be sure final dose is accurate;
maintain aseptic technique

Question 22

Minimizing discomfort

Answer 22

sharp needle (consider length);
select appropriate site;
apply vapocoolant or topical anesthetic;
position to relax muscles;
hold syringe steady;
inject med slowly (1mL/10 sec);
wait 10 sec and withdraw quickly and smoothly

Question 23

Angles of injection (IM, Subq, ID)

Answer 23

90, 45 or 90, 10-15 degrees

Question 24

Subcutaneous injection sites

Answer 24

upper arm, lateral aspect;
anterior thigh;
abdomen;
scapular region;
upper ventrogluteal regions

Question 25

IM injection sites

Answer 25

ventrogluteal; vastus lateralis; deltoid

Question 26

ID injection sites

Answer 26

forearm; | scapular region

Question 27

subcutaneous needle size and gauge #

Answer 27

1/2-5/8; | 25-27 gauge

Question 28

intradermal needle size and gauge #

Answer 28

3/8-1/2; | 25-27 gauge

Question 29

IM needle size and gauge #

Answer 29

1-11/2; | 19-23 gauge

Question 30

Insulin injection sites

Answer 30

subcutaneous locations; | abdomen preferred

Question 31

insulin needle size and gauge #

Answer 31

5/16-1/2; | 28-31 gauge

Question 32

subcutaneous syringe size

Answer 32

1-3mL

Question 33

insulin syringe size

Answer 33

U-100 syringe (.3mL, .5mL, 1mL)

Question 34

intradermal syringe size

Answer 34

1mL tuberculin

Question 35

IM syringe size

Answer 35

2-5mL; (up to 3mL most common)

Question 36

insulin types

Answer 36

short-acting insulin=clear; | intermediate and long= cloudy

Question 37

Mixing insulin types; clear and cloudy

Answer 37

put air in cloudy put air in clear draw up med from clear draw up med from cloudy

Question 38

what insulins do you not mix?

Answer 38

don't mix glargine (Lantus) or determir (Levemir) with any other insulin