Exam 2 - Med Admin Flashcards
safety needles should be used at all times with patient care. t/f
TRUE!
shaft =
length of needle
gauge =
diameter of hole (larger number = smaller diameter)
volume of tuberculin syringe
1mL
describe steps of ampoule use
break away from body (use alcohol swab or gauze), use filter needle or smallest gauge possible, change needles
describe steps of mixed dose insulin
roll cloudy, insert air in cloudy then clear, withdrawal from clear then cloudy.
intradermal administration used for what?
TB tests + allergy testing
locations for intradermal
inner forearm, upper back + upper chest
gauge size of intradermal needle
26-28g
length of intradermal needle
1/4 - 5/8 inch
angle for intradermal
5-15°
difference in needle positioning for intradermal
bevel up - to create wheal
do you massage intradermal?
no - allow for proper test/reading
gauge size for subcutaneous needle
25-27g
length of subcutaneous needle
1/4 - 5/8 inch
angle for subcutaneous administration
45-90°
areas for subcutaneous admin
macarena dance (including upper thighs)
aspirate with SCUT injections?
NO!!
do you massage subcutaneous?
no
method for efficiency and decreased pain with injections
pierce and remove QUICKLY, and inject medication SLOWLY
volume for IM injection
up to 4 or 5 mL - depends on muscle size
angle for IM injection
90°
gauge for IM injection
21 -25g
length of IM needle
depends on muscle but usually 1 - 3 inch
size of IM needle (gauge and length) for child and small adult
24g 5/8 inch
explain how to find deltoid location for IM
3 fingers - top one on acromion process, make line from axilla - center of this triangle is location
explain how to find vastus lateralis location for IM
put hand above need, put other hand in fold of leg, cut legs into 3rds and choose middle 3rd on lateral side
explain how to find ventrogluteal site for IM injection
put heel of hand on greater trocanter. point thumb to pee pee. touch pointer finger on hip bone. aim middle finger up. injection site is between those fingers
what is most dangerous site and shouldn’t be used without direct orders?
dorsal gluteal
should IM sites be massaged?
no
explain z track method
change needle after withdrawing medication. push skin away from injection site you’re using with pinky side of hand and hold. administer medication and hold 10 seconds. then remove needle and release hand. don’t massage
7 components you need on medication order
patient name/DOB physician signature time/date medication dosage frequency route
what are protocols?
standing orders than can be used under certain circumstances / situations
define routine medication
medication is taken until finished with prescribed dose or until order says stop
define STAT medication
immediately!
define now medication
within 15 minutes
what do you need to know about a med before you give it?
what is it? mechanism of action? why are they getting it? is it appropriate? what’s the normal dose? adverse effects? appropriate teaching? contraindications? drug-drug or drug-food interactions?
in terms of planning and preparation, what should you assess before giving a med?
the applicable vital sign or lab value (BP med - check BP and HR, insulin - check BG)
when should the 3 checks happen?
before preparing when taking meds out
after meds have been prepped
at client’s bedside
(all against MAR)
what are the 5 rights?
right patient right medication right dose right route right time
what is the standard time for giving meds?
30 minutes before or after. some places are okay with 1 hour.
what should you tell patients at bedside about the med? (4 things)
name of med
dosage
what it’s for
any teaching points
how to set up for success (with patient) for med admin?
high fowlers, make sure they have water, don’t open any meds until you talk to patient
what should be documented with med admin and when?
time taken
client response
….immediately AFTER.
notes for topical meds
- remove old doses (old patches) before applying new ones
- use in tact, non-hairy skin
- wear gloves
notes for nasal meds
lean forward and use a steady inhale
notes for MDI administration (client teaching)
exhale… inhale slowly as you push on inhaler… hold breath 10 seconds if possible… exhale slowly.
with enteral tube feedings, when should you stop feedings to administer meds?
15-30 mins before
steps for enteral tube feedings
check placement. flush with water to ensure patency, administer med, flush with water, administer med, repeat as necessary. final steps should be to flush with larger amount of water.
if person is on suction and needs meds administered what should you do?
turn suction off, administer med and wait 30 minutes to turn suction back on!
