INjectable med admin Flashcards
filter needles use
filter certain meds when drawing up like ampules; NEVER for administrations of meds
safe way of recapping needle
scoop up cap with needle and press against the wall or something flat
ID needle angle
5-15 degrees
SubQ needle angle
45-90 degrees
SubQ insulin needle angle
45-90 degrees
IM needle angle
90 degrees
ID needle diameter
25-27G
SubQ needle diameter
25-27G
SubQ insulin needle diameter
28-31G
IM needle diameter
18-25G
should contaminated needles be recapped
NO
how to withdraw soln from vial
- draw air into syringe - same air amount as soln needed
- cleanse rubber stopper & insert air
- invert vial and draw up soln
- flicker syringe as needed to get rid of air
withdraw meds from 2 vials - mixing
inject air into both vials
withdraw meds from vial B
withdraw meds from A with B in syringe
landmarks for deltoid muscle
acromion process and axillary line
2-3 fingers (1-2 inches) below
landmarks for vastus lateralis
head of the greater trochanter - one hand below
knee - one hand above
when to use deltoid muscle
2mL of meds
NOT for infants and toddlers younger than 3 yrs
when to use vastus lateralis
3mL of meds
YES for infants
when to do 45 or 90 degrees for SubQ injections
45 if can pinch 1 inch (2.5cm) of skin
90 if can pinch 2 inch (5cm) of skin
landmark for ventrogluteal
heel of hand on greater trochanter and index finger on anterior superior iliac crest
mechanical causes of phlebitis
inserting at areas of flexion;
excessively large IV catheter;
not stabilizing it enough
other causes of phlebitis besides mechanical
irritating solns;
break in asepsis and bacterial invasion
how often to assess IV sites
q4hrs for AxO4 adults;
1-2hrs for all other pts
what to do if phlebitis is found
stop infusion and remove;
new one inserted different area; document
S/O of infiltration
pallor, swelling, pain
S/O of extravasation
blistering, tissue necrosis, ulceration
infiltration vs. extravasation
IV slips out of vein or fluid leaks into tissues from another puncture site close to site; extravasation is with vesicants (vancomycin, dopamine, digoxin)
what to do with infiltration
stop IV, elevate, apply warm moist or cold compresses
what is speed shock
systemic rxn when IV meds is administered too quick -> causing blood lvls of meds to rise to toxic lvls
S/O of speed shock
chest pain, lightheadedness, palpitations, tachycardia; shock and cardiac arrest if untreated
how to treat speed shock
stop meds, change IV fluid to isotonic soln, notify PCP, treat effects and monitor vital signs, documents
how to prevent speed shock
use electronic infusion pump;
administer IV bolus over at least 1 min;
dilute prn;
what to do in case of severe allergic rxn
have another nurse call RRT, stop meds and start O2 at 90-100% via nonrebreather mask, replace IV tubing and infuse 0.9% NaCl. Elevate bed to help with SOB. may need to give epinehrine/diphenhydramine; DONT REMOVE IV in case to administer emergency meds
what’s IV catheter embolism
part of IV breaks off in a vein due to damage or too much force; can travel to other places in body
what to do in case of IV catheter embolism
remove and inspect damage to the tip, apply tourniquet above IV site and see if can palpate; notify PCP and get x-ray
preventing IV embolism
inspect for damage before inserting; never reinsert after removal; inspect after removal
what can lactated ringer’s treat
acidosis;
liver metabolizes lactate into bicarbonate
what fluid to use and NOT use with blood transfusions and why
use NS
DON’T use LR (leads to clots), Dextrose (leads to hemolysis)
what to always do with IV tubing
labeled with date, time, and initial
what does the Y-port do in PB infusions
back-check valve that prevents primary infusion flow while PB infusion and opens again once is done
placement of PB infusion
it should be hanged higher than the primary infusion
where to administer IV bolus
existing IV line or saline/IV lock
what to do before and after IV bolus administeration
flush of 0.9% NaCl
what’s tandem administration of IV
primary and secondary IV bags are infusing at the same time; they are hang at the same level
where are tandem secondary IV bags plugged into
lower port on the primary IV tubing
between 20 & 60 gtt/mL which is the micro-drop calibration
60
which side of the needle should be inserted
bevel up in and out same angle of insertion
needle length general rule for subQ
use needle length 1/2 width of injection site skin fold;
1 inch or less -> 45degrees
otherwise 90 degrees
larger muscles can receive how much meds in diff age groups
1mL in kiddos
2mL for older kiddos and adults
3mL in muscle people
where are nontunneled central venous catheters inserted
subclavian vein or internal jugular vein
what does insulin promote
entry of glucose, K, amino acids into cells
convert glucose into glycogen in the liver
list the 3 types of rapid-acting insulin
insulin lispro, insulin aspart, insulin glulisine
why is intermediate-acting insulin cloudy
has protein that delays the onset and duration
what is intermediate acting insulin called
insulin NPH
