Injectable Med Module Flashcards

Question

**prescribed:** diazepam 3 mg IV bolus every 3 hr PRN anxiety **available:** diazepam injection 5 mg/mL How many mL? (tenth)

Answer 1

usually less than 0.1 mL

Answer 2

* mostly hairless * free of lesions, wounds, tattoos * usually forearm or upper back

Answer 3

* tuberculin testing * allergy testing

Answer 4

* small, usually tuberculin syringe * 25- to 27-gauge * 1/4-5/8 in

Answer 5

raised area created by ID injection

Answer 6

5° to 15°

Answer 7

* cleanse site * pull skin taut * insert at 5° to 15° angle with **bevel up** * advance about 3 mm (1/8 in) * inject slowly, creating small bleb * withdraw needle at same angle

Answer 8

* heparin * insulin * others that need to absorb slowly

Answer 9

* outer posterior aspects of upper arm * abdomen, 2 in from umbilicus **(always for heparin and enoxaparin)** * upper back * upper hip below waist * anterior and interior aspects of thighs * no skin lesions * avoid bony prominences

Answer 10

0.5 to 1 mL

Answer 11

* depends on site, pt body weight, amt of SC tissue * 25 to 30 gauge * 5/8 to 1/2 in, or half the width of the injection site skin fold * shorter needle, 45°, if skin fold is ≤ 1 in * longer needle, 90°, if skin fold is \> 1 in

Answer 12

* nerve injury * abscesses * fibrosis * thrombosis

Answer 13

* larger muscles (vastus lateralis, ventral gluteal) can take larger volume * 1 mL for older infants and young children * 2 mL for older children, older adults, thin pts * 3 mL for adult with well-developed muscle * deltoid: no more than 1 mL

Answer 14

* depends on * size of pt * muscle used * viscosity of med - thicker needs bigger gauge

Answer 15

* ventrogluteal * vastus lateralis * deltoid * look for site with * no lesions * no tenderness * no nodules

Answer 16

* preferred for children and adults - not close to major blood vessels * put palm on greater trochanter with thumb toward groin, index finger on anterior superior iliac spine, and middle finger just under iliac crest (see image) * inject in middle of triangle formed by index and middle fingers

Answer 17

* generally well-developed in children and adults * preferred site for infants * muscle extends from midline of anterior thigh to midline of later aspect of thigh * choose area in middle third of thigh between greater trochanter and just above knee (see image)

Answer 18

* relatively small, not well-developed in adults * mostly used for immunizations in adults and children older than 18 mo * near many nerves and arteries * center of upper arm 3-5 cm (1-2 in) below acromion process (see image)

Answer 19

* meds * fluids * electrolytes * nutrition * blood * blood products

Answer 20

* \< 3 inches * rests in superficial vein in extremity

Answer 21

* terminates in superior vena cava * aka central venous catheter (CVC) * types * PICC - peripherally inserted central catheter * tunneled central venous catheter * nontunneled central venous catheter * implanted ports

Answer 22

* special training required * inserted into vein in upper arm and threaded to superior vena cava * used for * long-term IV med admin * vesicant meds * parenteral nutrition

Answer 23

* placed by MD or APRN * inserted in subclavian or internal jugular vein and threaded to superior vena cava * used in trauma and critical care

Answer 24

* calibrated by mL * depending on size, can show tenths or hundredths of mL * Luer-lock (threaded) or slip tip

Answer 25

* pick one with calibration closest to volume of med to be given * 3-5 mL: often used for IM, SQ, IV * tuberculin (0.3-1 mL): marked in hundredths of mL * insulin: marked in units

Answer 26

* long mark = tenths * short mark = hundredths * used for very small volumes of medication

Answer 27

* calibrated in tenths * long mark = 1 mL * used for SQ, IM, and IV med admin \< 3 mL

Answer 28

* 5 mL: admin meds with dose \> 3 mL * 10 mL: used to add diluent when reconstituting meds

Answer 29

* implications: exposure to bloodborne pathogens (hep B and C, HIV) * prevention * use needleless devices when possible * use safety syringe when necessary (passive or active) * dispose of needles in sharps container immediately after use * if sharps container is full, get a new one * do not force syringe into container * never leave needles or syringes at bedside * never put in pocket or trash can * never recap, bend, or break used needle

Answer 30

tuberculin or 1 mL

Answer 31

* dosages vary by manufacturer; double-check units * route of admin * expiration date * storage conditions (refrigeration, room temp, etc. after opening) * single- or multidose vial * concentration * warning label * date opened (for multidose vials)

Answer 32

* for pts who have absolute or relative insulin deficiency * promotes entry of glucose, potassium, amino acids into cells * needed for conversion of glucose into glycogen

Answer 33

* SQ (all types) * IV (four types) * regular insulin * insulin aspart * insulin lispro * insulin glulisine

Answer 34

* source can affect onset, peak, duration * produced using recombinant tech * identical to insulin produced in human body * modified to alter rate of absorption and duration of action

Answer 35

* rapid-acting * short-acting (regular) * intermediate-acting * Lente * NPH * long-acting * premixed * 75/25 * 70/30 * 50/50 * glargine

Answer 36

* onset: 10-15 min (most rapid) * duration: shortest * appearance: clear * admin: * immediately before meal to prevent hypoglycemia * SQ or IV * three types * insulin lispro * insulin aspart * insulin glulisine

Answer 37

* onset: 30 min * duration: short-acting * appearance: clear * admin * SQ or IV * IV reserved for DKA

Answer 38

* onset: 1-2 hr * NPH * appearance: cloudy * suspension with protein to delay onset and duration * only insulin type that's a suspension and requires agitation before drawing * often mixed with regular insulin * admin: SQ * Lente

Answer 39

* duration: 18-24 hr * glargine * U-100 (18-24 hr) or U-300 (\> 24 hr) * ultra long-acting * prefilled pen * degludec * ultra long-acting (\> 24 hr) * detimir * admin * in morning, afternoon, or evening * give at same time every day

Answer 40

* uses: pts who have trouble mixing (eyesight, dexterity) * contain one intermediate-acting and one rapid- or short-acting * examples * 70% NPH and 30% regular * 70% insulin aspart protamine and 30% insulin aspart

Answer 41

* comes in two concentrations * U-100: 100 units/1 mL * U-500: 500 units/1 mL * for pts with severe insulin resistance requiring very high doses * not often prescribed * only by SQ injection

Answer 42

* start education as soon as they know about diagnosis * educate in any setting * use interprofessional approach * include info about * purchage anc storage of insulin * syringes * monitoring supples * prep and admin of insulin * identifying and treating complications * onset, peak, duration of prescribed insulin

Answer 43

* disposable need * insulin-filled cartridge * dial to measure dose * jet injectors: needleless SQ admin; expensive; can cause bruising

Answer 44

* delivers rapid-acting SQ over 24 hr * set to infuse insulin at set basal rate to mimic pancreatic secretion * pt can adjust dose or get bolus * small, can be worn in pock or on belt * contains syringe with insulin connected to SQ needle

Answer 45

* pick syringe that matches concentration of insulin preparation * U-100 has orange cap (most common) * U-500 has green cap * SQ injection

Answer 46

* determine if types can be mixed * mix whenever possible to limit number of injections * mix as you would other meds (see image)