Injections Flashcards
Medication vials can be ________ or ________ dose
Single or multi
Medication vials can be _________ or ________
Plastic or glass (clear or dark)
Medication vials can be ________ or ___________ med
Liquid or powder
Always what when dealing with medication vials?
Check expiration and date and initial (if multi dose)
When choosing parenteral needles, ensure it is long enough to reach __________ respective to _____________
Targeted tissue
Age, weight, and muscle/tissue mass
Parental needles come
In various lengths and gauges
The gauge is also referred to as the
Diameter
Parental needles have an _______________ when it comes to sizing
Inverse relationship (18g is larger than 29g)
When choosing parenteral needles, ensure the needle is long enough to reach ___________ __________
Targeted tissue
Factors affecting needle length
Age
Weight
Muscle/tissue mass
Dermis (ID) needle length
1/2” to 5/8”
Subcut (SQ) anticoagulants needle length
3/8” to 5/8”
Subcut (SQ) insulin needle length
1/2” to 5/16”
Muscle (IM) needle length
1” to 1 1/2”
(Most common in adults)
Gauge of needle should be large enough to deliver
Viscosity of medication
Smaller gauge needles use _______ solutions
Thinner
(27-20g)
Less painful for the patient
Larger gauge needles use __________ solutions
Thicker
(21-18 g)
Filter needle
Small filter in hub catches debris
(Always use with ampules)
Blunt fill needle
Use with vials (rubber stopper)
If filter or blunt fill needle not available, use what?
Smallest gauge needle possible
Why should you never use a filter needle or blunt fill needle to inject into patients?
Extremely painful
If you recap blunt or filter needles, ALWAYS use what technique?
One handed recap technique
After you recap, then what?
Apply new sterile needle before placing syringe in med tray
No blunt/filter needles are allowed in a pts room when used for med admin, but only for
Blood specimens
Syringes are all calibrated in
mL
1st calibrated line near hub in syringe is
Zero
Read syringe volume from
Zero to leading ring (In front of rubber stopper)
How do you decide which syringe to use?
Always use the smallest syringe needed to correctly deliver the rx’d volume of medication ordered
Label syringes with a
Blue label
How long do you clean vial top/inj port
15 seconds
“Charging”
Injecting equal air and medication equalizing pressure
Multi-dose vials do not always need to ________
Charge (oftentimes overcharged)
For single dose vials, you have to withdraw ___________
The entire amount
When combining two medications in one syringe, prepare from the _______ first then __________
Vial, ampule
When combining two medications in one syringe, meds must be _____________
Compatible
Troubleshooting air & bubbles
Make sure needle is below fluid level
Withdraw med slowly
For single dose vials, withdraw __________ volume from vial and expect _____ __ ______
Entire, air to follow
For multi-dose vials, withdraw _________________, leave needle in vial, then _______ med back into the vial via plunger to ensure exact dose
More med than you need, then push med back
Ampules
Single dose medication
Made of glass (clear/dark)
Scored neck (colored)
Need syringe and filter needle
When withdrawing from an ampule,
Maintain asepsis
Hold the ampule ________ and ___________ to dislodge medication from neck
Upright, tap the top
Place barrier around neck and break _____ from you (ampule)
Away
Meds come in concentrated forms:
Powder, crystals, or liquid
reconstitution
The process of adding a liquid diluent to a dry or liquid concentrated ingredient solute to make a specific concentration of liquid injectable medication
Drugs in _________ form retain potency for a ______ period of time once reconstituted
Powder, short
Reconstituted volumes do not always equal the amount of diluent because
The medication itself has volume
The medication label or package inert dictates which diluent to use, typically —
NS or sterile water
Use sterile technique withdrawing diluent to add to medication using
Blunt fill needle
Pay attention to what warnings during medication reconstitution
Do not shake
IM injection sites
Deltoid, ventrogluteal, or vastus lateral is
When doing injections, avoid—
Scars, irritations, bruises, lesions in muscle, etc.
Visualize and palpate for _______ of well-developed, ________ muscle
“Belly”, relaxed
Inject at a rate of
1 mL/10 sec !!!!!
Wait ________ before removing needle after injecting
3-5 seconds
Assess ALL parts of the injection equipment before administering, what does this mean
Check integrity of needle and ensure volume is correct
Why should you not rub or massage post injection?
It can displace medication
What is the angle for IM injections?
90º
Deltoid recommended max volume, needle length, and syringe?
Max volume- 1mL
Needle length- 1”
Syringe- 3mL
Ventrogluteal 1st, vastus lateral is 2nd for
Thicker, painful, or irritating meds (Deep IM)
Ventrogluteal 1st, Vastus Lateralis 2nd recommendations
Max volume - 3mL
Needle length - 1” to 1 1/2”
Syringe - 3 mL
What is the recommended method when injecting ventrogluteal or vastus lateral is
Z-track method
For the deep IM (Z-Track) technique, how should you position the patient?
Sims position
If blood returns with aspiration,
DO NOT INJECT! Start over!
Avoid the __________________ muscle!
Dorsogluteal
When injecting insulin, there are
Several location options to inject
Subcutaneous injection types
Insulin
Anticoagulant
Hormones
Insulin has its own unique needle that is
Very fragile and permanently attached to the insulin syringe
Multi-dose vials of insulin
Short, intermediate, long acting
Where is the primary/main location to inject anticoagulants?
Abdomen
Needle used for anticoagulant
3/8-5/8” needle and appropriate syringe
SQ injection rule of thumb
Inject at a 90º angle if you can “bunch” the skin more than 2”. Otherwise, inject at a 45º angle
-SQ tissue can accommodate up to 1.5mL
Insulin is administered in
Units — NEVER mL!
What must you know/verify before administering insulin?
Blood glucose level or trends
Administer all insulins within _______ of preparation, because it will start to lose its efficacy
Minutes
Never ________ insulin
Shake
How do you mix insulin evenly?
Rotate/agitate gently in hands to mix
Where is insulin administered?
In the adipose (SQ) “fatty” areas of arms, abdomen, back or thighs
Where is insulins absorption rate faster?
Abdomen
Alternate/separate injection sites by at least
1 inch
Do not __________, _____ or __________ any SQ injections
Aspirate, rub or massage
Insulin syringe size must match the
Vial
What position is always best for Enoxaparin injection?
Reclining/supine position
For enoxaparin injections, where do you administer it?
Abdomen
Administer enoxaparin _______ ____ , NEVER ______
Deep SQ, IM
Never __________, ________, or ______ an enoxaparin injection
Aspirate, massage, rub
During the enoxaparin injection process, bunch during ________ injection
Entire
Do not aspirate or expel _________ _________
Nitrogen bubble
Intradermal injections are commonly used for
Allergy testing and TB testing
Where is intradermal injections site?
Forearm
When doing intradermal injections, ensure a “_______ or ________”
Bleb or wheal
Injectable rates of absorption (fastest to slowest)
IV (IVP)
IM
SQ
ID
