injections Flashcards
Parenteral route used when
patient is vomiting
cant swallow
restricted from oral fluids
Size of syringe, length & gauge of needle based on
type of medication
volume of solution to inject
route of injection
patients body size
what improves accuracy when choosing a syringe
choosing the smallest possible size
ID syringe size, needle length and gauge
25g - 27g; 3/8” - 5-8”; 1 mL
SC syringe size, needle length and gauge
25g- 27g; 3/8” - 5/8”; 1/2” - 5/8”;less than 2mL
IM syringe size, needle length and gauge
20g- 25g; 1”- 1.5”; 1-3 mL; no more than 5mL(bigger muscles)
SESIP
sharp w engineered sharps injury protection (prevents needlesticks)
Ampule
Single dose, 1-10 mL, MUST use filter need, use different needle to administer
Vial
Single ~or~ multidose, plastic or glass, rubber seal at the top, contain liquid or dry, may use filter needle, closed system (insert air)
Regular Insulin
clear; adminster IM or IV
Modified Insulin (NPH)
cloudy, subcutaneous
Order to mix insulin for single shot
put air in modified, air in regular, fill syringe w regular, then w modified (cloudy, clear, clear, cloudy)
Why would u change needles before injection after u got it from a vial??
provide a sharper needle
prevent medicine from tracking from shaft thru tissues
SC injection go into whaT
loose connective tissue under dermis that has poor supply of blood vessels, slower absorption than IM
WHat can allow for faster SC absorption?
exercise, hot or cold compress to increase blood flow
SC injection sites
upper arm, abdomen, thighs
Site rotation prevents what
formation of lipohypertrophy/ lipoatrophy on skin
Bodyweight/fat =
depth of sc tissue
whats the antidote for oral anticoagulant
vitamin k
whats the antidote for heparin
protamine sulfate
Administering in area of scar tissue/infection could
cause additional discomfort
aggravate skin condition
unable to tell if there was a reaction
improper absorption
Hypoglycemic symptoms
confusion
cold sweatz
blurred vision
shakey
IN case of anaphylactic shock, what would u do
administer antihistamines/epinephrine
Best site for injection for thin patient
upper abdomen
What lessons the chance for pain and bruising
a slow injection
Y would u not massage skin after an SC injection
it could lead to tissue damage/bruising
Angle of injection for patient of normal size/obese
45 - normal
90 - obese
ID injections are primarily for what
skin tests (slow absorption)
Whats the angle of insertion
5-15
Allergic reaction symptoms
difficulty breathing
itching
rash
In case of allergic reaction nurse should do what
take vital signs
observe for difficulty breathing
give epinephrine/antihistamine
Questions to ask for TB test
their ability to return w/in 72 hrs
meds they take including otc
past positive results
area to inject
on nondominant forearm; 3-4 fingers below antecubital space, 1 hands width above wrist
Positive TB results- 15mm, 10mm, 5mm
15- no risk factors
10- high risk, immigrants, drugs, younger than 4
5- HIV, organ transplants, immunosupressed
How can you tell if needle is tOo deep
theres no resistance, there SHOULD be some slight resistance
IM injection
good blood supply= faster absorption (10-30min)
Angle of insertion
90
what should you do before you inject the medicine
aspirate to make sure you dont get blood
Z track does what
prevents leakage into SC tissue which can cause irritation and injury to the SC tissue; move 2.3-3.5 cm w ulnar side of hand
what is there risk for w IM injections
Nerve injury
when do you observe for effectiveness
during onset, peak, and duration
Morphine side effects
vertigo
lightheaded
nausea/vomiting
hypotension
what reverses the depressed respiratory effects of morphine
Naloxone (Narcan)
Finding Ventralgluteal site of injection
position on side, knee bent, upper leg ahead of bottom, palpate greater trochanter, index towards anterior superior iliac spine, middle finger extends back along iliac crest
IF you cant use ventalgluteal then use what
vastus lateralis (used for babies)
When can you touch the hub
Only to attach or tighten the needle
