insulin & injections Flashcards
What are the 3 most common types of syringes?
Leur-lok syringe
TB syringe
Insulin syringe
What are the 3 parts of a needle?
Bevel
Shaft
Hub
What are the 3 parts of a syringe?
Plunger
Barrel
Tip
What are the differences in calibration with the different types of syringes?
- Leur-lok syringe marked in 0.1 tenths
- Tb syringe long thin barrel- calibrated in sixteenths of a minim and in hundredths of a milliliter- 1 ml capacity
- Insulin syringe Insulin 1ml and calibration in units- pre attached needle (cap often orange)
- Insulin syringe Insulin 0.5 ml and calibration in units- pre attached needle (cap often orange)
Why do we wipe away the first drop of blood?
It is typically contaminated with excess tissue fluid and may contain alcohol residue that can hemolyze the specimen. There have been reports of isopropyl alcohol contamination causing errors in blood glucose testing.
vials
A vial is a closed system where air must be injected into the vial to assist with easy withdrawal – a blunt needle is used to draw up from vials
Vials can be single or multidose
ampules
Ampules contain a single dose of medication and are made of glass that is broken open with a plastic shield – careful not to cut yourself
Air is not injected into ampules to withdraw medication
A filter needle is used to prevent small glass fragments from entering the syringe when drawing up from an ampule
the only medication drawn up using the needle tip used for injection
The only medication that is drawn up with a needle attached is insulin – using a filter or blunt needle prevents irritation to tissues upon injection and preserves the sharpness of the needle
Insulin Administration max dose
needle size
- 1 mL (sometimes up to 2 mL)
- The standard needle used for subcutaneous injections is 25-gauge 1.6-cm needle inserted at a 45-degree angleor a 1.3-cm needle inserted at a 90-degree angle
Where is the correct spot for a TB skin test?
palm side of the forearm
5cm to 10cm below elbow
dose of 0.1 mL of PPD
bevel up
a wheal/bleb forms just under epidermis (surface) skin
What other things might be given intradermal?
- allergy test
- influenza vaccine
sc syringe size
Common gauge for subcutaneous injections is 25 g and 1.6cm length
max amount of volume in sc site
1-2 mL
would you draw up from a vial or ampule first if you were mixing medications
When mixing medications from a vial and an ampule, the nurse should prepare medications from the vial first and then withdraw medication from the ampule using the same syringe and a filter needle.
what size syringe do we use for IM
1.0 (youth) to 1.5 (adult) inch needle
21-22 gauge
3mL
size of patient
size of muscle
Intramuscular Injections: Advantages
- faster absorption; more blood supply
- can be helpful in an emergency situation
- can inject large volumes of medication
- recommended for more viscous medications
- long-lasting duration of effect
Intramuscular Injections: Disadvantages
- Greater risk of damage to blood vessels and nerves, therefore accurate landmarking is important
- Depending on the size of the needle the absorption can be erratic
- Needle phobia
- Contraindicated in patients on anticoagulants
angle of insertion for an IM injection
90 degrees
The volume that can be injected into a normal, well-developed patient (IM)
3 mL
- Smaller muscles like the deltoid should only be injected with up too 2ml of medication
Deltoid Site &Landmarking
- Not used in infants or children with underdevelopedmuscles
- Use of the muscle involves potential for injury to thebrachial artery and to the radial and ulnar nerves
- May be used for immunizations of toddlers, olderchildren, and adults
- recommended for hep B vaccines and rabies injections
Ventrogleuteal Site & Landmarking
- Offers a deep site, situated away from majornerves and blood vessels
- Offers less chance of contamination inincontinent patients and infants
- Identified easily by prominent bonylandmarks
- Is preferred site for medications (e.g.,antibiotics) that are larger in volume, moreviscous, and irritating for adults, children,and infants
- middle finger at iliac crest
- forefinger at anterior superior iliac spine
- heel of hand on greater trochanter of femur
- injection site in between forefinger and middle finger
rate of medication dose per second
10 seconds per mL
Vastus Lateralis Site & Landmarking
- Lacks major nerves and blood vessels
- Facilitates rapid drug absorption
- Used frequently with infants (younger than12 months old) receiving immunizations
- May also be used in older children andtoddlers receiving immunizations
Benefits of the Z-track Method
- TheZ-track methodis recommended because it minimizes local skin irritation by sealing the medication in the muscle tissue
- This technique leaves a zigzag path that seals the needle track
- The medication cannot escape from the muscle tissue resulting in the full dose being administered
- Injections using the Z-track technique cause less irritation to the skin and subcutaneous tissues
