Lab 1

Question 1

• Technically refers to any route other than via
  gastrointestinal system
• Commonly refers to meds given by injection with needle
  and syringe (IM, SUBCUT, ID, IV)
• Generally act quickly because more rapidly absorbed than
  oral meds
• Sterile solutions, generally nonirritating
• Preferred route if client is vomiting, unconscious, or has a
  nonfunctioning GI tract

Answer 1

parenteral medications

Question 2

• Sealed glass container designed to hold single
  dose
• Designed to snap open
• Use protective sleeve, alcohol wipe package,
  or sterile gauze to hold while snapping open
• Insert filter needle into open ampule and
  withdraw medication by pulling back on
  syringe plunger
• Withdraw meds with filter needle to prevent
  aspiration of tiny glass or rubber particulate
• Remove and discard filter needle and attach
  appropriate needle for med administration

Answer 2

ampules

Question 3

• Plastic or glass with rubber stopper or
  diaphragm
• Sterility of rubber stopper not guaranteed—
  wipe first with alcohol
• Single dose or multi-dose
• Always measure regardless
• May require reconstitution
• Injection of air equal to amount to be withdrawn
  facilitates removal of solution—DO NOT
  OVERFILL
• Draw up only amount of solution needed for
  dose

Answer 3

vial

Question 4

Has two compartments—powder separated by
stopper from solution; mix before administration

Answer 4

mix-o-vial

Question 5

• Prefilled glass or plastic, fits into an applicator
• White tip can be removed to reveal rubber stopper

Answer 5

cartridge

Question 6

Premeasured dosage in a syringe with or without
needle attached

Answer 6

prefilled syringe

Question 7

what are the components of syringes?

Answer 7

barrel
plunger
tip

Question 8

outer calibrated portion to hold medicine

Answer 8

barrel

Question 9

fits into the barrel to withdraw and inject medicine

Answer 9

plunger

Question 10

end of syringe upon which needle or blunt tip device is placed or into which it is prebuilt; may be slip tip or luer-lok

Answer 10

tip

Question 11

• Sizes 0.5 mL to 60 mL
• Calibrated in hundredths, tenths, and whole mL
• Term “cc” or cubic centimeter not best choice to write
• Minims—RARE, and use is discouraged
• Express dose in metrics—use decimals for partial dose
• Do NOT read dose at pointed tip of rubber on plunger; read
  where rubber touching solution also touches inside barrel

Answer 11

hypodermic syringe

Question 12

• Narrow—capacity of 1 mL
• Calibrated 0.1 to 0.01 (tenths to hundredths)
• Provide accurate measurement
• Heparin, skin testing, and pediatric dosing

Answer 12

tuberculin syringe

Question 13

• Measured in units
• Syringe calibrated to match insulin doses
• U-100 syringes for U-100 insulin
• NEVER think in terms of mL when giving insulin; think in
  units

Answer 13

insulin syringe

Question 14

what are the 2 types of insulin syringes?

Answer 14

Lo-dose U
standard U

Question 15

what are the meds measured in units?

Answer 15

heparin, pitocin, insulin, and penicillin

Question 16

what are the meds in millimoles?

Answer 16

potassium and sodium bicarbonate

Question 17

• Some medications are stable for only short periods in
  the liquid state.
• Once mixed, a medication is good for only 1 to 14
  days.
• Nurses may have to mix medications just before
  administration or in the home setting

Answer 17

reconstitution

Question 18

powdered or concentrated liquid medication

Answer 18

solute

Question 19

liquid added to the ____, type depends on the med

Answer 19

solvent or diluent

Question 20

liquid mixture that results when the solvent dissolves in the solute

Answer 20

solution

Question 21

what are the basic principles for reconstitution?

Answer 21

1. Manufacturer provides directions
   * Including solvent amount in mL, diluent, storage
   instructions, concentration after admixture
2. Diluents—Check expiration dates before use!
   * Most common—sterile water or normal saline
   * Others: D5W, special solution (provided)
3. Must identify the following information:
   * Type of diluent, amount of diluent
   * Expiration period after admixture
4. If components in item #3 are unavailable, consult the
   CPS or other reliable source
5. After reconstitution using a multi-dose vial, LABEL it
   with:
   * Date and time, dosage strength, expiration date, and
   time
   * Storage instructions (e.g., “refrigerate” )
   * Nurse’s initials
   * Apply label so that med information is visible
   * Discard if labeled inappropriately
6. The concentration of new mixture MUST be on the label
   (e.g., 500 mg per mL)
7. Powder often adds significant substance to the total
   volume of the solution (e.g., volume of diluent is 2.5 mL
   and total volume of solution is 3 mL). The label should
   indicate the total volume and concentration after the
   reconstitution has occurred

Question 22

what are the guidelines for choosing appropriate concentrations>

Answer 22

1. Route of administration
2. Choose concentration that is closest to the order from
   prescriber
3. “Respectively” means “in the order given”

Question 23

• Standard type for general infusions
• Delivers 10, 15, or 20 gtt/mL
• Used to deliver large volumes

Answer 23

macrodrip

Question 24

• Delivers tiny drops—60 gtt/mL
• Used to deliver small amounts with exactness
• Because drop factor is 60 gtt/mL, drops per minute equals
  mL per hour (e.g., 25 mL per hour = 25 gtt/min)

Answer 24

microdrip

Question 25

what are the key points of documentation?

Answer 25

• On MAR after administration
• In Meditech or CRMS (written notes for PRN medications or
  assessment required/ completed)
• Medication labels
• Label vials once reconstituted (Discard by date included)
• Initial, sign, date all labels and records.
• Discarded Narcotics need to be witnessed and documented
  with 2 Nurses