Med Admin

Question 1

The 4 parental Meds

Answer 1

Intradermal
SubQ
Intramuscular
Intravenous

Question 2

What are parental meds & what technique should you use?

Answer 2

Injections which introduce meds under the skin layers

Always use aseptic technique

Question 3

Types of syringes

Answer 3

Standard
Tuberculin
Insulin

Question 4

Standard syringes key points

Answer 4

0.5 to 60 mL syringes
For subQ/IM injections use 1-3 mL syringes

Always choose smallest syringe that holds the needed medication amount

Question 5

Tuberculin syringes

Answer 5

1 mL calibrated in tenths

Question 6

Insulin syringes

Answer 6

Hold 0.3 mL to 1 mL

Calibrated in units

Question 7

What influences needle choice?

Answer 7

Depth needed - depends on injection

Viscosity of medication - thickness of medication

Patient size - bigger patient with more fat needs bigger needle than a thin or old person with little fat tissue.
Also plays a part in comfort - smaller needle is less painful

Question 8

Needle gauges

Answer 8

The inside of the needle

The larger the gauge the smaller the needle

The smaller the gauge the larger the needle

Question 9

Bevel

Answer 9

The slant on one side of the needle

Pierces skin easier

Question 10

Vials key points

Answer 10

Closes medication system

Single or multi dose

Air must be injected into vial first before withdrawing medication

Question 11

Ampules

Answer 11

Closed glass medicine

Used more in OR setting

Use filtered needle then switch needle for administration.

Question 12

injection key points

Answer 12

Assess sites of injection

Rotate sites to prevent scarring

Always clean with alcohol wipe inner from outer

Question 13

Angles of insertion for IM, SQ, & intradermal

Answer 13

IM is 90 degree with dart like motion

SQ is 45 or 90 degree
45 degree is used on thin or older pt.
90 degree is used for patients with lots of fat tissue

Intradermal can be injected at 5-15 degree angles

Question 14

Sites of intradermal injections

Answer 14

Inner forearm(most common)
Upper back
Scapula

Longest absorption of all parental medications

Question 15

Equipment for TB

Answer 15

Length: 1/4 to 1/2”

Gauge: 25 or 27

Question 16

SubQ injections key points

Answer 16

Needle length: 3/8 to 5/8”
Gauge: 25-27

Do not massage! Can cause damage to tissue and have unwanted increase absorption rate

Rotate injection sites

2mL max dose

Question 17

SubQ sites

Answer 17

Absorb at different rates

Abdomen - fastest
Outer upper arm
Anterior things
Upper ventral

Question 18

Medications given subcutaneously

Answer 18

Insulin

Anticoagulants
Heparin
Lovenox

Question 19

Insulin

Answer 19

Are classified by onsets, peak, duration

Attempt to mimic body release of insulin

Ssliding scale coverage

Accurate dosage is IMPORTANT
have 2nd nurse confirm correct dosage in needle

Mixing insulin’s
Clear to cloudy (regular then NPH)

never mix lantua insulin

Question 20

What are two anticoagulants and what are they used for

Answer 20

Heparin and lovenox

Used to treat DVT or to keep clots from forming

Question 21

Administering anticoagulants

Answer 21

Double check drug for accurate dose!

Give in abdomen 2” from umbilicus

Don’t pinch skin
Do not run after administration
Do no breathe in

Question 22

What equipment is need for IM injections

Answer 22

Needle size - depending on size of patient

Normally 1- 1 1/2”
Gauge size: 20-25

Most common: 20-22

Question 23

Sites for IM injections

Answer 23

Vastus Lateralis
Deltoid
Ventrogluteal

Question 24

Why do we use Z track method

Answer 24

Minimizes local irritation

To decrease pain

Prevent leakage of medication into SQ tissue

Forms a seal

Prevents skin stains

Question 25

How to minimize discomfort in injections

Answer 25

Use smallest possible sharp beveled needle Position to reduce muscular tension Proper injection site Divert attention through conversation Insert using dart like motion( quick and smoothly) Hold needle steady Inject slowly & steadily

Question 26

How do you keep yourself safe?

Answer 26

Wear gloves Use safe needles Place in sharps immediately Never force needles into full sharps container Use one handed technique to recap

Question 27

Common high risk medications

Answer 27

Anticoagulants Opioids Insulin Anti-diabetic agents

Question 28

Most affected from adverse drug events

Answer 28

Older adults ``` Ppl with: Language barriers Low health literacy Limited access to health care Low socioeconomic status ```

Question 29

Common causes of errors

Answer 29

``` Lack of knowledge regarding drugs or patient Faulty communication Interruptions during drug preparation Calculation errors Identification not checked Bad time management Fatigue or not paying attention Personal problems ```

Question 30

Error prevention techniques

Answer 30

``` Using computers for typing not writing Smart pumps for IVs Barcoding Using automated dispensing units(pixus) Not using abbreviations Medication reconciliation ```

Question 31

Computer prescriber order entry system | CPOE

Answer 31

System where provider enters order into computer using a standard format Guides provider in complete, accurate ordering Order transmits directly to pharmacy Eliminates guessing with illegible or similar drug names

Question 32

Intradermal injections key points

Answer 32

Longest absorption of all parental meds Ex. TB Use a 1/4 to 1/2” needle Common gauge 25-27 Inject no more than 0.5 mL Use a 5-15 degree angle