Med Admin Flashcards
The 4 parental Meds
Intradermal
SubQ
Intramuscular
Intravenous
What are parental meds & what technique should you use?
Injections which introduce meds under the skin layers
Always use aseptic technique
Types of syringes
Standard
Tuberculin
Insulin
Standard syringes key points
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
Tuberculin syringes
1 mL calibrated in tenths
Insulin syringes
Hold 0.3 mL to 1 mL
Calibrated in units
What influences needle choice?
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
Needle gauges
The inside of the needle
The larger the gauge the smaller the needle
The smaller the gauge the larger the needle
Bevel
The slant on one side of the needle
Pierces skin easier
Vials key points
Closes medication system
Single or multi dose
Air must be injected into vial first before withdrawing medication
Ampules
Closed glass medicine
Used more in OR setting
Use filtered needle then switch needle for administration.
injection key points
Assess sites of injection
Rotate sites to prevent scarring
Always clean with alcohol wipe inner from outer
Angles of insertion for IM, SQ, & intradermal
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
Sites of intradermal injections
Inner forearm(most common)
Upper back
Scapula
Longest absorption of all parental medications
Equipment for TB
Length: 1/4 to 1/2”
Gauge: 25 or 27
SubQ injections key points
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
SubQ sites
Absorb at different rates
Abdomen - fastest
Outer upper arm
Anterior things
Upper ventral
Medications given subcutaneously
Insulin
Anticoagulants
Heparin
Lovenox
Insulin
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
What are two anticoagulants and what are they used for
Heparin and lovenox
Used to treat DVT or to keep clots from forming
Administering anticoagulants
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
What equipment is need for IM injections
Needle size - depending on size of patient
Normally 1- 1 1/2”
Gauge size: 20-25
Most common: 20-22
Sites for IM injections
Vastus Lateralis
Deltoid
Ventrogluteal
Why do we use Z track method
Minimizes local irritation
To decrease pain
Prevent leakage of medication into SQ tissue
Forms a seal
Prevents skin stains
How to minimize discomfort in injections
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
How do you keep yourself safe?
Wear gloves
Use safe needles
Place in sharps immediately
Never force needles into full sharps container
Use one handed technique to recap
Common high risk medications
Anticoagulants
Opioids
Insulin
Anti-diabetic agents
Most affected from adverse drug events
Older adults
Ppl with: Language barriers Low health literacy Limited access to health care Low socioeconomic status
Common causes of errors
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
Error prevention techniques
Using computers for typing not writing Smart pumps for IVs Barcoding Using automated dispensing units(pixus) Not using abbreviations Medication reconciliation
Computer prescriber order entry system
CPOE
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
Intradermal injections key points
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
