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Pharmacology > Med Admin Part 2 > Flashcards

Med Admin Part 2 Flashcards

1
Q

What equipment is part of the syringe?

A
  • Tip (slip tip or lure lock)
  • Barrel
  • Plunger
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2
Q

What parts must be sterile?

A
  • Do not touch the interior plunger or tip or hub of needle
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3
Q

Tuberculin Syringe

A
  • 1 mL in volume

- small needle in length and gauge

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4
Q

Syringe size

A

1 ML 3 ML 5 ML

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5
Q

insulin syringe

A
  • measured in units
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6
Q

What is the shaft of the needle?

A
  • length of the needle
  • packages tell you how long
  • 5/8, 1, 1 1/4
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7
Q

Gauge

A
  • diameter of hole
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8
Q

small guage

A

27, 25

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9
Q

Large guage

A

20, 18

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10
Q

Bevel

A

Slant of needle

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11
Q

You can only recap when….

A
  • it hasn’t been used on a patient yet

- use one handed scoop technique

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12
Q

one handed scoop

A
  • laying cap down on surface

- moving needle with one cap until you hear a snap

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13
Q

Safety needles

A
  • Learn how to use safety mechanism
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14
Q

Blunt fill needle

A
  • Used to fill syringe
  • not as sharp
  • hard to stick yourself with it
  • reduces medication spilling out of syringe
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15
Q

Carpuject or Tubex

A
  • pre-filled unit dose
  • verify the correct medication
  • insert cartridge into holder
  • activate the needle
  • expel the air and excess med
  • admin the med
  • holder can be reused
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16
Q

How do I change needles

A
  • never place non assemble syringes on table

- hold the needle within package

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17
Q

Filter needles

A

-mechanism that filters glass for ampules

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18
Q

Safety vs Nonsafety

A

-Non- safety needles should not be used in routine practice

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19
Q

How to read dosage

A
  • on the plunger read the line underneath mound
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20
Q

Where to place fingers while drawing a med?

A
  • dont touch needle or plunger
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21
Q

Glass Ampule: How to prepare

A
  • Tap the top of ampule
  • liquid falls below neck
  • use gauze or an alcohol swab to cover fingers
  • break the neck away from the body
  • Use a filter needle if available (use a small needle if filter is not available)
  • Insert the needle into the solution
  • Invert the ampoule (or leave on surface)
  • pull back on plunger and pull back to appropriate dose
  • remove syringe
  • tap the barrel of syringe to remove air
  • push he plunger expel excess air or medication
  • scoop the cap onto the needle
  • change the needle
  • Discard the ampoule into a sharps container
22
Q

Vial: preparation

A
  • Remove the metal of plastic covering
  • Swab the top with an alcohol swab
  • Fill the syringe with air equal to the amount that you are drawing out
  • insert the needle into the center of the rubber stopper
  • instill the air from the syringe
  • invert the vial
  • pull back the syringe to desired amount of medication
  • make sure needle tip is in the fluid
  • Remove when desired amount is reached
  • use the scoop technique to recap
  • change the needle before admin
23
Q

Regular Insulin

A
  • “Clear” fast acting “pure”
24
Q

NPH Insulin

A
  • “cloudy” slower acting contaminated
25
Q

Mixed insulin dose prep

A
  • Instill air in both vials first
  • Draw up first med (you can manipulate this one)
  • have nurse check this amount
  • 2nd vial has to perfect ( can not push back in if you have too much) needs to be discarded
  • have nurse check this
  • Insulin is a high alert med
26
Q

Insulin pen

A
  • Dial the dose
  • Insert the needle (wait)
  • dial returns to zero
  • remove needle
  • Can be use on one or multiple patients
27
Q

Intradermal Sites

A
  • inner forearm
  • may use back and upper chest (allergy testing)
  • tuberculin skin testing
28
Q

Intradermal Volume

A

-0.1 -0.5 mL

29
Q

Equipment for intradermal

A

-gloves, TB syringe (1 mL, 28-25 gauge, 1/4-5/8 inch long needle) alcohol swab

30
Q

Admin angle intradermal

A

5-15 degrees

31
Q

How to admin a intradermal injection

A
  • Prepare the med
  • gather supplies
  • identify the site (on intact skin)
  • don gloves
  • cleanse site with alcohol
  • pull skin taut ( pull skin opposite of needle direction)
  • insert needle with bevel up at 5-15 degrees
  • right underneath skin 1/8 in depth
  • push plunger to instill med creating a wheal
  • withdraw angle at same angle it was inserted
  • Cover site with gauze for bleeding. Do not message
  • Do not recap. Activate safety feature
  • place needle in sharps container uncapped
32
Q

Subcutaneous Admin

A
  • adminstered in site between muscle and skin (adipose fat)
  • common subq injections are lovenox, heparin, and insulin
  • onset is half an hour
33
Q

Subcutaneous Volume

A
  • 1 mL typically but can use 3 mL
34
Q

Syringes to be used for Subq?

A
  • TB syringe or insulin syringe could also use a 3cc syringe ( 25-27g, 1/2- 5/8 inch needle) gloves, alcohol swab
35
Q

Admin angle for subq?

A

45- 90 degrees (most are 90 degrees)

36
Q

Subcutaneous sites

A
  • Back of the upper arms
  • Abdomen ( 1 inch away from umbillicus)
  • Lower back
  • Love handles
  • Anterior aspect of thigh
  • in-between scapula
37
Q

SQ Admin process

A

-Prepare med
-Gather meds
-Identify site (large pinch)
- don gloves
- cleanse skin with alcohol
- Bunch the skin
- Hold needle like dart
-pierce skin with quick motion 45-90 degrees
- Do not aspirate
-inject med slowly
-quickly remove needle
- do not recap activate safety feature
place needle in sharps container uncapped

38
Q

IM injections

A
  • goes into muscle group

- onset is variable

39
Q

IM volume

A
  • up to 4 mL depending on muscle
40
Q

Equipment for IM injection

A
  • Gloves, 1-5 mL syringe, needle ( 21-25g, 1-3 inch needle) alcohol swab
  • any injection below the waist use 1.25 inch or 1.5 inch
  • RN is responsible to choose needle size a and gauge
41
Q

Admin angle for IM

A

90 degrees

42
Q

IM admin site: Deltoid

A
  • Palpate for lower edge of acromion process
  • place 3 fingers across the deltoid muscle with top finger at acromion process. This forms the base of the triangle.
    -draw an imaginary line at the axilla
    -This forms the apex of the triangle
  • Injection site is the center of the triangle
    -2-3 finger widths (1-2 inches)
    below the acromion process
43
Q

IM admin site Vastus lateralis

A
  • one hand above the knee
  • one hand below the greater trochanter
  • locate midline of ant thigh and midline of lateral thigh
  • injection site is the lateral area of the thigh (middle third)
44
Q

IM admin Ventral Gluteal site

A
  • Preferred injection site due to leat amount of bvs and nerves
  • Palm of hand on greater trochanter of femur
  • Index finger on anterior superior iliac spine (hip bone)
  • Middle finger extended toward iliac tubercle
  • Injection site is between index and middle finger
45
Q

IM Admin Dorsal Gluteal site

A
  • MOST DANGEROUS SITE!
  • Locate the posterior iliac spine
  • locate the greater trochanter
  • Draw an imaginary line btwn these two
  • injection site is above and lateral to line
  • dangerous due to sciatica nerve location
  • only use if directed to
46
Q

IM Adminsitration

A
  • Prepare med ( 5 rights compare with MAR)
  • gather supplies
  • identify site
  • don gloves
  • swab with alcohol
  • Pull skin taut (esp below waist)
  • stabilize needle
  • aspirate for blood
  • if no blood instill med slow and steady
  • quickly remove needle
  • Do not recap activate safety place needle in sharps container uncapped
  • massage site with alcohol swab
  • Remove gloves
47
Q

If you see blood

A

Remove the needle and discard

48
Q

CDC says

A

you do not have to aspirate

49
Q

Z- track technique

A
  • used to decrease pain
    -have to use with irritating meds
    -Iron and Hydrozizine
    used to trap medication in muscle and prevent tracking of solution through tissues
50
Q

Z-track IM admin

A
  • prepare med
  • change needle after drawing up med
  • -gather supplies
  • identify site
  • put on gloves
  • cleanse site with alcohol
  • displace skin laterally 1- 1.5 inches from injection site
  • While holding skin insert needle with a darting motion at a 90 degree angle
  • stabilize needle with thumb and forefinger that is displacing the skin
  • aspirate
  • no blood inject med slow and steady
  • wait 10 secs
  • quickly withdraw needle
  • then release skin
  • cover site with swab and don’t massage
  • Do not recap. activate safety feature
  • place needle in sharps container uncapped
  • remove gloves
51
Q

Methods to decrease pain

A
  • have client relax muscle
  • position prone with feet inverted for dorso gluteal injection
  • Change needle after preparing medication in syringe
  • avoid injecting into sensitive or hardened skin
  • use needle long enough to reach syringe
  • Dart needle quickly into muscle
  • use smallest gauge possible
  • do not remove needle once inserted
  • withdraw needle quickly
  • use z-track for IM injection
  • EMLA cream may be applied
  • apply pressure/ ice before injection and to pressure to site after
52
Q

injection complications

A
  • Pain,
  • Damage tissue: sterile abcess, discoloration, hematomas, muscle contraction
  • nerve damage
  • bone injury (hit bone with needle )
  • speed shock ( gets med in vein or artery right away)
  • infection

Pharmacology (14 decks)

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