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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
Mixed insulin dose prep
- 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
Insulin pen
- Dial the dose - Insert the needle (wait) - dial returns to zero - remove needle - Can be use on one or multiple patients
27
Intradermal Sites
- inner forearm - may use back and upper chest (allergy testing) - tuberculin skin testing
28
Intradermal Volume
-0.1 -0.5 mL
29
Equipment for intradermal
-gloves, TB syringe (1 mL, 28-25 gauge, 1/4-5/8 inch long needle) alcohol swab
30
Admin angle intradermal
5-15 degrees
31
How to admin a intradermal injection
- 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
Subcutaneous Admin
- adminstered in site between muscle and skin (adipose fat) - common subq injections are lovenox, heparin, and insulin - onset is half an hour
33
Subcutaneous Volume
- 1 mL typically but can use 3 mL
34
Syringes to be used for Subq?
- TB syringe or insulin syringe could also use a 3cc syringe ( 25-27g, 1/2- 5/8 inch needle) gloves, alcohol swab
35
Admin angle for subq?
45- 90 degrees (most are 90 degrees)
36
Subcutaneous sites
- Back of the upper arms - Abdomen ( 1 inch away from umbillicus) - Lower back - Love handles - Anterior aspect of thigh - in-between scapula
37
SQ Admin process
-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
IM injections
- goes into muscle group | - onset is variable
39
IM volume
- up to 4 mL depending on muscle
40
Equipment for IM injection
- 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
Admin angle for IM
90 degrees
42
IM admin site: Deltoid
- 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
IM admin site Vastus lateralis
- 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
IM admin Ventral Gluteal site
- 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
IM Admin Dorsal Gluteal site
- 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
IM Adminsitration
- 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
If you see blood
Remove the needle and discard
48
CDC says
you do not have to aspirate
49
Z- track technique
- 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
Z-track IM admin
- 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
Methods to decrease pain
- 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
injection complications
- 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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