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NF2 Final > Module 13: Administration of Medication via ID, SC, or IM Route > Flashcards

Module 13: Administration of Medication via ID, SC, or IM Route Flashcards

1
Q

IM Injections

A
  • Intramuscular
  • Patients with developed muscles can tolerate 3 mL
  • 0.5 - 1 mL recommended for less developed muscle
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2
Q

Factors to consider for IM injections

A
  • Body weight
  • Amount of adipose tissue
  • Type of solution
  • Supplies
  • Landmarking
  • Comfort
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3
Q

Needles and Syringes for IM

A

Length – 1.3cm to 7.5cm
Gauge - 18G to 27G
Angle – 90 degrees
-Needles need to be long enough to penetrate past subcutaneous tissue, but short enough to not penetrate underlying blood vessels or bone
-Syringes need to be large enough for the solution but easy to manage

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4
Q

Proper Landmarking

A

Avoid sites with:

  • Large blood vessels
  • Nerves
  • Bone
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5
Q

Common IM Locations

A
  • Deltoid
  • Ventrogluteal
  • Vastus Lateralis
  • Rectus Femoris
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6
Q

Ventrogluteal Site

A 
Advantages:
-Away from large nerves or blood vessels
-Large developed muscle
Landmarking:
-Heel of hand over greater trochanter, thumb pointed to groin, index finger to anterior superior iliac spine, middle finger extended along iliac crest.
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7
Q

Vastus Lateralis Site

A

Advantages

  • Site of choice in infants, toddlers, and children
  • Anterolateral aspect of the thigh
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8
Q

Rectus Femoris Site

A
  • Occaisonally used
  • Self-admin
  • More painful
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9
Q

Deltoid Site

A
  • Small muscle
  • Common for immunizations
  • Max volume 1mL
  • Use with caution
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10
Q

IM Contraindications

A
  • Nodules
  • Lumps
  • Abscesses
  • Tenderness
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11
Q

Technique Considerations

A
  • Z-track
  • Hold skin taut
  • 1mL every 10 seconds
  • Wait 10 seconds post
  • Do not aspirate (as per policy & protocol)
  • Remove within same track
  • Gentle pressure, do not massage
  • Discard in sharps container STAT
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12
Q

Reconstitution

A

Some drugs may be stored in a powder form because they become inactivated after a prolonged amount of time when mixed in a solution

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13
Q

Reconstitution- Diluent

A
  • Sterile water, sodium chloride
  • Check with Parenteral Drug Monograph or Medication Vial
  • Must do 3 checks
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14
Q

Subcutaneous Butterfly Catheters

A

A device which provides access for subcutaneous medication administration and hypodermoclysis

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15
Q

Hypodermoclysis

A
  • The subcutaneous infusion of fluid
  • Limited IV access
  • Palliative care patients (with caution)
  • Mild dehydration
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16
Q

Subcutaneous Butterfly Catheters- Recommended Sites

A
  • Abdomen (preferred)
  • Upper arms
  • Upper back (scapular area)
  • Anterior thighs
  • Anterior upper chest
17
Q

Subcutaneous Butterfly Catheter- Safe Site Considerations

A
  • Lesions
  • Erythema
  • Swelling
  • Ecchymosis
  • Inflammation
  • Tissue Damage
18
Q

Subcutaneous Butterfly Catheter-Preparing Medication

A
  • Obtain correct medication
  • Obtain syringe and blunt fill needle/ blunt filter needle and alcohol swabs
  • Draw up correct amount of medication
19
Q

Subcutaneous Butterfly Catheter-Technique Consideration

A

-For needless systems:
=>Additional medication is required to prime tubing and injection cap with FIRST dose
+>Note: Priming amount may change with different sets.
-Only insert subcutaneous butterflies when medication is needed (nurse discretion)
-Don gloves
-Cleanse skin and let dry
-Ensure bevel up and wing bubbles are toward the patient (squeezing wings locks the bevel)
-Insert SC 20-40 degree angle (or as per policy) ***
-Secure with transparent drsg (ie Tegaderm)

20
Q

Subcutaneous Butterfly Catheter- Safety Considerations

A
  • One medication per site
  • Each site to be labeled with Medication, Concentration, Date
  • Can remain in site up to 7 days
  • Assess site EVERY shift
  • Infusion bags good for 24 hours (continuous HDC)
  • Sol’n admin sets good for 72 hrs (continuous HDC)
21
Q

Subcutaneous Butterfly Catheter- Documentation

A
  • Date & Time
  • Discipline & -Focus
  • Site of Insertion
  • Gauge
  • Primed with ?
  • Tolerated ?
  • Signature
22
Q

Ampules

A
  • Single doses of medication
  • Open system
  • Glass vial with colored ring to indicate weak spot
  • Filter needle required to draw up medication
23
Q

Vials

A
  • Single dose or multidose container with rubber seal
  • Contain liquids or powdered forms of medications
  • Closed system, air must be injected into vial prior to withdrawal
24
Q

Mixing medications from two vials

A
  1. Do not contaminate one medication with another
  2. Ensure final dose is accurate
  3. Maintain aseptic technique
25
Q

Mixing from a vial and an ampule

A
  1. Prepare med from vial first

2. Use same filter needle to draw up med from ampule

26
Q

Subcutaneous Injections

A

Administering medication into loose connective tissue under the dermis

  • Is absorbed slower than IM as it is not as rich with blood vessels
  • Is absorbed completely if circulatory status is normal
  • May experience discomfort as tissue contains pain receptors
27
Q

Subcutaneous Injection- Sites

A
  • Back of arms (outer posterior aspect of upper arms)
  • Abdomen, below costal margins to iliac crests
  • Anterior aspects of thighs
28
Q

Intradermal Injections

A
  • Commonly performed for skin testing
  • Medications are potent and administered into the dermis
  • Blood supply is reduced so absorption is slower
29
Q

Intradermal Injection- Sites

A
  • Inner forearm
  • Upper back
  • Site must be lightly pigmented, free of lesions, relatively hairless

NF2 Final (6 decks)

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