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n242 > module 3 (part A- parenteral meds) > Flashcards

module 3 (part A- parenteral meds) Flashcards

1
Q

parenteral=

A

administered in a manner than is not through the digestive tract

  • enter body tissues and circulatory system by injection
  • more quickly absorbed than oral
  • invasive, pose greater risk
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2
Q

what kind of technique for parenteral meds?

A

aseptic technique!

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3
Q

when is parenteral used?

A

faster (emergencies), when pts are vomiting, cannot swallow, and/or restricted from fluids

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4
Q

four routes of parenteral?

A

subcutaneous
intramuscular
intradermal
intravenous

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5
Q

subcutaneous injection is into..

A

tissue under dermis of the skin

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6
Q

intramuscular is into

A

the muscle

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7
Q

intradermal is into

A

the dermis just under epidermis

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8
Q

intravenous is into

A

a vein

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9
Q

ethnicity, genetics, and culture influence:

A

drug response, pharmacokinetics, pharmacodynamics, and patient adherence and education

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10
Q

how do you prevent contamination of solution?

A

ampules should not sit open, meds should be removed quickly

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11
Q

how do you prevent needle contamination?

A

avoid letting needle touch contaminated surface, avoid touching the length of the plunger or inner part of barrel

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12
Q

prepare skin of person to avoid infection when giving injection by?

A
  • washing skin soiled with dirt, drainage, or feces with soap and water
  • swab from centre of site and move outward in a 5 cm radius
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13
Q

how can you minimize a patients discomfort when giving an injection (many thiiings!)

A
  • use sharp, beveled needles in the shortest length and smallest gauge
  • change needle if liquid med coats its shaft
  • position and flex patients limbs to reduce muscular tension
  • divert pts attention away from injection
  • apply vapocoolant spray or topical anesthetic
  • insert needle at proper angle
  • inject med slow but smooth
  • gently apply antiseptic pad to site
  • apply gentle pressure
  • rotate injection sites to prevent formation of indurations and abscesses
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14
Q

recommendations for prevention of needlestick injuries?

A

avoid using needles when effective needleless systems or SESIP devices avail

  • immediately dospose of used needles
  • maintain a sharps injury log
  • report all needlestick injuries immediately
  • attend education offerings regarding bloodborne pathogens
  • do not recap needles after med admin
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15
Q

where is the most frequent route of exposure to bloodborne disease for HCWs?

A

needlestick injuries!

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16
Q

what is SESIP?

A

sharp with engineered sharps injury protection- device that is effective in preventing needlesticks

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17
Q

appropriate size, length, and gauge of needle is based on?

A

quantity and type of medication prescribed and body size of patient

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18
Q

infusion pumps ensure ?

A

a constant and accurate delivery of medication

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19
Q

types of syringes?

A

either Luer-Lok or non Leur-lok

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20
Q

leur lok syringe?

A
  • needles or needleless devices that are twisted onto the tip and lock themselves in place
  • prevent accidental removal of a needle from syringe
21
Q

non-leur lok syringe?

A

needles or needleless devices that slip onto the tip

also known as leur slip

22
Q

variety of syringe sizes?

A

0.5-60ml syringes, use smallest size possible

23
Q

Needles?

A
  • some come attached to syringes, others packed individually
  • disposable, made of stainless steel
24
Q

three parts of a needle?

A
  • hub (fits onto top of syringe)
  • shaft (connects to the hub)
  • bevel or slanted tip
25
Q

never use filtered needles when?

A

administering a med!! it is big

26
Q

tip of needle or bevel is always

A

slanted

27
Q

most needles vary in length from

A

3/8 to 3 inches

28
Q

smaller the needle gauge?

A

larger the needle diameter

29
Q

needles are color coded for

A

ease of selection!

30
Q

longer needles for?

A

IM injections

31
Q

ampules contain?

A

single doses of injectable medication in liquid form

  • 1 to 10ml or more
  • made of glass with a neck that is snapped off to access med
32
Q

what needle is used with ampules?

A

filter needles to prevent glass particles from being drawn up into the syringe

33
Q

a vial is?

A

a single- or multi dose plastic or glass container with a rubber seal at the top

  • after u open a single dose you must discard it regardless of amt used
  • if a multi dose write the date it is opened on it
34
Q

how do you prepare a ampule (steps)?

A
  • tap top of ampule lightly until fluid moves from neck
  • place small quaze around neck and snap
  • draw up med quickly with filter needle long enough to reach the bottom of ampule
  • hold ampule upside down or set it on flat surface
  • to expel excess air bubble, remove needle from ampule, hold syringe with needle pointing up and tap side of syringe
  • use sink for disposal if excess fluid in syringe
  • replace filter needle with regular sharps
35
Q

how do you prepare vial containing a solution?

A
  • remove cap covering top
  • alcohol swab surface of rubber seal, allow to dry
  • remove needle cap on syringe, pull back on plunger to draw amount of air into syringe equivalent to volume of med to be aspirated
  • vial flat on surface, insert tip of needle through center of rubber seal
  • inject air into air space of vial
  • invert vial, keep tip of needle below fluid level
  • allow air pressure from vial to syringe gradually with med
  • when you obtain desired volume, position nedle into air space of vial, tap side of syringe gently, eject any air remaining at top into vial
  • remove needle
  • hold syringe eye level 90 degree angle to ensure correct volume and no air bubbles
  • if needed change needle to appropriate gauge and length
36
Q

mixing parenteral meds in one syringe?

A

some meds need to be mixed from two vials or a vial and a ampule

  • avoids need to give more than one injection
  • do not contaminate contents of vial with med from another vial or ampule
37
Q

when you mix meds from vial and ampule, which do you prep first?

A

-prep meds from vial first, then withdraw med from ampule using same syringe and a filter needle

38
Q

reasons to give a med by parenteral?

A

-client is vomiting, client cannot swallow

39
Q

important safety guidelines for prepping any meds?

A

-avoid distractions, verify medication not expired, strict aseptic techniques, educate client about med and side effects

40
Q

what step helps to minimize clients discomfort when giving an injection?

A

-inject med slow and smoothly

41
Q

do you use sharp beveled needles with the smallest length and smallest gauge?

A

yes! when you can always the smallest size

42
Q

what gauge is smallest?

A

the largest number is actually the smallest diameter for gauges! so 25 is smaller than 18

43
Q

what needles should never be injected into a client?

A

blunt fill needle and filter needle

-both used for prepping the meds

44
Q

can ampules be used for multi-dose meds?

A

no! only single dose.

vials can be used for multi dose for one client only!

45
Q

what is the formulary LWMH for the prevention and treatment of VTE as of June 2019

A

enoxaparin!

-unrestricted, mainly used to treat/prevent VTE and also used in acute coronary syndrome

46
Q

format of enoxaparin and dalteparin?

A
  • multidose vials

- prefilled safety syringes

47
Q

dosing of enoxaparin and dalteparin is based on?

A

bodyweight and renal function

48
Q

dalteparin is restricted to?

A
  • cancer associated thrombosis
  • trauma
  • acute spinal cord injury
  • clotting in hemodialysis or renal extracorporeal systems
49
Q

enoxaparin dosage is in…

A

MILLIGRAMS

whereas dalteparin is UNITS

n242 (7 decks)

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