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1. Exams - Semester 3 > MP & S - Injections & IV's > Flashcards

MP & S - Injections & IV's Flashcards

1
Q

How hight above site should you attach tourniquet?

A

3-5in above

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2
Q

What site section should you Avoid drawing blood from?

A
  • Same side as a Masectomy or edema
  • Above an IV site or at least 5in below it
  • On an arm w/ cannula, fistula, or vascular graft, or hematoma
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3
Q

About vacutainer?

A
  • Uses vacuum to withdraw blood
  • Low cost / fast
  • Can’t see flashback, not good for small veins
  • No transfer needed to lab, ↓ risk of self stick
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4
Q

About syringe?

A
  • Can control amount of pressure
  • Higher cost / slower
  • Can see flashback & better for small veins
  • Transfer to lab, ↑ risk of self stick
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5
Q

Needle sizes?

A

Length & diameter
• Diameter = gauge = ># = smaller diameter
• 19g – largest-mainly for large volume draws
• 21g – moderate amnt-draw from AC space
• 22g – most frequently used with vacutainer/ 1-3 tubes to draw/ AC space
• 23g – most versatile
• 25g – small veins

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6
Q

About Order of draw?

A

• Depends on types of tests ordered
o Blood culture → must use Betadine
o Na Citrate coagulation tubes
o Serum tubes, Additive tubes

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7
Q

About Site preparation?

A
  • Clean site w/ 70% isopropyl alcohol
  • Betadine is alternative
  • Allow to air dry!!!
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8
Q

About Needle stick?

A
  • Reapply tourniquet, Disinfect
  • Position bevel up, Pull skin taut
  • Enter skin at 15 degree angle
  • Stabilize needle and insert tubes
  • Untie tourniquet → as the last tube is filling - before withdrawing the needle
  • Withdraw needle and apply gauze and pressure for 3 – 5 min (folding the arm up isn’t enough pressure)
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9
Q

Intradermal injection - Procedure?

A
  • Entire bevel penetrates skin
  • Raise a “bleb”
  • Insert needle at 35-40 degrees
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10
Q

Intradermal injection - Purposes?

A
  • PPD testing,
  • Anesthesia
  • Cosmetic,
  • Allergy test
  • Vaccine,
  • Sentinal node biopsy
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11
Q

Intradermal injection - Equipment Sites?

A
  • 24-30 gauge,
  • ½ inch length
  • 1cc small amounts (syringe)
  • Alcohol & gauze
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12
Q

Intradermal injection - RFs?

A
  • ***Hematoma,
  • Inf
  • Hypersensitivity rxn
  • Granulomatous rns
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13
Q

SQ injection procedure?

A
  • Prep w/ EtOH,
  • Pinch SC tissue,
  • roll between thumb & forefinger.
  • Insert needle at 45-degree angle,
  • Extend ¾ total length
  • Aspirate.
  • If blood appears = remove!!
  • Inject slow, w/draw, apply pressure & bandage
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14
Q

SQ injection - Purposes?

A

Drugs requiring
- Slow absorption + long duration of action

     - i.e. Insulin, Hormones, Vaccines
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15
Q

SQ - Equipment Sites?

A

23-25 gauge = adults
25-27 = children
5/8 – ¾ inch length

Infants = thigh 
Adults = deltoid, upper outer thigh, abdomen
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16
Q

SQ - RFs?

A

Dermatitis

Cellulitis

17
Q

IM - Procedure?

A
  • Prep w/ EtOH,
  • Hold like a dart @ 90-degree angle,
  • Hold muscle firm,
  • Insert needle quickly,
  • Hold barrel w/ weak hand,
  • Aspirate,
  • Inject slow,
  • W/draw,
  • Gentle pressure

Gluteal:

  • Use UOQ,
  • Avoid sciatic

Deltoid:
- Avoid radial in kids

18
Q

IM - Purposes?

A
  • Drugs not absorbed well orally
  • Intermediate rate of onset + duration preferred.
  • When parental delivery necessary.
  • Abx
  • Narcotics
  • Pain meds
  • Hormones
19
Q

IM - Equipment & Site?

A
  • 19-22 gauge,
  • 1 ½ inch - Long enough to pass SQ tissue.
  • EtOH wipes
  • Sterile gauze & dressing
  • Size depends on muscle size, depth, viscosity, substance

Infants
- buttocks, deltoid
Adults
- ant thigh, butt, deltoid

20
Q

IM - RFs?

A

Inject to a vessel:
- Toxic rxn, injury, hematoma

Inject to a nerve:
- Pain, parasthesia,
nerve damage

Needle can break off into muscle
Sterile/septic abscess

21
Q

Venous Cath - Procedure?

A

Use largest vein in area where movement around joint wont be disrupted

22
Q

Venous Cath - Purposes

A
  • Fluid replacement,
  • Delivers meds,
  • Blood sampling

Consider length of time cath to be in place.

23
Q

Venous Cath - Equipment / Sites

A

Size depends on purpose + vein:

  • 18-20 gauge = small vn
  • 12-18 gauge = lg veins

Smaller # = larger catheter

Need:

  • Betadine,
  • EtOH sponge,
  • Tourniquet,
  • Gloves,
  • 2 IV caths,
  • Tape,
  • Sterile dress,
  • IV solution,
  • Tubing, pole
24
Q

Venous Cath - RFs

A

Phlebitis = if use small vn in hand

Infiltration
Infection

25
Q

Venous Cath - procedure part I?

A

Procedure Part I:
• Place extremity in dependent position
• Plan for mess
• Apply tourniquet to constrict venous return
• Prepare the equipment
• Prepare the site
• Enter skin and advance catheter until blood return seen – advance plastic sheath into vein – withdraw needle; release tourniquet

26
Q

Venous Cath - procedure part II?

A

Procedure Part II:
• Connect the tubing to the catheter sheath
• Tape the tubing to the skin
• Cover the catheter with dressing (semipermeable dressing / Tegaderm)

1. Exams - Semester 3 (21 decks)

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