NSG352 Medication Administration Part 2

Question 1

Medications given by injection/infusion

Answer 1

Parenteral

Question 2

How can tissue damage occur with parenteral medication administration?

Answer 2

If the pH, osmotic pressure or solubility of the medication is not appropriate for the tissue where the medication is given

Question 3

True or False: Parenteral administration is often cheaper than other routes of administration

Answer 3

False

Question 4

Needles are measured in __________ and __________

Answer 4

Gauges and Length

Question 5

How do you determine how small/large the gauge of a needle is?

Answer 5

The higher the gauge, the smaller the diameter of the needle

Question 6

When drawing medication from an ampule, what needle will you use? What does this prevent?

Answer 6

Filter Needle, prevents glass shards

Question 7

What measurement are syringes usually in?

Answer 7

mL but can also be in units (mainly for insulin)

Question 8

True or False: Ampules are always single dose

Answer 8

True!

Question 9

True or False: Vials are always single dose

Answer 9

FALSE! They can be multi dose OR single dose. If the are multi dose, keep track of the expiration date.

Question 10

Steps for drawing up a mediation

Answer 10

1. Remove the cap from the vial and wipe with alcohol
2. Inject an equal amount of air into the vial (NEVER DO THIS WITH AN AMPULE)
3. Turn the vial upside down and withdraw the amount of medication you need from the vial
4. Ensure your needle is in the fluid the whole time you are drawing up the liquid (or you will get air in the syringe)
5. If you get air, tap the syringe so the air rises to the top and then inject the air back into the vial
6. Give the medication as soon as you draw it up. If you cannot, label the patient name, med name, date and time

Question 11

Steps to reconstituting medications

Answer 11

1. Use correct amount of diluent as ordered
2. Remove cap from vial and wipe with alcohol
3. Inject diluent from syringe into vial
4. Mix powder and diluent in the vial gently, SWIRLING the vial (some medications foam up if you violently shake, let foam settle if you have foam as it contains medication)
5. Draw up and administer once free of clumping

Question 12

When mixing medications, you should always check if they are what?

Answer 12

Compatible

Question 13

Steps to mixing mediations

Answer 13

1. inject air into each vial
2. Draw up first medication, withdraw any necessary air/medication
3. Draw up second medication slowly/accurately

Question 14

What should you consider when mixing insulin? What are the types of insulin?

Answer 14

CLEAR BEFORE CLOUDY
Clear insulin: rapid-acting (humalog, novolog), short-acting (regular) or long-acting insulin (lantus, levemir)
Cloudy insulin: intermediate-acting insulin (NPH)

Question 15

What should you ensure before administering IVP medication?

Answer 15

1. Can this medication be given IVP?
2. Peripheral or Central? (small/large vein)
3. How fast?
4. Side effects?

Question 16

Steps to administering IPV medications

Answer 16

1. Clean injection port with alcohol
2. Flush with compatible solution, generally normal saline is safe
3. Administer medication at correct rate
4. Flush afterwards with compatible solution, flush at the same rate as the medication

Question 17

What are the primary ICF electrolytes?

Answer 17

potassium, phosphate, and sulfate

Question 18

True or Fale: 1/3 of the bodies fluids is ICF

Answer 18

False! Its 2/3, ECF is 1/3

Question 19

What causes older adults to have decreased total body water?

Answer 19

Decreased renal function, ability to concentrate urine, ability to conserve Na and K, perception of thirst, lean muscle mass
Diuretics
Excessive use of laxatives

Question 20

What is the average intake for an adult?

Answer 20

Oral fluids: 1,300 mL
Fluid in foods: 1,000 mL
Oxidation of Food: 300 mL
Total = 2,600 mL

Question 21

What is the average output for an adult?

Answer 21

Urine: 1,500 mL
Stool: 200 mL
Perspiration: 100-200 mL
INSENSIBLE LOSS
Lungs: 300 mL
Skin: 300-400 mL
Total = 2,400 - 2,600 mL

Question 22

Where is thirst typically stimulated from?

Answer 22

The thirst center in the hypothalamus

Question 23

A sudden gain/loss in weight shows what?

Answer 23

Excess fluid or thirst deficit

Question 24

What laboratory tests should be performed on patients who are at risk for fluid disturbances?

Answer 24

BUN, Creatinine, Albumin

Question 25

All fluids and foods that become liquid at room temperature

Answer 25

Full liquid diet

Question 26

Food with reduced fiber content, which require less energy for digestion

Answer 26

Soft diet

Question 27

Regular diet, patients appetite, ability to eat, food tolerance

Answer 27

Diet as tolerated

Question 28

Colloids

Answer 28

• particles do not break down in water
• tend to stay in vascular space
• used for volume expansion but small volumes are needed

Question 29

Crystalloids

Answer 29

• small particle size
• particles break down in water

Question 30

Examples of Colloids

Answer 30

• packed RBCs (PRBC)
• plasma (human or synthetic)
• albumin (natural protein seperate from plasma)
  = keeps fluid in vessels & maintains volume
  = treatment of shock and protein replacement
• hetastarch (synthetic starch)
  = shifts fluid into vessel (vasular expansion)
• mannitol (alcohol sugar)
  = diuresis
  = reduces cerebral edema

Question 31

How do isotonic fluids expand the vasculature? What are they used for? Risks?

Answer 31

• By adding volume, does not change the cell.
• Used for replacement/maintenance of fluid/electrolytes
• Fluid overload

Question 32

How do hypotonic fluids expand the vasculature? Associated risks?

Answer 32

• expand intravascular compartment but shifts fluid out of vessels
• May worsen hypotension or cause hyponatremia