NSG352 Medication Administration Part 2 Flashcards
Medications given by injection/infusion
Parenteral
How can tissue damage occur with parenteral medication administration?
If the pH, osmotic pressure or solubility of the medication is not appropriate for the tissue where the medication is given
True or False: Parenteral administration is often cheaper than other routes of administration
False
Needles are measured in __________ and __________
Gauges and Length
How do you determine how small/large the gauge of a needle is?
The higher the gauge, the smaller the diameter of the needle
When drawing medication from an ampule, what needle will you use? What does this prevent?
Filter Needle, prevents glass shards
What measurement are syringes usually in?
mL but can also be in units (mainly for insulin)
True or False: Ampules are always single dose
True!
True or False: Vials are always single dose
FALSE! They can be multi dose OR single dose. If the are multi dose, keep track of the expiration date.
Steps for drawing up a mediation
- Remove the cap from the vial and wipe with alcohol
- Inject an equal amount of air into the vial (NEVER DO THIS WITH AN AMPULE)
- Turn the vial upside down and withdraw the amount of medication you need from the vial
- Ensure your needle is in the fluid the whole time you are drawing up the liquid (or you will get air in the syringe)
- If you get air, tap the syringe so the air rises to the top and then inject the air back into the vial
- Give the medication as soon as you draw it up. If you cannot, label the patient name, med name, date and time
Steps to reconstituting medications
- Use correct amount of diluent as ordered
- Remove cap from vial and wipe with alcohol
- Inject diluent from syringe into vial
- 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)
- Draw up and administer once free of clumping
When mixing medications, you should always check if they are what?
Compatible
Steps to mixing mediations
- inject air into each vial
- Draw up first medication, withdraw any necessary air/medication
- Draw up second medication slowly/accurately
What should you consider when mixing insulin? What are the types of insulin?
CLEAR BEFORE CLOUDY
Clear insulin: rapid-acting (humalog, novolog), short-acting (regular) or long-acting insulin (lantus, levemir)
Cloudy insulin: intermediate-acting insulin (NPH)
What should you ensure before administering IVP medication?
- Can this medication be given IVP?
- Peripheral or Central? (small/large vein)
- How fast?
- Side effects?
Steps to administering IPV medications
- Clean injection port with alcohol
- Flush with compatible solution, generally normal saline is safe
- Administer medication at correct rate
- Flush afterwards with compatible solution, flush at the same rate as the medication
What are the primary ICF electrolytes?
potassium, phosphate, and sulfate
True or Fale: 1/3 of the bodies fluids is ICF
False! Its 2/3, ECF is 1/3
What causes older adults to have decreased total body water?
Decreased renal function, ability to concentrate urine, ability to conserve Na and K, perception of thirst, lean muscle mass
Diuretics
Excessive use of laxatives
What is the average intake for an adult?
Oral fluids: 1,300 mL
Fluid in foods: 1,000 mL
Oxidation of Food: 300 mL
Total = 2,600 mL
What is the average output for an adult?
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
Where is thirst typically stimulated from?
The thirst center in the hypothalamus
A sudden gain/loss in weight shows what?
Excess fluid or thirst deficit
What laboratory tests should be performed on patients who are at risk for fluid disturbances?
BUN, Creatinine, Albumin
All fluids and foods that become liquid at room temperature
Full liquid diet
Food with reduced fiber content, which require less energy for digestion
Soft diet
Regular diet, patients appetite, ability to eat, food tolerance
Diet as tolerated
Colloids
- particles do not break down in water
- tend to stay in vascular space
- used for volume expansion but small volumes are needed
Crystalloids
- small particle size
- particles break down in water
Examples of Colloids
- 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
How do isotonic fluids expand the vasculature? What are they used for? Risks?
- By adding volume, does not change the cell.
- Used for replacement/maintenance of fluid/electrolytes
- Fluid overload
How do hypotonic fluids expand the vasculature? Associated risks?
- expand intravascular compartment but shifts fluid out of vessels
- May worsen hypotension or cause hyponatremia
