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Section 1 242 > Parental Medications > Flashcards

Parental Medications Flashcards

1
Q

8 Ways to Reduce Needle Stick Injuries

A

1 Avoid using needles when effective needleless systems or SESIP safety devices are available.

2 Do not recap needles after medication administration.

3 Plan safe handling and disposal of needles before beginning procedure.

4 Immediately dispose of used needles into sharps disposal
containers.

5 Maintain a sharps injury log (see agency policy).

6 Attend educational offerings regarding blood borne pathogens and take vaccines

7 Report all needlestick and sharps-related injuries immediately

8 Participate in the selection and evaluation of needleless
systems of SESIP devices with safety features within your place of employment whenever possible.

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2
Q

Prevention of Infection in Injections (4)

A

1) Prevent contamination of solution
- Ampules should not sit open, and medication should be removed quickly

2) Prevent Contamination of needle
- Don’t allow needle or length of plunger to touch anything

3) Prepare Skin
- Use antiseptic swab (+ wash if actually solid) in 5cm radius

4) Reduce Microorganisms
- Hand Hygiene 15s min.

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3
Q

What needs to be checked before mixing parental medication in one syringe

A

Check Compatibility charts. They are located in drug reference guides, posted within patient care areas, or available electronically. If you are uncertain about medication compatibilities, consult a pharmacist.

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4
Q

Consideration when drawing up mixed parental medication

A

When using multi-dose vials, do not contaminate the contents of the vial with medication from another vial or ampule.

Need to put air into both vials before drawing up from either

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5
Q

Special Heparin Considerations

A

Any potential for bleeding (ulcers, trauma, etc)

PT-INR time (More forWarfarin), PTT check (heparin)

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6
Q

How much fluid can be administered SC?

A

up to 2ml Adult, 0.5ml Pediatric

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7
Q

Which parental med absorbs faster SC or IM?

A

IM injection route deposits medication into deep muscle tissue, which has a rich blood supply, allowing medica- tion to absorb faster

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8
Q

What influences needle size selection for injections?

A

viscosity of the medication, injection site, patient’s weight, and amount of adipose tissue influence needle size selection

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9
Q

Basic Range for IM needle gauge choices?

A

Administer immu-nizations and parenteral medications in aqueous solutions with a 20- to 25-gauge needle. Give viscous or oil-based solution with an 18- to 21-gauge needle. Use a small-gauge (22- to 25-gauge) needle for children

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10
Q

Basic Range for IM needle length choice?

A

An adult patient who is thin requires a needle length of 5/8 to 1 inch; whereas an average patient requires a 1-inch needle

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11
Q

Two indications for use of SCBF?

A

Medication of same type and concentration will be given multiple times SC

PO not possible or recommended

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12
Q

Insertion sites for SCBF

A

Abdomen (5cm from umbilicus), Upper arm (shoulder), anterior thigh

Readings- Supraclavicular or posterior flank as well

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13
Q

Assessments/considerations pre administration of SCBF

A

What is the additional dose for first admin
Condition of skin at site
Same concentration of med
+ allergies and I.D bracelet

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14
Q

Should the bevel be up for SCBF? What angle?

A

Yes. Bevel up @ 30 degrees

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15
Q

Written Info on SCBF?

A

Initials, Med and Concentration, Date Inserted

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16
Q

Will administration of LMWH (low molecular weight heparin) change PTT numbers?

A

No

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17
Q

What is the primary reason for interdermal injections?

A

Skin testing - tuberculosis screening and allergy tests.

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18
Q

Why do you administer potent medications into the dermis?

A

Blood supply is reduced
Drug absorption occurs slowly

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19
Q

What is the typical length of an interdemal needle?

A

3/8 to 5/8 of an inch.

20
Q

What guage needle is typically used for interdermal injections?

A

fine-guage, 25 - 27

21
Q

What is the angle of insertion for interdermal injections?

A

5 to 15 degrees

22
Q

What amount of medication should be injected?
Children?

A

0.01 - 0.1 mL
Children: 0.1 mL

23
Q

What does it mean if a bled does not appear?

A

Medication may have entered the subcutaneous tissues.

24
Q

Should you needle site bleed after needle withdrawal?

A

No.
If the needle site bleeds after an interdermal needle it is likely that the medication may have entered the subcutaneous tissues.

25
Q

Can you delegate an interdermal to nursing assistance?

A

Nope.

26
Q

Is it necessary to aspirate during an ID injection?

A

Hell no. Dermis is relatively avascular. No need to aspirate.

27
Q

What is a solvent?

A

A substance (liquid) that dissolves another substance to prepare a solution.
Synonymous term: Diluent

28
Q

What is a solute?

A

a substance to be dissolved or diluted.

Can be solid of a liquid

29
Q

What is a solution?

A

The resulting mixture of a solution and a solutte.

30
Q

Why are some medications stored in powdered form?

A

They are unstable.

They need to be dissolved or reconstituted prior to administration.

31
Q

Do nurses typically reconstitue drugs?

A

No.
Pharmacists typically do this, but nurses must understand the process.

32
Q

What are the two types of reconstituted parenteeral solutions?

A

Single strength & Multiple Strength

33
Q

When multiple directions for diluting are given, the ______ the amount of dilutent added, the stronger the resulting solution concentration will be.

A

Smaller.

34
Q

Reconstitution Question:

Order: Ceftazidime 250 mg IM q12h
Supply: 1000 mg vial - Instructions: Add 3mL of sterile water for injection. SHAKE WELL. Provides Ceftazidime 280 mL per mL

Calculate the dose to be administered:

A

Add 3 mL sterile water to solute = 280 mg/mL

Order/Supply x Quantity =
250mg / 280mg/mL x 1 = 0.9 mL IM q12h

35
Q

What is the purpose of Heparin therapy?

A

Providing theraputic anticogulation to reduce risk for thrombus formation.

36
Q

What is the main risk/concern with Heparin patients?

A

Risk of bleeding

Including - Gums, heatemesis, hematuria.

37
Q

What pre-existing conditions or test(s) or should be conducted for for a Heparin patient?

A

Coagulation blood tests - PTT, Platelets

Any conditions with increased risk of bleeding: recent childbirth, severe diabetes, ulcers, lesions (GI, GU).

38
Q

Name two other drugs that interact with Heparin?

A

Asprin (ASA), NSAIDs

39
Q

What two ways can Heparin be administered?

A

Subcutaneously, Intravenously

40
Q

Where on the body do you administer Heparin?

A

The left or right side of the abdomen

At least 5 cm (2 inches) away from the umbilicus

41
Q

Should you expell the “air bubble” from the pre-filled Heparin syringe?

A

Naw.

42
Q

What is an advantage of IM injections?

A

Rich blood supply - faster adsorption

43
Q

What is the ideal volume for IM injections?

In children?

A

Adult = 2mL
Child = 1 mL, unless the child is a fatty (“larger”), then they can endure 2 mL

If you’re using my cue cards and offended, I’m sorry. I’m not really like this, I’m just bored of making cards.

44
Q

What s the Z-track Method?

What’s it’s purpose? Explain the procedure.

A

Technique for pulling the skin during an IM injection.

It prevents leakage of medication into subcutaneous tissue and minimizes irritation.

Procedure: Pull skin and subcut tissues 2.5-2.5 cm laterally to the side. Use the ulnar side of the non-dominant hand. Hold until you have administered. Release skin after withdrawing needle.

45
Q

What should you consider when selecting an injection site?

A

Location of underlying structure (bones, nerves, blood vessels).
Free of pain, infection, bruising, and abrasions?

Section 1 242 (8 decks)

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