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Anesthesia > Parenteral Conscious Sedation I > Flashcards

Parenteral Conscious Sedation I Flashcards

1
Q

Administered and absorbed through the GI tract.

A

Enteral

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2
Q

Bypasses the GI tract.

A

Parenteral

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3
Q

Enteral routes.

A

Oral, rectal, and sublingual

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4
Q

Parenteral routes.

A 
IV
IM
Intranasal
Submucosal
Subcutaneous
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5
Q

When to use intramuscular route.

A
  • If pt can’t take oral meds.
  • No veins are accessible.
  • Uncooperative patients.
  • Mentally ill patients.
  • To administer adjunctive or emergency meds.
  • Preoperative sedation for minor procedures not requiring general anesthesia.
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6
Q

How to identify landmarks for IM administration.

A

PALPATION

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7
Q

Avoid injection here for IM.

A

Deep subcutaneous tissue.

Want the belly of the muscle.

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8
Q

How to hold the syringe for IM.

A

Like a dart (index finger and thumb).

Make sure you aspirate.

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9
Q

Onset and presictability of IM route.

A

Greater than oral meds, but less than IV administration.

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10
Q

Adv of IM

A
  • Cannot be lost from vomiting.

- Avoids GI tract, first pass hepatic metabolism, and good in stomach.

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11
Q

Can IM be titrated?

A

NO!

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12
Q

Can IM be easily reversed?

A

No

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13
Q

IM injection sites.

A

1) Gluteus Maximus
2) Ventrogluteal area
3) Deltoid
4) Vastus lateralis

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14
Q

Patient position for gluteus maximus injection.

A

Lying prone because the muscle is not relaxed while standing.

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15
Q

Injection site for gluteus maximus.

A

Upper outer quadrant

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16
Q

What do you avoid hitting when in the upper outer quadrant.

A

Sciatic nerve and superior gluteal artery.

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17
Q

Located in lower inner quadrant.

A

Sciatic nerve

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18
Q

Located in upper inner quadrant.

A

Sacral plexus

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19
Q

Located in lower outer quadrant.

A

Femur

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20
Q

This IM injection site is contraindicated in infants, bc paralytic complications may not be recognized until walking begins.

A

Gluteus Maximus

Ventrogluteal area

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21
Q

This IM injection is farthest from all major nerves and vessels.

A

Ventrogluteal area

22
Q

The advantage of this injection site is that it can be used in any position.

A

Ventrogluteal area

23
Q

3 bony landmarks for ventrogluteal area

A

1) Anterior superior iliac spine
2) Iliac crest
3) Greater trochanter of the femur

24
Q

Where to give the deltoid injection and why.

A

Between the upper and lower portions of the deltoid to avoid the radial nerve.

25
Q

Avoid this nerve in the deltoid injection.

A

Radial nerve

26
Q

Muscle injection that cane be given from one hand width below the greater trochanter, to one hand width above the knee.

A

Vastus lateralis.

27
Q

This injection is given prone or supine.

A

Vastus lateralis

Ventral gluteal

28
Q

No important nerves or vessels in this IM site.

A

Vastus Lateralis

29
Q

This lower body injection is good for kids and infants.

A

Vastus lateralis

30
Q

Complications of IM Technique

A
  • Local tissue injury
  • Injury to major nerves
  • Intravascular injection
  • Hematoma
  • Broken needles (don’t insert to hub).
  • Infection/abscess
31
Q

Avoid this type of injection in an anticoagulated patient.

A

Intramuscular

32
Q

Uses for the intravenous route of administration.

A

1) Conscious sedation, deep sedation for minor to moderate invasive surgical or diagnostic procedures.
2) To administer adjunctive meds (antibiotics, corticosteroids), or emergency meds.
3) Pre-medication prior to general anesthesia

33
Q

Intravenous solutions.

A

1) Normal saline (0.9%)
2) 1/2 normal saline (0.45%)
3) Lactated Ringer’s Sol’n

34
Q

Components of saline solution

A

Na+

Cl-

Dextrose additive

35
Q

Components of Lactates Ringer’s solution

A

K+

Ca 2+

Dextrose additive

36
Q

The puncture of a vein to draw blood or administer an IV.

A

Venipuncture

37
Q

Locations of a venipuncture.

A

Dorsal hand

Antecubital fossa

38
Q

“Elbow” in Lain

A

Cubitus

39
Q

Elbow pit where venipuncture is done.

A

Antecubital fossa.

40
Q

A device to stop the flow of blood through a vein or artery, typically by compressing a limb with a cord or bandage.

A

Tourniquet

41
Q

Technique for IV

A
  • Apply tourniquet
  • Cleanse skin with antiseptic
  • Stabilize the vein distally
  • Puncture the skin at about 30 degrees with the needle bevel UP in adults.
  • Decrease the angle to enter the vein, and verify VENOUS entry.
  • Insert catheter over the needle, and cannulate the vein.
  • Remove the tourniquet.
  • Attach IV line, verify VENOUS entry.
  • Start flow of solution.
  • Secure with tape.
42
Q

Arm-brain circulation time with an IV.

A

20-25 SECONDS

43
Q

Can IV’s be titrated?

A

YES!

44
Q

It’s easier to determine the dose for this parenteral technique.

A

IV

45
Q

This parenteral technique has a shorter recovery time than with IM techniques.

A

IV.

46
Q

Potential for this in IV administration.

A

Bloodborne pathogen exposure.

47
Q

These patients must be NPO for this parenteral technique.

A

IV

This is why you can’t eat before getting blood taken (done by IV).

48
Q

Associated with which parenteral route?

  • Potential systemic complications are immediate.
  • Happen fast and are more difficult to treat.
A

IV

49
Q

Inflammation of the walls of a vein.

A

Phlebitis

50
Q

Potential local IV complications:

A
  • Chronic pain
  • Hematoma
  • Phlebitis
    Thrombophlebitis
  • Phlebothrombosis
  • Burning on drug injection.
  • Extravasation, infiltration, skin injury.
  • Intra-arterial injection

Anesthesia (11 decks)

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