Parenteral Injection Flashcards
Equipment for Parenteral injections (8)
- Exam Gloves
- Medication
- Alcohol Swabs
- Appropriate Syringes
- Needle to withdraw
- Needle to Inject
- Medication Labels
- Clean medication drawer
How long do you clean the top of the medication vial
15 secs
What must be done after using a Multi-dose vial?
Date, initial, and leave in the med room
What do you assess for to decide on which needle length to use? (3)
- Age
- Weight
- Muscle/Tissue mass
What is the needle length for Dermis (ID) injections
1/2” to 5/8”
What is the needle length for Subcut (SQ) anticoagulants?
3/8” to 5/8”
What is the needle length for Subcut (SQ) insulin ?
1/2”- 5/16”
What is the needle length for Muscle (IM) injections?
1”-1 1/2”
Which gauges do you use for thinner solutions
Smaller gauges (27-20g)
Which gauge needles do you use for thicker solutions?
Larger needles (21-18g)
What type of needle do you use for ampules
Always use a filter needle
Never use what types of needle use on a patient? (2)
Filter needles and blunt fill needles
Are blunt/filter needles allowed in patient rooms
Only with blood withdrawal
Do you take the vial of insulin into a patient to scan?
No, Insulin is a multi-dose vial
If you combine two medications, the medications must be?
Compatible
Steps to preparing an injection (single dose vial) (6)
- Clean the top of the vial for 15 seconds with alcohol pad
- inject air equal to amount of medication to be withdrawn
- Withdraw the entire amount from the vial by inverting vial
4 Prepare to deliver the exact amount of medication by wasting excess - Remove BF needle & attach sterile needle
- Label syringe with blue label
Steps for withdrawing from an ampule (6)
- Apply gloves, prepare syringe, & attach filter needle
- Hold the ampule upright and tap the top to dislodge the medication from neck
- Place barrier around neck and break away from you
- Withdraw all medication- dispose of excess medication
- Connect correct needle
- Place glass ampule and syringe/needles in sharps container
What are the three sites for IM injections
Deltoid, Ventrogluteal, vastuslateralis
what spots on the muscle should you avoid for injections (4)
-Scars
- Irritations
- Bruises
-Lesions
What is the rate of the injection
1 mL/ 10 secs
How long should you wait before removing the injection needle
3-5 seconds
Why should you not rub or massage the injection site?
Medication migration
what is the angle of injection (IM)
what is the angle of remove (IM)
90 degrees
90 degrees
Deltoid
Max Volume recommended?
Recommended Needle Length?
1 mL
1”
Ventrogluteal/ Vastus Lateralis
Maxium Volume Recommended?
Recommended Needle Length?
3 mL
1”-1 1/2”
What must you do when administrating Leg IM injections
Always aspirate No Blood Return
When can you inset SQ injections at 45 degrees
When you can bunch the skin
What type of Insulin in Glargine?
Long acting
What type of insulin in detemir
Long acting
What type of insulin in NPH
Intermiediate
What type of insulin in Lispro
Rapid
What type of insulin is aspart
Rapid
What type of insulin is glulisine
Rapid
What type of insulin is Admelog
Rapid
What must you do before giving insulin
Know the Glucose level
Always administer insulin when
First
Always prepare insulin
Last
Where do you administrator insulin? (4)
Fatty areas of the arms, abdomen, back, or thighs
Separate injection site by 1”
Avoid areas of brusing or Lipodystrophy
Avoid the linea alba and umbilicus
What are the steps to administrator insulin (4)
- Bunch the selected site
- Inject at a 90 degree (to the hub) and release bunch
- Wait 3-5 seconds and withdraw at same angle
4.Engage safety device and place in sharps box
Enoxaparin injections steps
- Select site, cleanse with alcohol and let dry
2.bunch during entire injection - inject at 90 degree into love handle to hub
- Do not aspirate or expel nitrogen bubble
- Waite 3-5 secons & withdraw at same angle
- Engage safety device and place in sharps box
Steps to intradermal injections
- Select site ( free of tattoos, blemishes, hair, scarring, bruises)
- cleanse area
- Stretch middle 1/3 middle of forearm tight
- inject at 5-15 degree angle until bevel needle barely disappears under skin
- Inject and ensure a bleb or wheal
- Withdraw and release skin
Steps to mix 2 medications (5)
- Charge Vial A
- Charge Vial B
- Invert vial B and withdraw med
- Invert Vial A and withdraw med
- Change needle
Requirement of orders (5)
- Patient name
- Drug name
- Proper dose
- Frequency
- Route
What is the maxium amount of volume for subq
1 mL
What does enoxaparin to patients
To prevent blood clots
