Parenteral Injection Flashcards
What are the different classifications of med vials?
- Single or multidose
- Plastic or glass
- Liquid or powder
- Sealed top and rubber injection port
What must you always check on med vials?
Expiration date
What do you do after using a multi dose vial?
Date and initial it
What is a gauge?
The diameter of needle
When choosing a needle, what must you ensure that it can reach?
The targeted tissue
Needle size for Dermis (ID) Injection
0.5” to 5/8”
Needle size for SQ anticoagulants and insulin
Anti: 2/8” to 5/8”
Insulin: 1/2” to 5/16”
Needle size for IM injection
1” to 1.5”
Which needle type/size is most common for adults?
IM (1” to 1.5”)
What gauges of needle is considered small and which ones are large?
Small: 27g - 20g
Large: 21g - 18g
What types of needles are used for ONLY withdrawing needles?
Filter and Blunt filled needles
Why are filter needles called that and what should you always use these with?
- There’s a small filter in them to catch any debris
- Ampules, it is best practice
What should you use blunt filled needles with?
Vials (Rubber stopper)
For withdrawing meds, if there are no Blunt filled needles, what should you use?
Filter needle, or smallest possible needle
After withdrawing medications, what should you do?
Throw away the needle and replace with a new and sterile injection needle
When throwing away a blunt/filtered needle used for med withdrawal, what can you do and how do you do this?
- You CAN recap if you want
- IF you do ALWAYS use only one hand
What types of needles are not allowed in a pt’s room except for certain scenarios?
- Blunt/Filter
- ONLY when used for blood specimens
How do you decide which syringe you use?
Use smaller possible needle needed to administer med
How can you keep syringe’s sterility?
Never place it down
What is the first check of med preparation?
Acknowledge HCP orders
What is the second check of med prep?
Take med from Pyxis and verify against eMAR screen
What must you check on the meds?
Expiration date and package integrity
How do you clean the med injection port?
Use an alcohol swab for 15 seconds
What must you do for Multi-Dose vials?
Date and initial them
What is the third checkoff med admin?
Verify/scan the vial/ampule at the bedside
5 steps of preparing single dose vial meds?
- Selects proper syringe and BF needle
- Clean the top if vial and then inject air equal to amount of meds needed to be withdrawn (“Charge” the vial)
- Withdraw the entire amount from the vial
- Prepare the exact amount of med
- Remove the BF needle and attach the appropriate sterile needle
Can you mix 2 meds in one syringe?
Yes as long as theyre compatible
If getting meds from a vial and an ampule, which one do you get first?
Vial and then the ampule
How many uses are ampule meds?
Single
Ampiles have ___ necks
scored
For ampules, blunt or filter needles? and why?
Filter, to avoid glass shards
How do you take meds from an ampule? 4 steps
- Hold the ampule upright and tap the top to dislodge med
- Place a barrier around the neck and break away from you
- Withdraw all medication
- Place everything in the sharps box
What’s a med reconstitution
A med that must be made with a fluid/diluent
What is the med’s concentrated form?
Solute: The powder crystals or liquid
Reconstitution
Adding a diluent to a solute to make a specific concentration of a liquid injectable
How long do meds keep their potency after reconstituted>
Not long, administer them soon
What are the 2 typical diluents?
NS or sterile water
3 possible muscles for IM injections?
- Deltoid
- Ventrogluteal
- Vastus Lateralis
What should you avoid when giving IM injections?
- Scars
- Irritations
- Bruises
- Lesions
What should you assess just before giving an injections?
Needle and volume
For IM injection, what rate should med be administered?
1mL/10 sec
For IM injections, how long do you wait before removing the needle?
3-5 secs
Why cannot you not rub an injection site just after?
Cause it’ll misplace the med
Angle for IM injection
90 degrees
Max recommended med for Deltoid injection?
1 mL
Largest needle size for deltoid injection?
1”
Which muscle is recommended for thicker and more painful IM meds?
Ventrogluteal first and then Vastus Lateralis 2nd
Max volume recommended for abd and thigh IM injection?
3mL
Largest needle size for abd and leg IM injection?
1” to 1 1/2”
Recommended syringe for IM abd and leg IM injections?
3mL
Why’ doe we do the Z track method?
it moves the muscle so that the muscle can get trapped
What needle and syringe do you use for insulin?
The ones they come with :)
Insulin is injected in ____ tissue?
SubQ
What is the SQ main site location?
Abdomen
Recommended needle for Anticoagulant SQ meds?
3/8” to 5/8”
Max volume of injectable SQ med?
1.5 mL
Angle for SQ injections?
45 degrees unless you can bunch up the skin, then you can do 90 degrees
what do you do FIRST when going to inject insulin?
Confirm BS
How is insulin measured?
units
How fast do you have to inject insulin after prepping it?
Minutes
Why cannot you not shake insulin needles?
It may create air bubbles
Where is insulin absorbed the fastest?
the abdomen
How far should insulin injections be from each other?
1”
How far should you inject from the lines alba and umbilicus
at least 2”
Angle for insertion of insulin/
90 degrees
SQ injection site?
Abdomen
How do you position pt’s for SQ injections?
Reclining/Supine
What’s the region for SQ injection?
“Love Handles”
Angle for deep SQ injection?
90 degrees
Where do you administer intradermal (ID) injections?
Middle 1/3 of forearm
Angle for ID injections
5 to 15 degrees, only go until bevel enters
What matters about ID injections that normally does not about others?
Bevel direction, it must be facing up
Fastest to slowest injection rates of absorption
- IV
- IM
- SQ
- ID
