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Nursing 242 Parenterals > Parenteral Injections > Flashcards

Parenteral Injections Flashcards

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1
Q

Is subcutaneous or IM injection absorbed faster?

A

IM injection

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2
Q

With what injection do you aspirate before giving the medication?

A

IM injection (but not vaccines)

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3
Q

What angle do you put the needle in for subcutaneous?

A

45 or 90 degree angle depending on the patient

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4
Q

What sites would you be able to insert over 2 mL of medications to subcutaneously?

A

Abdomen, outer thigh..

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5
Q

When inserting SubQ injection to outer upper arm, what is the maximum amount of med to give?

A

2 mL

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6
Q

What is the subQ injection inserting the medication to?

A

Loose connective tissue underlying the dermis (not as many BV as muscle, therefore it absorbs more slowly)

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7
Q

Where is an IM injection inserting medication to?

A

Body of a muscle

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8
Q

When would you use the “Z tract technique” when inserting medication?

A

When inserting medication to the muscle
Pull skin 1 1/2 inch over, insert med, hold for 10 seconds, let skin move back.
Z tract prevents leakage of medication, and locks medication in.

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9
Q

What size needle would you use for a IM in an adult?

A

1 - 1 1/2 inches (site depending..)

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10
Q

When inserting a medication to IM, what are you trying to avoid?

A

Nerves and major BV

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11
Q

Where to insert IM med to infant?

A

Vastuslateralis

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12
Q

What is the maximum dose to administer IM to deltoid?

A

2 mL

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13
Q

Why do you not administer meds to infants in deltoid?

A

Not well developed muscle

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14
Q

How do you landmark the deltoid?

A

3 finger length from acromion proccess

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15
Q

At what age would you start injecting vaccines to the deltoid?

A

18 months +

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16
Q

Is drug absorption rapid in the muscle?

A

Yes.

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17
Q

When would ID injections be used?

A

Testing for allergies and TB

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18
Q

What do you expect to see when giving ID injection?

A

Bleb appear. 6 mm or 1/2 an inch.

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19
Q

What angle would you insert for ID?

A

5 - 15 degrees

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20
Q

What angle would you insert needle for subQ for obese pt.?

A

90 degrees.

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21
Q

Maximum amount of medication to give ID?

A

0.01-0.1 mL

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22
Q

What way should the bevel face when inserted into the skin?

A

Bevel up!

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23
Q

To minimize pt. discomfort, what would you do?

A

Use sharp needles in the shortest length and gauge possible

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24
Q

If you insert a needle at 45 degrees, at what angle would you then take the needle out at?

A

45 degrees

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25
Q

What is the range for capacity in a syringe?

A

0.5 - 60 mL

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26
Q

Are syringes ever reused?

A

Heck no.

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27
Q

Needles contain three parts. What are they?

A

The hub (fits into the syringe) the shaft (connects to the hub) the bevel creates a narrow slit that closes after needle is removed)

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28
Q

When is a filter needle used?

A

When preparing medication from an ampule.

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29
Q

Needles vary in what lengths?

A

3/8 of an inch to 3 inches

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30
Q

A gauge that is 25 is thiner or thicker than a gauge that is 27?

A

Thicker.

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31
Q

What size needle used for subQ?

A

5/8 inch to 1/2 an inch (normally, unless patient has lots of adipose, then may use 1 inch)

32
Q

Viscous meds require a larger or smaller gauge?

A

Larger.

33
Q

Ampules are single use or reusable?

A

single use.

34
Q

How do you mix meds in a vial?

A

Roll in your palms

35
Q

T or F: Vials only contain liquid meds.

A

F. Vials can also contain dry meds

36
Q

What is the first step of preparing a medication from a vial?

A

Put the amount of air equal to the amount of med you will be taking from the vial, into the vial.

37
Q

What should you do if you can see air bubbles in the syringe?

A

Tap with a pen. Make sure all air bubbles are gone before inserting med.

38
Q

What would be the factors in selecting a needle length for subQ injection

A

pt.s weight / estimate of subQ tissue

39
Q

When injecting low molecular weight heparin, how far must you stay away from the umbilicus?

A

2 inches away.

40
Q

What are you palpating for before administering a subQ?

A

Hardness and tenderness

41
Q

What are you assessing for 30 minutes post med admit?

A

pain, numbness, burning, tingling

42
Q

Can subQ injections be done at home?

A

After proper teaching, yes.

43
Q

Maximum pediatrics subQ injection ?

A

0.5 mL

44
Q

When mixing meds from vial and ampule, which med would you prepare first?

A

The vial.

45
Q

Maximum IM injection for:
Adult:
Kids 6 - 12:
0 - 6 years:

A

Adult: 5 mL
Kids 6 - 12: 2 mL
0-6: 1 mL

46
Q

Doses less than one mL, round to what?

A

The nearest hundredth.

47
Q

giving 0.7 mL of a med, what size syringe would you use?

A

1 mL

48
Q

When giving medications over 1 mL, round to what?

A

Nearest tenth.

49
Q

Insulin is measured in what form?

A

Units.

50
Q

What is the most commonly used diluents for reconstituting medications?

A

0.9% NaCl (normal saline) and water

51
Q

What would you label on a multi dose vial that has been reconstituted?

A 
Date / Time of prep
Strength or concentration of volume
Potency expiration
Recommended storage
Your initials
Example of insturctions
52
Q

When the nurse would select the strength of the reconstitution… what would they be deciding this on?

A

Depends on the patients dose.

53
Q

When reconstituting medications.. if you add less solvent the final solution will be more or less concentrated?

A

More concentrated.

54
Q

D X Q = X means what?

When reconstituting medications

A

The desired solution strength multiplied by the quantity of the desired solution = amount of the solute

55
Q

SubQ butterfly should be changed how often?

A

Once a week

56
Q

When priming a subQ butterfly using Maxzero, what do you prime it with?

A

Additional 0.4 mL to the dose of the med

57
Q

When priming SubQ butterfly using clearlink, prime it with what?

A

Additional 0.28 mL to the dose of the med

58
Q

Insulin is classified on what?

A

Rate of action: Short, moderate, and long

59
Q

T or F: a subQ butterfly can have meds of various concentrations?

A

F. Different concentrations and different meds require different subQ butterfly.

60
Q

What are you assessing the site of a subQ butterfly for?

A

Irritation, swelling, redness

61
Q

What site is preferred IM injection site for adults?

A

Deltoid

62
Q

How do you landmark the vasutslateralis?

A

One hand from above knee, one hand below hip. Anywhere in the muscle here

63
Q

How would you decrease a patients pain when inserting med to deltoid?

A

Have pt. relax the arm

64
Q

Is inserting a 3 mL med to the deltoid okay?

A

No. No more than 2 mL

65
Q

Ampules are opened how?

A

Breaking the neck off.

66
Q

What angle do you insert a SubQ butterfly at?

A

30 - 45 degree angle

67
Q

When would you aspirate?

A

Before IM, accept for vaccines

68
Q

Where would you document that you inserted a SubQ butterfly?

A

PPN

69
Q

Where is the site for a ID injection?

A

Front and back of forearm

70
Q

Why would you not insert med to atrophied muscle?

A

Med will not absorb well

71
Q

Why would “literature” believe that ventrogluteal = best site for IM injection?

A

Deep, situated far away from BV and major nerves. Easily identifiable by prominent bony landmarks (hand over the greater tronchanter, point index finger towards the superior ilic spine, extend the middle finger back along the iliac crest. V shaped triangle then formed: this is the injection site.

72
Q

What is important when inserting to an IM?

A

The muscle is well developed.

73
Q

The Z tract is helpful in what?

A

Decreasing pain, decreasing leaking, helps to lock the medication in.

74
Q

Why hold an IM needle in the site for 10 seconds after injection?

A

Allows the med to spread evenly.

75
Q

When would you insert a SubQ at 90 degree angle?

A

When the pt. has a lot of subQ tissue

76
Q

Why do we rotate injection sites?

A

To avoid Lypohypotrophy

Nursing 242 Parenterals (1 decks)

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