Parenteral Med Admin Flashcards by Katelyn Kelley

What equipment is needed for parental admin

Gloves
meds
alcohol swabs
appropriate syringes: needle to withdraw and needle to inject
Med labels
Clean med drawer

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What kind of medication vials can we use

Single/multidose
Plastic or glass (clear or dark)
Liquid or powder med

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What should we do before giving a pt a med from a vial

Clean top before use
Check expiration
Always date and initial multi-dose vial

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What should the needle be to reach the targeted tissue ofthe pt respective to age, wt, and muscle/tissue mass

Long enough

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Why should we care about the needle being long enough

Because we want the medication to reach the correct tissue and be correctly absorbed

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How far does a dermis (id) injection go

1/2” to 5/8”

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How far do we inject a subcutaneous (SQ) anticoagulants

3/8” to 5/8”

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How far do we inject subcutaneous (SQ) insulin

1/2” to 5/16”

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How far do we inject meds into the muscle (IM)

1” to 1 1/2” most common in adults

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What can smaller gauge needles inject best

Thin solutions

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What can larger gauge needles best inject

Thicker solutions

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What is the filter needle

Small filter in hub that catches debris

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What should we always use filter needles with

Ampules

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What is a blunt fill needle used with

Used with vials

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Why should we not use a blunt fill needle on a pt

Because it will hurt them

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If you choose to recap a blunt fill needle or filter needle what technique should you use

The one-hand technique

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What is the most common syringe used to deliver the medication

3ml syringe

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What is our first check when giving meds

Looking at the dr ‘s order for the meds

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What is our second check when giving meds

Verifying against the eMAR

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Where is our third check when giving meds

At the bed side w/ the pt

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What do we do in the med room to prepare medications

Don gloves
Select appropriate syringe and needle - based on placement, injection site, volume, & med
Table syringe witha blue label which includes initials date and time

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What is our first step when preparing to withdraw a single dose vial med

After cleaning top for 15 secs or more, inject air equal to amount of meds to be withdrawn

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What is it called when we inject air equal to amount of med to be withdrawn

It is called charging

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Why should we withdraw the entire amount out of the vial

They cannot be used again

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How do we deliver the exact amount of medication when we are using a one use vial

We will draw up the meds that we need to get and then we need to waste the medication so no one abuses it

What do meds have to be in order to draw up two and administer them together

They must be compatible with each other

What should redo it we have air bubbles when drawing meds up

Make sure needle is below fluid level Withdraw meds slowly

What should we do when we have air bubbles when drawing up a single dose vial

Withdraw entire volume of med needed - expect air to follow this Expel the air and medication, if more than required is in the syringe, to ensure the exact dose

What should we do if we have air bubbles with multi-dose vials

Withdraw more med than what is needed, leave the needle in vial, then push med back Into the vial via plunger to exact dose If there are still bubbles then gently thump syringe

Are ampules single or multi-dose meds

Single-dose always

What do we need for an ampule med admin

A needle syringe and filter needle

When we withdraw from an ampule what do we do first

Tap the top of the ampule to dislodge any med from the neck

What do we do after taping the ampule and making sure all medication will be given

Place a barrier on top of the ampule and break away from you

What do we do after breaking the ampule

Withdraw all medication and dispose of excess Connect correct needle

Do reconstituted meds volume always equal the amount of diluent

They do not because the med itself has volume

What technique should be used when withdrawing diluent

Sterile technique

What do we use to add the diluent to the solute med

Use a blunt-fill needle

How do we get the solute and diluent to combine

Mix it well

What do redo after mixing the reconstituted med

Pull off the blunt fill needle and place the needle that will be used for injection

What should we compare the meds to in the pts room

Compare them to the eMAR

What should we always address after scanning medications

Adress the Pop ups on the computer to acknowledge that we gave the med

What should we do prior to administering the injection

Select the proper site and landmark, visualize, and palpate

What should we always consider before giving an injection

Med Age Muscle/tissue mass Last injection site

How do we clean the injection site

Start in the center and work our way out

What do we verify with the needle and volume

Verify integrity

what angle should we pull the needle out of the skin after giving the injection

Pull out the same way you pur it in to avoid skin/tissue damage

What should we discharge immediately after the injection

The safely mechanism

What should we base IM injections on

Med Volume Injection site Pt

What three muscles can we select to do an IM injection

Deltoid Ventrogluteal Vastuslateralis

How do we choose where to do an IM injection

We choose based on which muscle can accommodate the med

What should we visualize and palpate for before giving the injection

A "belly" of well-developed and relaxed muscle (this sister deepest/densest part)

What should we avoid for IM injections

Scars Irritations Bruises Lesions in muscle

What rate should we use for an IM injection

1mL/10 sec

How many seconds should we wait before removing the needle for IM injections

3-5 secs

Why do we wait 3-5 secs before removing the needle for IM injections

Allows muscle tissue time for it to expand to accommodate med (1mL/10 sec) and then 3-5 secs to make sure the med stays

Why do we not rub an injection site post-injection

To prevent displacement of med

What angle do we inject for IM meds

90° angle

What is the deltoid muscle used for injections wise

For smaller volumes, less irritating meds

What are some examples of deltoid injections

Vaccines B-12

What is the max volume recommended

1mL

What is the recommended needle length for deltoid injections

How to we landmark the deltoid site

Find acromion process, 2-3 fingers down, feel for densest part of muscle

For leg IM injections which one do we use first (ventrogluteal or vastus lateralis)

Ventrogluteal

Why is the ventrogluteal the first choice

It is the most dense to accommodate the meds

What injectable meds is the vastus lateralis is used for

Thicker, painful, or irritating meds (deep IM)

What is the maximum volume recommended for ventrogluteal and vastus lateralis injections

3 ml syringe

What is the recommended needle length for deep IM injections

1”- 1 1/2"

Why is 3ml the recommended syringe size for deep IM injections

We have to aspirate for blood return

How should we position the pt for a deep IM injection

Have the hip up for the injection Opposite leg is straight Bend the leg and hip the injection will be given

What is the Z-track method

It is pulling the shin back to better give an injection

Do we z-track for deep IM injections

Yes

How do we inject with deep IM injections

Inject @90° Aspirate 3-5 secs

Why do we aspirate for 3-5 secs after inserting the needle for deep IM injections

We need to make sure we are not in a vein or artery

What happens it we see blood return when we aspirate deep IM injections

We du not inject and startover

What rate do we inject for deep IM injections

1mL per 10 secs

How long do we wait to pullout the needle for deep IM injections

Wait 3-5 secs then withdraw needle

What do we do after withdrawing the needle from deep IM injections

Release the z-track

What do we inject sub-q

Insulin and anticoagulants

Do insulin injections have their own needles

Yes

What needle do we use for anticoagulant injections

3/8" - 5-8”

What should we do with the skin if we are injecting a sub-q med @ a 90° angle

Bunch it for more than 2”

How do we inject a sub-q med if we cannot bunch the skin more than 2 inches

Inject it at a 45° angle

What type of vials do we use for insulin

Multi-dose vials

What 3 types of insulin do we have

Short acting Intermediate acting Long acting

What should we verify before administering insulin

Blood sugar/levels

Why should we give insulin first to our pt

Because it be comes less potent over time

How should we mix insulin

Gently rotate it in palms

Why do we not Shake insuin

Can destroy properties to create air bubbles

Where do we administer sub-q injections

In fatty areas of arms, abdomen, back, thighs

What areas should we avoid when giving sub-q injections

Bruising lipodystrophy Linea alba Umbilicus

How do we administer insulin

Bunch skin Inject @90° Release the bunch Wait 3-5 secs and withdraw needle

Where do we give enoxaparin

In the abdomen / love handles

Do we bunch for the entire enoxaparin injection

Yes

What angle do we inject for enoxaparin

90°

Do we aspirate or expel the nitrogen bubble in enoxaparin injections

Why do we not aspirate/expel the nitrogen bubble for sub-q injections

This seals the med deep within the sub-q tissue

How long do we wait before withdrawing the needle

3-5 secs then withdraw at 90°

What should the site be free of when doing intradermal injections

Tattoos Blemishes Hair Scarring Bruises

What angle do we do intradermal injections

5 -15°

Which way should the bevel face for intradermal injections

Face up

Why should the level face up for intradermal injections

Because you will barely push it under the skin

What should we see after injecting the solution for an intradermal injection

Should see a bleb or wheal