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IM2 > Parenteral Med Admin > Flashcards

Parenteral Med Admin Flashcards

1
Q

What equipment is needed for parental admin

A

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

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2
Q

What kind of medication vials can we use

A

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

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3
Q

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

A

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

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4
Q

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

A

Long enough

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5
Q

Why should we care about the needle being long enough

A

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

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6
Q

How far does a dermis (id) injection go

A

1/2” to 5/8”

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7
Q

How far do we inject a subcutaneous (SQ) anticoagulants

A

3/8” to 5/8”

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8
Q

How far do we inject subcutaneous (SQ) insulin

A

1/2” to 5/16”

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9
Q

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

A

1” to 1 1/2” most common in adults

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10
Q

What can smaller gauge needles inject best

A

Thin solutions

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11
Q

What can larger gauge needles best inject

A

Thicker solutions

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12
Q

What is the filter needle

A

Small filter in hub that catches debris

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13
Q

What should we always use filter needles with

A

Ampules

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14
Q

What is a blunt fill needle used with

A

Used with vials

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15
Q

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

A

Because it will hurt them

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16
Q

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

A

The one-hand technique

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17
Q

What is the most common syringe used to deliver the medication

A

3ml syringe

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18
Q

What is our first check when giving meds

A

Looking at the dr ‘s order for the meds

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19
Q

What is our second check when giving meds

A

Verifying against the eMAR

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20
Q

Where is our third check when giving meds

A

At the bed side w/ the pt

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21
Q

What do we do in the med room to prepare medications

A

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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22
Q

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

A

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

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23
Q

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

A

It is called charging

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24
Q

Why should we withdraw the entire amount out of the vial

A

They cannot be used again

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25
Q

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

A

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

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26
Q

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

A

They must be compatible with each other

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27
Q

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

A

Make sure needle is below fluid level
Withdraw meds slowly

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28
Q

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

A

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

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29
Q

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

A

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

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30
Q

Are ampules single or multi-dose meds

A

Single-dose always

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31
Q

What do we need for an ampule med admin

A

A needle syringe and filter needle

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32
Q

When we withdraw from an ampule what do we do first

A

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

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33
Q

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

A

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

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34
Q

What do we do after breaking the ampule

A

Withdraw all medication and dispose of excess
Connect correct needle

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35
Q

Do reconstituted meds volume always equal the amount of diluent

A

They do not because the med itself has volume

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36
Q

What technique should be used when withdrawing diluent

A

Sterile technique

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37
Q

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

A

Use a blunt-fill needle

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38
Q

How do we get the solute and diluent to combine

A

Mix it well

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39
Q

What do redo after mixing the reconstituted med

A

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

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40
Q

What should we compare the meds to in the pts room

A

Compare them to the eMAR

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41
Q

What should we always address after scanning medications

A

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

42
Q

What should we do prior to administering the injection

A

Select the proper site and landmark, visualize, and palpate

43
Q

What should we always consider before giving an injection

A

Med
Age
Muscle/tissue mass
Last injection site

44
Q

How do we clean the injection site

A

Start in the center and work our way out

45
Q

What do we verify with the needle and volume

A

Verify integrity

46
Q

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

A

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

47
Q

What should we discharge immediately after the injection

A

The safely mechanism

48
Q

What should we base IM injections on

A

Med
Volume
Injection site
Pt

49
Q

What three muscles can we select to do an IM injection

A

Deltoid
Ventrogluteal
Vastuslateralis

50
Q

How do we choose where to do an IM injection

A

We choose based on which muscle can accommodate the med

51
Q

What should we visualize and palpate for before giving the injection

A

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

52
Q

What should we avoid for IM injections

A

Scars
Irritations
Bruises
Lesions in muscle

53
Q

What rate should we use for an IM injection

A

1mL/10 sec

54
Q

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

A

3-5 secs

55
Q

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

A

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

56
Q

Why do we not rub an injection site post-injection

A

To prevent displacement of med

57
Q

What angle do we inject for IM meds

A

90° angle

58
Q

What is the deltoid muscle used for injections wise

A

For smaller volumes, less irritating meds

59
Q

What are some examples of deltoid injections

A

Vaccines
B-12

60
Q

What is the max volume recommended

A

1mL

61
Q

What is the recommended needle length for deltoid injections

A

1”

62
Q

How to we landmark the deltoid site

A

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

63
Q

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

A

Ventrogluteal

64
Q

Why is the ventrogluteal the first choice

A

It is the most dense to accommodate the meds

65
Q

What injectable meds is the vastus lateralis is used for

A

Thicker, painful, or irritating meds (deep IM)

66
Q

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

A

3 ml syringe

67
Q

What is the recommended needle length for deep IM injections

A

1”- 1 1/2”

68
Q

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

A

We have to aspirate for blood return

69
Q

How should we position the pt for a deep IM injection

A

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

70
Q

What is the Z-track method

A

It is pulling the shin back to better give an injection

71
Q

Do we z-track for deep IM injections

A

Yes

72
Q

How do we inject with deep IM injections

A

Inject @90°
Aspirate 3-5 secs

73
Q

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

A

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

74
Q

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

A

We du not inject and startover

75
Q

What rate do we inject for deep IM injections

A

1mL per 10 secs

76
Q

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

A

Wait 3-5 secs then withdraw needle

77
Q

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

A

Release the z-track

78
Q

What do we inject sub-q

A

Insulin and anticoagulants

79
Q

Do insulin injections have their own needles

A

Yes

80
Q

What needle do we use for anticoagulant injections

A

3/8” - 5-8”

81
Q

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

A

Bunch it for more than 2”

82
Q

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

A

Inject it at a 45° angle

83
Q

What type of vials do we use for insulin

A

Multi-dose vials

84
Q

What 3 types of insulin do we have

A

Short acting
Intermediate acting
Long acting

85
Q

What should we verify before administering insulin

A

Blood sugar/levels

86
Q

Why should we give insulin first to our pt

A

Because it be comes less potent over time

87
Q

How should we mix insulin

A

Gently rotate it in palms

88
Q

Why do we not Shake insuin

A

Can destroy properties to create air bubbles

89
Q

Where do we administer sub-q injections

A

In fatty areas of arms, abdomen, back, thighs

90
Q

What areas should we avoid when giving sub-q injections

A

Bruising
lipodystrophy
Linea alba
Umbilicus

91
Q

How do we administer insulin

A

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

92
Q

Where do we give enoxaparin

A

In the abdomen / love handles

93
Q

Do we bunch for the entire enoxaparin injection

A

Yes

94
Q

What angle do we inject for enoxaparin

A

90°

95
Q

Do we aspirate or expel the nitrogen bubble in enoxaparin injections

A

No

96
Q

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

A

This seals the med deep within the sub-q tissue

97
Q

How long do we wait before withdrawing the needle

A

3-5 secs then withdraw at 90°

98
Q

What should the site be free of when doing intradermal injections

A

Tattoos
Blemishes
Hair
Scarring
Bruises

99
Q

What angle do we do intradermal injections

A

5 -15°

100
Q

Which way should the bevel face for intradermal injections

A

Face up

101
Q

Why should the level face up for intradermal injections

A

Because you will barely push it under the skin

102
Q

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

A

Should see a bleb or wheal

IM2 (17 decks)

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