Parenteral Medication Flashcards
Non-oral administration of medication; introducing a medication into the body with an injection.
Parenteral medication
Medication given in this route is absorbed quickly and are irretrievable once injected.
Parenteral medication
It must be used since injections are highly invasive procedures.
Aseptic technique
It is where the needle is attached.
Tip
Where the calibration is indicated; where the medication will move on as it is aspirated from the vial.
Barrel (Barrel’s Flange)
The one being manipulated to aspirate the medication.
Plunger (Plunger’s Flange)
Parts of the syringe that must be kept sterile:
- Tip
- Inside of the barrel
- Shaft of the plunger
Kinds of Syringes:
- Hypodermic syringe
- Insulin syringe
3.Tuberculin syringe - Syringes of other sizes
- Prefilled syringe
Sizes are by 2 ml, 2.5 ml, 3 ml; has two scales in minim and ml.
Hypodermic syringe
Designed for insulin; needle is fixed and irremovable; common is in 100-unit calibrated scale.
Insulin syringe
In an insulin syringe, the needle used in aspiration and administration is:
the same
Originally designed to administer tuberculin (TB Exposure); can only accommodate 1 cc or ml; narrow, calibrated in tenths and hundredths of an ml; precise measurements or small doses.
Tuberculin syringe
Sizes are in 5 ml, 10 ml, 20 ml ,50 ml; useful for adding medications to intravenous solutions or for irrigating wounds; useful for administering additional
amount of medication.
Syringes of other sizes
Medications are already inside; no need for aspiration but need to attach a needle; sometimes comes with a safety lock or retractable needles.
Prefilled syringe
Variations on the syringe tip:
- Luer lock
- Non-Luer lock (Luer slip)
Tip is threaded; tip requires the needle to be twisted onto it to prevent accidental removal of the needle.
Luer lock
Has smooth graduated tip onto which needles are slipped.
Non-Luer lock (Luer slip)
Made of stainless steel and
mostly disposable.
Needles
Parts of a needle:
- Hub
- Canula/Shaft
- Bevel
Part which fits into the syringe.
Hub
Attached to the hub.
Cannula/Shaft
Slanted part at the tip of the needle; always pointed upward.
Bevel
Three Variable Characteristics of a
Needle used for Injections:
- Slant or Length of the bevel
- Length of shaft
- Gauge (diameter of the shaft)
Sharpest and causes less discomfort; used for IM and SC.
Long bevel
Used for ID and IV injections; prevents occlusion inside.
Short bevel
½ to 2 in.; depends on the client’s muscle development, weight, and type of injection.
Length of the shaft
Varies from gauge #18 to #28; the larger the gauge number, the smaller the diameter.
Gauge (diameter of the shaft)
Gauge for subcutaneous:
24-#26
Gauge for intramuscular:
20-#22
One of the most potentially hazardous procedures; wounds
caused by needles that accidentally
puncture the skin.
Needlestick injury
Preventing Needlestick injury:
- Use appropriate puncture-proof
disposal containers for sharps. - “Scoop method” or “fishhook technique”
Glass containers usually designed to hold a single dose of a drug; made of clear glass and has
a constricted neck.
Ampules
If an ampule is not pre-scored, it should be:
filed with a small file then broken off at the neck
Small glass bottles with a sealed rubber cap; comes in single
dose or multi-dose.
Vials
Adding a solvent to a powdered drug to prepare it for administration.
Reconstitution
Before withdrawing medication from a vial:
swab the rubber cap with a disinfectant from center to out
Routes of administering Parenteral medications:
- Intradermal injections (ID)
- Subcutaneous injections (SC/SQ)
- Intramuscular injections (IM)
Administration of drugs into the dermal layer of the skin just beneath the epidermis.
Intradermal injection (ID)
Indications for intradermal injection:
- Skin testing
- TB screening
- BCG vaccinations
Common sites of intradermal injection:
- Inner lower arm
- Upper chest
- Back beneath the scapula
Several allergens are introduced to the skin; test is positive if the skin shows a reaction; bevel is only inserted; original edges are marked with a pen.
Skin test
Administration of drugs into the subcutaneous layer.
Subcutaneous injection (SC/SQ)
Indications for subcutaneous injection:
- Vaccines
- Pre-operative medications
- Narcotics
- Insulin (no need for massage)
- Heparin (no need for massage to
prevent bruising)
Common sites of subcutaneous injection:
- Outer aspect of the upper arms
- Anterior aspect of the thighs
- Abdomen
- Scapular areas of the upper back
- Upper ventrogluteal site and dorsogluteal site
Advantages of subcutaneous injection:
Drug is almost completely absorbed
from the tissue (30 minutes) thus the amount of drug absorbed is predictable.
Pinch the tissue:
length of the needle is half width of the skin fold
1 in. of tissue can be grasped.
45° angle
2 in. of tissue can be grasped.
90° angle
Rotate injection sites to prevent:
lipodystrophy
Abnormal fat distribution in the body.
Lipodystrophy
Introduction of medication into the muscle tissue.
Intramuscular injection (IM)
Indications for intramuscular injections:
- Rapid absorption of drugs
- Administer greater volume of fluid
- Irritating medications
Size of the needle for IM depends on the following:
- The muscle
- Type of solution
- Amount of adipose tissue covering the muscle
- Age of the client
Common sites for Intramuscular injections:
- Ventrogluteal site
- vastus lateralis
- Dorsogluteal site
- Deltoid site
- Rectus femoris
The gluteus medius muscle which lies over the gluteus minimus.
Ventrogluteal site
How to locate the ventrogluteal site:
- Heel of the thumb – rest on great
trochanter. - Index finger – pointed toward the
anterior superior iliac spine. - Middle finger – pointed towards the iliac crest.
- Site is on the V-zone.
Advantages of the ventrogluteal site:
- Area contains no large nerves and blood vessels.
- Contains less fat than the buttocks area.
- Sealed off by bone.
Position for injecting on the ventrogluteal site:
Back-lying or side-lying with knee and hip flexed to relax gluteal muscle.
Thick and well-developed muscle both in adult and children; lateral aspect of the infant’s thigh
(lateral middle third).
Vastus lateralis
Vastus lateralis is the site of choice for infants in this age:
less than 7 months
Rationale for injecting on the vastus lateralis:
Absence of major blood vessels
or nerves.
Position for injecting on the vastus lateralis:
- Back-lying
- Sitting
Composed of thick gluteal muscles of the buttocks.
Dorsogluteal site
The dorsogluteal site is not to be used for children in this age:
below 3 years old (unless if the child has been walking for 1 year)
What to avoid in dorsogluteal injection:
- Sciatic nerve
- Blood vessels
- Bone
Position for injecting on the dorsogluteal site:
Prone or side-lying with the upper knee flexed and in front of the lower leg.
Found on the lateral aspect of the upper arm, 2-3 fingerbreadths below the acromion process.
Deltoid site
Why is the deltoid not often used for IM injections?
Because of its proximity to the radial nerve and artery.
The deltoid site is considered for use in adults because of:
rapid absorption; can accommodate up to 1ml
Situated on the anterior aspect of the thigh.
Rectus femoris
Advantage for injecting on the rectus femoris:
For patients who administer their
own injections.
Used for parenteral iron preparation to seal the drug deep into the muscle and prevent staining of the skin.
Z-track Technique
Steps in the Z-track technique:
- Retract skin laterally (use the ulnar side of the non-dominant hand to pull the skin approximately 1 inch to the side).
- Do not massage the injection site.
It prevents leakage into subcutaneous tissue and decreases the change of local irritation.
Z-track technique
Injecting medications into the vein; has a rapid effect on the patient’s body; lessens discomfort.
Intravenous medication
