Parenteral Medications Flashcards

1
Q

What gauge and size needle should be used for intradermal, subcutaneous, and intramuscular injections?

A

1) Intradermal - Guage: 26 or 27; Size: 1/4” to 1/2”
2) Subcutaneous - Gauge: 25 to 30; Size: 3/8” to 1”
3) Intramuscular - Gauge: based on medication being administered (aqueous solutions = 20 to 25 & oil-based solutions = 18 to 25); Size: 5/8” to 1 1/2”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the maximum amount of medication (mL) that can be injected intradermally, subcutaneously, and intramuscularly?

A

1) Intradermal - 0.5mL
2) SQ - 1mL
3) IM - 4mL (1mL for deltoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What site should you absolutely avoid when giving intramuscular injections? Why?

A

Dorsogluteal site, because it’s too close to the sciatic nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the term “wheal” mean?

A

It is a pocket of fluid that forms when medication is given intradermally with the bevel upwards.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What angle should be used when giving injections

1) intradermally?
2) subcutaneously?
3) intramuscularly?

A

1) intradermal - 15 deg
2) subcutaneously - 45 to 90 deg
3 intramuscular - 72 to 90 deg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of needle is used to withdraw medication from an ampule?

A

A filtered needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When mixing the following medication, which one is drawn up into the syringe first?

1) NPH and regular insulin
2) Single-Dose vial and Multidose-Vial
3) Ampule and Vial

A

1) Regular insulin is drawn up into the syringe before NPH (think clear then cloudy)
2) Multidose vial is drawn up into the syringe before the single-dose
3) Draw up medication in the Ampule before drawin up the vial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

(T/F) Insulin dosages must be checked by two nurses?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two different methods of administering IV fluids and drugs? What is the difference between the two?

A

1) Continuous - Replaces or maintains fluid and electrolytes and serve as a vehicle for drug administration.
2) Intermittent (aka saline or heparin lock) - Used for IV administration of drugs and supplemental fluids (i.e., IVPB & IV push).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which parenteral route has the 2nd fastest absorption rate, next to IV?

A

Intramuscular - muscles have a large vascular network that ensures rapid absorption into the bloodstream.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name two reasons why you would choose to use the IV route to deliver medications? Name two disadvantages of this route?

A

1) Indications - Immediate effect, Only route available (PT may be NPO) or tissue absorption is poor.
2) Disadvantages - Least safe of all medication routes, instant drug Rx (no recall), infiltration into tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do we flush IVs with normal saline at regular intervals, before and after medications, and PRN?

A

Flushing ensures patency so there is no clotting or air in the line. It also clears the vein of any residual medication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are medications such as nytroglicerin and albumin packaged in glass vials instead of plastic IV bags?

A

Because medications such as these react with plastic to form a precipitate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How often are IV bags, IV tubes, and IV catheters changed?

A

IV bags are changed every 24 hrs, IV tubes and catheters are changed every 48 to 96 hrs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the formula used to calculate gtt/min?

A

Gtt/min = (Volume in mL x drop factor [gtt/mL]) / Time in mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the primary cause of air in the IV tubing?

A

Priming the tubing too quickly

17
Q

Why do you warm cold IV medications

A

Because giving cold IV medications can cause venous spasms.

18
Q

List at least 3 complications that can result from IVs.

A

1) Infiltration
2) Phlebitis
3) Fluid Overload
4) Air Embolus
5) Speed Shock - Delivering medication too fast via an IV
6) Thrombus

19
Q

What is the drip rate of macrodropper and microdroppers? why select one over the other?

A

1) Macrodroppers - 10 drops in 1mL (used for adults)

2) Microdroppers - 60 drops in 1mL (used for pediatrics)

20
Q

How is it possible for a patient to have excess fluid volume and still have low BP?

A

The fluid may be outside of the vascular space (i.e., edema)

21
Q

When do most medication errors occur?

A

During shift to shift transitions

22
Q

How drugs in hospitals generally classified?

A

By body systems

23
Q

What is an example of a class of drugs that the FDA do not have oversight of?

A

Herbals

24
Q

Because many drugs are still metabolized by the liver, regardless of the route, Dr.s write dosages based on what patient variable?

A

Based on the patient’s liver functioning

25
Q

What is the worst/most severe adverse effect a person could have to a drug?

A

An anaphylactic reaction

26
Q

What 3 things happen during anaphylaxis? Name 6 different methods used to treat anaphylaxis.

A
Anaphylaxis results in respiratory distress, sudden severe bronchospasms, and cardiovascular collapse.
This reaction is treated with:
1) Vasopressors
2) Bronchodilators
3) Corticosteroids
4) Oxygen Therapy
5) IV fluids
6) Antihistamines
27
Q

(T/F) Antibiotics are the most important drugs to maintain serum levels in order to achieve a therapeutic level.

A

True

28
Q

(T/F) Half-Life affects dosage (how often a drug will be given, I.e., a.4h, bid, etc.,)

A

True

29
Q

What are the 7 parts of a medication order?

A

1) Patient’s name
2) Date and time order was written
3) Name of drug
4) Dosage of drug
5) Route
6) Frequency of administration
7) Signature of prescriber

30
Q

List the three times a medication label should checked during preparation and administration

A

1) When the nurse reaches for the medication
2) Immediately before pouring or opening the medication
3) Before giving the medication to the patient

31
Q

What are the 7 “rights” of medication administration?

A

1) Right patient
2) Right medication
3) RIght dosage
4) Right route
5) right time
6) Right reason
7) Right documentation

32
Q

Name the 5 sites on the body where SQ injections can be given

A

1) Upper arm
2) Abdomen
3) Anterior Thigh
4) Upper back
5) Upper ventral or dorsogluteal area

33
Q

What steps should be taken if a patient refuses to take a medication?

A

1) Explore why
2) Educate the PT why the medication is beneficial
3) Document
4) Inform the physician

34
Q

What kinds of medications are administered intradermally, SQ, and IM?

A

1) Intradermal - Tuberculin and allergy tests
2) SQ - Insulin and LMWH
3) IM - Antibiotics, hormones, and vaccines

35
Q

Name the 6 complications that can happen from an IM injection

A

1) Abscesses
2) Cellulitis
3) Injury to blood vessels, bones, and nerves
4) Lingering pain
5) Tissue necrosis
6) Periostitis

36
Q

What are the 3 sites on the body where IM injections can be given?

A

1) Ventrogluteal
2) Vastus Lateralis
3) Deltoid

37
Q

What is an actovial?

A

A vial containing diluent and powder but separated by a rubber stopper. The rubber stopper is activated when the nurse is ready to reconstitute the med.

38
Q

Why should you give potassium-based IVs in larger veins? What can you do if the problem persists in the larger vein?

A

Potassium irritates the vein and causes a burning sensation. If the problem persists when you switch to a bigger vein, try slowing the rate of infusion.