Parenteral Medications Flashcards
What gauge and size needle should be used for intradermal, subcutaneous, and intramuscular injections?
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”
What is the maximum amount of medication (mL) that can be injected intradermally, subcutaneously, and intramuscularly?
1) Intradermal - 0.5mL
2) SQ - 1mL
3) IM - 4mL (1mL for deltoid)
What site should you absolutely avoid when giving intramuscular injections? Why?
Dorsogluteal site, because it’s too close to the sciatic nerve.
What does the term “wheal” mean?
It is a pocket of fluid that forms when medication is given intradermally with the bevel upwards.
What angle should be used when giving injections
1) intradermally?
2) subcutaneously?
3) intramuscularly?
1) intradermal - 15 deg
2) subcutaneously - 45 to 90 deg
3 intramuscular - 72 to 90 deg
What type of needle is used to withdraw medication from an ampule?
A filtered needle
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
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
(T/F) Insulin dosages must be checked by two nurses?
True
What are the two different methods of administering IV fluids and drugs? What is the difference between the two?
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).
Which parenteral route has the 2nd fastest absorption rate, next to IV?
Intramuscular - muscles have a large vascular network that ensures rapid absorption into the bloodstream.
Name two reasons why you would choose to use the IV route to deliver medications? Name two disadvantages of this route?
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
Why do we flush IVs with normal saline at regular intervals, before and after medications, and PRN?
Flushing ensures patency so there is no clotting or air in the line. It also clears the vein of any residual medication.
Why are medications such as nytroglicerin and albumin packaged in glass vials instead of plastic IV bags?
Because medications such as these react with plastic to form a precipitate.
How often are IV bags, IV tubes, and IV catheters changed?
IV bags are changed every 24 hrs, IV tubes and catheters are changed every 48 to 96 hrs.
What is the formula used to calculate gtt/min?
Gtt/min = (Volume in mL x drop factor [gtt/mL]) / Time in mins