Parenteral Medications Flashcards
needle length for subQ at 45 degrees and 90 degrees?
45- 5/8 inches
90- 1/2 inch
needle length for subQ peds?
less than 1/2 inch
needle length for subQ butterfly?
3/4 inch (19mm)
needle length for IM?
3/4-1.5 inches
needle length for ID?
1/8-5/8 inches
volume allowed for subQ?
0.5-1.5mL
volume allowed for subQ peds?
<0.5mL
volume allowed for SubQ butterfly?
2-3mL
volume allowed for IM?
2-5mL
needle length for IM peds?
5/8-1 inch
volume allowed for IM peds?
1mL max
volume allowed for ID?
0.01-0.10mL
gauge size for subQ?
25-27G
gauge size for subQ peds?
25-30G
gauge size for SubQ butterfly?
24G
gauge size for IM?
22G
gauge size for ID?
25-27G
gauge size for IM peds?
25-30G
what to be watch for with ID injections?
you want a bleb to appear. this proves it went into dermis, and not subQ tissue
which is the best site for ID injections? and what do you wanna make sure you dont do?
inner forearm or upper back (dont pinch)
best site for SubQ’s?
fatty part of body: lower abdomen, back of arm, upper thigh
what is the best site for LMWH SubQ’s?
“love handles”
best site for IM?
ventrogluteal muscle, vastus lateralis, deltoid
best side for IM peds?
vastus lateralis, ventrogluteal muscle (can be given via deltoid after 18mths)
what IM site is least painful and why?
ventrogluteal: least painful cause least nerve endings
what is ID injections used for?
for TB and allergy testing
what is the Z-track method?
method for pulling skin during an IM injection. it prevents leakage of meds into subQ tissue, seals medications in the muscle, and minimizes irritation
what do you need to ensure when inserting an IM injection?
keep needle inserted for 10 seconds to allow it to disperse evenly
When the nurse administers the IM she sticks herself with the needle. What does she do first?
- Cleans with soap and water
- Cleans with alcohol swab
- Apply sterile dressing if necessary
- Notify manager or CNL
- Go to ER within 2hrs
- report incident
what do you do if you get splashed with blood or bodily fluids?
- Rinse mucous membranes well with tepid water or saline
- go to ER within 2hrs
- notify manager/supervisor
- report incident
what do you do if a dirty needle or sharp hits you or a splash on non intact skin?
Wash the affected body part with soap & water only
- do not squeeze wound
- do not use any disinfectant -apply sterile dressing if necessary
List ways that infection can be prevented during an injection
- ampules should not sit open
- needle should not touch any contaminated outer surface
- avoid touching plunger or inner part of barrel
- wash skin site thoroughly and swab center outward to 5cm/2in radius
- wash your hands!
does subQ or IM absorb meds slower and why?
meds absorb slower in subQ then IM because the tissue doesnt contain as many BV’s as in muscle. IM has a rich blood supply!
what syringe size do you use for SubQ?
1-3mL
what syringe size do you use for subQ peds?
weight based
what syringe size do you use for IM adults?
2-3mL
what syringe size do you use for IM peds?
0.5-1mL
what does the bevel do?
it creates a narrow slit when injected into tissue that quickly closes after needle is removed to prevent leakage of meds. blood or serum
true or false, for intradermal you should feel resistance
yes you should because if you dont, the needle is too deep
in which case is the deltoid site for IM’s ideal?
for small volumes (2mL or less)
what are 3 landmarks for ventrogluteal IM admin?
- place palm of hand over greater trochanter of patient’s hip (use left hand for right hip and right hand with left hip)
- point thumb towards patients groin
- point index finger to the anterior superior iliac spine and middle finger toward the buttocks
how do you mix two meds in one syringe?
- Check compatibility (chart)
- Draw up vial first (inject air to create positive pressure) then ampoule second using filter needle
