Parenteral Medications - Preparation (M5A) Flashcards

1
Q

parenteral medications indications

A
  • pt vomiting
  • pt cannot swallow
  • rapid onset needed
  • pt is NPO
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2
Q

parenteral medications compared to other routes

A
  • more quickly absorbed than PO

- pose greater risks than nonparenteral meds

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3
Q

parenteral medication routes

A
  • subcutaneous (into tissues just under dermis of skin)
  • intramuscular (into body of muscle)
  • intradermal (into dermis just under epidermis)
  • intravenous (into vein)
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4
Q

ways to minimize discomfort w/ parenteral medications

A
  • use sharp, beveled needles in shortest length & smallest gauge possible
  • change needle after drawing up med
  • position & flex pt’s limbs to reduce muscular tension
  • divert pt’s attention away from injection
  • apply vapocoolant spray/topical anesthetic to site before admin
  • place wrapped ice on site for a min before injection
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5
Q

1st choice of site for IM injections

A

ventrogluteal site (b/c reduced risk of nerve/muscle injury)

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6
Q

safety guidelines regarding injections

A
  • inject med slowly & smoothly
  • hold syringe steady once needle in tissue to prevent tissue damage
  • gently apply gauze pad to site
  • apply gentle pressure at injection site
  • rotate injection sites to prevent formation of indurations and abscesses
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7
Q

needle-stick injuries

A
  • most frequent route of exposure to bloodborne disease for HCWs
  • occurs when recap needles, mishandle IV lines, or leave needles at pt’s bedside
  • special containers for disposal of sharps
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8
Q

size of syringe, length & gauge of needle for IM injections determined by…

A
  • vol prescribed
  • med route
  • type of med
  • viscosity of med
  • pt body size
  • age
  • gender
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9
Q

syringes

A
  • single use, disposable, & either Luer-Lok or non-Luer Lok
  • come w/ or w/o sterile needle & needleless SESIP device
  • range from 0.5-60mL
  • 1-3mL syringe usually adequate for subQ or IM
  • low dose & insulin syringes hold 0.3-1mL
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10
Q

needles

A
  • some needles come attaches to syringes
  • disposable, most made from stainless steel
  • 3 parts: hub, bevel, slanted tip (must remain sterile at all times)
  • use longer needles for IM; shorter needles for subQ
  • some come w/ filters
  • bevel always slanted to minimize discomfort
  • vary in length from 6.4mm=76mm
  • selection of gauge based on viscosity of fluid
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11
Q

ampoules

A
  • contain single doses of injectable med in liquid form
  • avail in sizes from 1-10mL or more
  • use filter needles when prep med from ampoule to prevent glass particles from going in syringe (do not use filter needles when admin med)
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12
Q

vials

A
  • single or multi dose plastic/glass container w/ rubber seal on top
  • after opening single dose vial, discard no matter how much used
  • multi dose can be used multiple times ONLY on same pt (write date opened, conc of drug per mL, & initials on vial)
  • must inject air into vial to permit easy withdrawal of soln (vial is closed system)
  • unstable meds in dry form
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13
Q

assessments before prepping IM or subQ med

A
  • pt’s body build
  • pt’s muscle size
  • pt’s weight
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14
Q

preparation of ampoule

A
  • tap ampoule lightly & quickly until fluid moves back from its neck
  • clean ampoule w/ swab
  • snap neck of ampoule away w/ gauze
  • do not allow needle tip to touch rim of ampoule
  • if you aspirate air bubbles, do not expel air into ampoule
  • tap side of syringe and eject air to remove air bubbles
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15
Q

preparation of vial

A
  • wipe rubber seal w/ swag for 15 seconds
  • inject air into space of vial, holding onto plunger
  • if any air bubbles, tap side of syringe to dislodge; eject air remaining into vial
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16
Q

preparation of vial containing powder

A
  • mix med thoroughly
  • roll in palms
  • do not shake
17
Q

intradermal injections

A
  • used for skin testing (ex. TB or allergy tests) or for Tx
  • injected into dermis where blood supply reduced and drug absorption occurs slowly
  • may have anaphylactic rxn if meds enter circulation too quickly
  • ensure site free of lesions & injuries & hairless
18
Q

ideal location for ID injection

A
  • inner forearm (3-4 finger widths below antecubital space and 1 hand width above wrist)
  • upper back (if cannot use forearm)
19
Q

needle w/ ID injections

A
  • use tuberculin (TB) or small syringe
  • short, fine gauge needle
  • angle of insertion = 5-15 deg
  • inject only small amounts
  • ensure bleb appears (no bleb = may have entered subcu tissues)
20
Q

admin ID injections

A
  • nondom hand stretches skin over site w/ forefinger & thumb
  • insert at 5-15deg slowly until resistance felt (approx 3.2mm below skin surface)
  • bulge of needle tip seen through skin
  • bleb should appear
  • if pt recevied immunotherapy, stay w/ pt for 30mins following injection
21
Q

evaluation of ID injections

A
  • return in 15-30 mins
  • ask if any acute pain, burning, numbness, tingling at site
  • inspect bleb for induration (hard, dense, raised area)