Parenteral Medications - Preparation (M5A) Flashcards
1
Q
parenteral medications indications
A
- pt vomiting
- pt cannot swallow
- rapid onset needed
- pt is NPO
2
Q
parenteral medications compared to other routes
A
- more quickly absorbed than PO
- pose greater risks than nonparenteral meds
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)
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
5
Q
1st choice of site for IM injections
A
ventrogluteal site (b/c reduced risk of nerve/muscle injury)
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
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
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
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
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
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)
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
13
Q
assessments before prepping IM or subQ med
A
- pt’s body build
- pt’s muscle size
- pt’s weight
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
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
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)
