Parenteral Meds + Diabetes Flashcards
What does parenteral mean?
Umbrella term to describe intradermal, subcutaneous, IM, and IV. Uses aseptic technique and its invasive.
Advantages and disadvantages of parenteral administration?
A- faster onset, used for NPO, unconscious client, if they have nausea, avoids first past digestion
D- painful, cause damage to nerves/tissues, risk for infection, individuals more anxious
Characteristic for subcutaneous injections (angles, length…)
Syringe size 1-3 mL, volume of medium is 0.5-1.5 mL, gauge is 26-31 g, length is 1.3-1.6 cm, angle of insertion is 45-90 degrees. (insert 90 with shorter needle and vice versa)
Intramuscular characteristic of needle?
Syringe size is 2-3 mL, volume of medium is 2-5 mL (2 mL max into deltoid), gauge is 19-25 mL, length is 2.5-3.8 cm, and angle of insertion is 90 degrees.
Characteristics of ampule/vials?
A- one time use, contains single sterile dose of drug, use blunt filter needle
V- single or multi dose vial, use blunt needle, need to inject air first before withdrawing
Characteristics for site selections?
Free of rashes, redness, scar tissue, edema, bruises, choose site 2.5 cm away from previous injection/umbilicus.
How do we prepare the skin for injection?
Use chlorhexadine swab.
Is medication absorbed slower for subcut?
yes because tissue doesn’t have a good blood supply.
How do we pinch/spread skin and how do we choose what angle for subcut injections?
Spread skin if there’s a lot of tissue. Pinch if there is a little tissue. 2.5 cm of less of tissue we use 45 degrees and 2.5 cm or more we use 90 (like in stomach).
Sites for subcut injections?
Back of arm, abdomen (between coastal margin and illiac crest), just above buttocks font of upper thigh, top of back.
What are intradermal injections usually used for?
Skin testing like allergies or tuberculin.
Sites of intradermal injections?
Forearm and back.
Needle characteristics for intradermal?
Needle length is 1-1.9 cm, gauge is 26-28 g, angle of insertion is 5-15 degrees, volume of fluid is around 0.1 mL usually.
Is medication absorbed quick er for IM?
Yes
What is the dorsogluteal site?
Not recommended and its used in emergencies. It could cause paralysis or nerve damage if it hits the sciatic nerve.
What is the Z track method?
Used for IM. Mimics local skin irritation by sealing the med into muscle tissue. Pull overlying skin 2.5 to 3.5 cm laterally with non dominant hand and then inject needle. After withdrawing needle you’ll release the skin.
What to do in case of needle stick injury?
Allow area to bleed, wash area with soap/water, call SHA incident reporting lien, and report to your instructor.
What is diabetes mellitus?
Chronic hyperglycemia from impaired process in glucose regulation (reduced insulin secretion).
What is insulin and where is it produced?
Facilitates glucose to move across cell membrane. Glucose in stored as glycogen. Produced in beta cells in the pancreas.
What is glucagon?
Releases glucose from storage sites.
What are microvascular and macrovascular effects of DM?
Macro- CV disease, cerebrovascualr disease, reduced immunity
Micro- retinopathy, neuropathy, sexual dysfunction, cognitive dysfunction
What happens when there is too much glucose in our bloodstream?
Body breaks down fats/energy which release free fatty acids and ketones into blood. Leads to polyuria (excessive urine) and extreme thirst.
What is type 1 and 2 for diabetes?
Type 1- auto immune disorder, beta cells destroyed (can’t produce insulin)
Type 2- more common, insulin resistance/defiency
Risk factors for diabetes?
Hyperglycaemia, abdominal obesity, hypertension, and hyperlipidemia.
