Seminar 4 Flashcards
syringes have what three components to them?
a tip, barrel, and plunger
a non luer locked syringe is referred to as a?
“slip tip”
What size syringe is usually used for IM And SC injections?
Typically a 1mL to 3mL syringe is used for Subcut and IM
If the syringe is more than 2/3 or 75% full, what should the nurse do?
a larger syringe size should be used
Smaller syringes often have a non- what?
non-removable needle
example, insulin and TB needles
The larger the gauge number the b).. the diameter of the shaft
b) smaller
gauges vary from varies from
16G to #28G
2 things
Length of needle is dependent on assessment:
- client weight & size
- location of injection site
3 things
Needle gauge is determined by:
- Viscosity of medication
- Location of injection
- Type of injection (SC or IM)
What is this?
HUB:
fits onto the end of the syringe
What is this?
Shaft:
hollow needle opening or lumen
What is this?
Bevel:
Slanted pointed tip
what colour hub is the blunt Fill Needle With Filter
(Lilac hub)
What colour hub is the Blunt Fill Needle
(Red hub)
on a ampoule, if it has a dot, this is where you
apply pressure
Ensure all fluid is located in the a).. of the ampoule
bottom
-flick ampoule if fluid is stick in the top.
What type needle should you use to draw fluid from a ampoule?
blunt filtered fill needle (lilac)
remember
Syringes containing medication for injection must be labelled with:
2 Client Identifiers
Name of Medication
Dose/Volume
Route
How much fluid can be injected into the SC tissues?
Usually less than 1mL injected via subcutaneous route
(Some institutional policies may state up to 2mL)
1mL for exam
what gauge and size is typically used for a subQ injection
Needle size: 5/8” long
(gauge): usually 25G
if 2.5 cm tissue can be grasped at the site, what angle should medication be adminsitered?
Administer at a 45 degree angle
If 5 cm of tissue can be grasped at the site, what angle should a SubQ injection be administered
Administer at a 90 degree angle
3 things
Subcutaneous injection sites need to be rotated to:
- Minimize tissue damage
- Maintain absorption
- Avoid discomfort
Where can you give a SUBq injection
Anywhere you can pinch a inch
Lateral thighs, abdomen, mid back, upper lateral arms,
Heparin should be injected a).. away from the umbilicus
at least 5 cm
Heparin is injected at a).. degrees
90
What is the preferred site for SC Heparin injections
the abdomen, because it has slow absorption
NOTE ** (opposite of insulin which is absorbed faster in abdomen)
over how many seconds should subq heparin injections be administered?
Administer very slowly over 10 to 20 seconds
LMWH (low molecular weight Heparin) comes in a spring-loaded prefilled safety syringe with the needle attached.
Should we prime this type of syringe?
NO, do not prime or remove the air bubble
cloudy insulin should be a).. prior to withdrawing
rolled between the hands to mix
Insulin needles are usually what gage and what length?
gauge: 26 - 31
Length: ¼ - ½ inches long
Sometimes two types of insulin are combined into one insulin syringe,.
Why?
Less injections to administer
When injecting a multi-dose of insulin, what order should air be drawn and what order should med be withdrawn?
air into cloudy
air into clear
withdraw from clear
withdraw from cloudy
remember RN for (regular than NPH). CLEAR insulin sandwhich
Insulin via syringe can be administered in what three places?
And in what order is faster absorbed?
- abdomen, then
- arms, then
- thighs and buttocks
When initiating a subcutaneous butterfly, the line and needleless cap must be primed when?
after insertion
small amount of air WILL be injected into patient
intial priming volume
Saf-T-Intima device line = 0.17 mL (yellow)
MAX Zero Needleless cap = 0.19 mL
Priming Total =
Saf-T-Intima device line = 0.17 mL (yellow)
MAX Zero Needleless cap = 0.19 mL
Priming Total = **0.36 mL
**
This is in addition to the dose of medication you are giving
when inserting a subq butterfly, the skin needs to be swabbed with?
chlorhexidine
when angle should a subq butterfly be inserted?
30-45 degree angle
when labeling the tegaderm for a subq butterfly, what information should be included?
Label the Tegaderm with the date, name of medication and concentration
When charting a SCBF what should be documented and where?
Chart in nursing notes:
- insertion of the device,
- location,
- how the client tolerated the process
how many days can s SCBF be used for?
Can be used for up to 7 days (IH: usually 4 days)
Subcutaneous devices can only be used for a).. that is on the label
specified medication and concentration
When giving IM injections, drugs have a a) onset of action
faster
what size needle and gauge should be used for IM injections?
Gauge: 21-23G
Length: 1/2 -1 ½” long needle
a obese client may need what size needle for IM injection?
up to a 3” long
IM injections should be given at what angle
90 degrees
Site of a IM injection is determined by the
medication and volume
Length of a IM injection is determined by the
site and weight of the individual
the volume administered for a IM injection will be determined by
muscle development and mass
what is the preferred IM injection sit in adults?
Ventrogluteal
What volume can be administered into the ventrogluteal muscle?
Typically up to 3mL (in some cases up to 5mL)
You can administer a ventrogluteal IM injection into a patient in what three positions
Side-lying
Supine
Prone
What are the three landmarks when giving a IM ventrogluteal injection?
Greater Trochanter
Iliac crest
Anterior superior iliac spine
what volume of medication can be adminstered into the deltoid muscle
Up to 2mL
what landmark do you use for the deltoid muscle?
3-5cm below acromion process
what volume of medication can be adminstered into the vastus lateralis
Typically up to 3mL (in some cases up to 5mL)
what position should you patient be in when doing a IM vastus lateralis injection?
Can administer to client in:
Supine
Sitting
What landmarks should the nurse use when giving a vastus lateralis injection
= Anterior lateral aspect of the thigh into the middle third
= Greater Trochanter
= Lateral femoral condyle
What volume can be injected into the rectus femoris?
Typically up to 3mL (max 5mL)
a IM rectus femoris injection should be administered into the A)
anterior aspect of thigh
What landmarks should be used for giving a IM rectus femoris injection
Anterior aspect of the thigh
Anterior superior iliac crest
Patella
Why are rectus femoris IM injections not the first site choice?
They can cause significant discomfort for the patient
What position should the patient be for a rectus femoris injection?
Can administer to client in:
Sitting
Lying
IM injections should be given in the dorsogluteal muscle
True or false
FALSE!!!!!
Risk for sciatic nerve damage
Often end up in subcutaneous tissue and not muscle
10 risk
Risk for IM injections
Muscle fibrosis
Contractures
Hematoma
Injury to blood vessels, bone, nerves
Pain
Bleeding
Abscess
Cellulitis
Tissue Necrosis
Granuloma
How can you reduce risk when giving a patient a IM injection
Proper landmarking.
Insert needle quickly and than 5-10 second injection. Have patient hold still, not flexed (relaxed).
