Skills Exam 5 part 2 Flashcards
what is a Nebulizer?
Machine that is connected to oxygen or air that converts a liquid medication to gas form and should be inhaled over a period of 10 to 15 minutes using a mask or a mouthpiece
how should you administer Prescribed ophthalmic eyedrops?
-Wear gloves, tilt patients head back, pull down lower lid, and administer drops in the conjunctival sac.
should you ever share your prescribed drops with someone else or use on non infected eye?
No you should never.
What should you avoid when administering eye drops?
The cornea and touching the eye or eyelid with dropper or tube.
Suppositories contain medications that exert local effects
you should insert suppositories with rounded end entering opening first ( this will prevent trauma during insertion)
which route is used to insert a suppository?
Vaginal or rectal
Steps before insertion of a suppository
- Hand hygiene
- lubricate suppository
- For vaginal lay patient in dorsal recumbent position
- For rectal lay patient in left lateral sim’s position
How far should a suppository be inserted rectally?
you should insert approximately one inch or once you feel the medication bypass the sphincter ( it should be placed on wall and not in the stool)
when assessing blood glucose you will need…
- Gauze (at least two pieces)
- Alcohol prep pad
- Lancet
- Glucometer
- Test Strip
steps to taking a blood glucose
Step 1: Clean Hands
Step 2: Choose puncture site. Stable adults: select the lateral side of a finger, avoid central tip. Clean site to be punctured with alcohol swab. Allow site to dry completely. Instruct patient not to move hand/finger!
Step 3: Insert test strip into glucometer
Step 4: Don gloves
Step 5: Hold area to be punctured in dependent position. Do not milk or massage. Stick site with lancet.
Step 6: Lightly squeeze around puncture site until drop of blood has formed
Step 7: Wipe first drop of blood with cotton ball
Step 8: Lightly squeeze around puncture site again until drop of blood has formed
Step 9: Collect blood using test strip
Step 10: Await blood glucose results. Interpret appropriately.
Step 11: Place lancet in sharps container. Throw trash in appropriate container.
Parenteral routes are?
Subcutaneous (SQ)
Intramuscular (IM)
Intradermal (ID)
Intravenous (IV)
What system is completely avoided when a medication is given via parenteral route?
The GI system
using the parenteral route medical asepsis technique is required to prevent infection
This means performing good hand hygiene, wearing gloves, and cleaning the skin with alcohol prep.
What should be done if a patient is injected routinely?
you should rotate the sites to maintain appropriate skin and tissue integrity, and to decrease infection risk
Length of a needle for injection is picked depending on what type is to be given, for example
- 3/8 inches to 5/8 inches (used for subcutaneous or intradermal)
- 1 inch to 1 ½ inches (used for intramuscular)
gauge of needle measures what?
the diameter of the needle
What happens if the gauge number decreases?
the size (diameter) increases the smaller the number the bigger the needle
What is a blunt tip needle used for?
to draw medication out of vials
When should you use a blunt filter needle?
when drawing medication from ampules/glass
Why is the blunt needles not as sharp as an injection needle?
to decrease risk of harm to self during medication preparation
Review steps for injection from a vial with or without a blunt needle
slide #81/82
Review Steps for Preparing an injection from an ampule using a blunt filter needle
Slide 86
Why can you recap a blunt tip needle and not others?
because you need to protect yourself from a needle stick injury while removing a needle from the syringe or while taking the syringe to the patient
should you ever recap after an injection is administered?
NOOOOO! engage safety
what technique is used when recapping a blunt tip needle?
The One Hand Scoop Technique
What is the priority after an injection is complete?
Activate the safety using one hand, then place in sharps
A term used for devices with sharp points or edges that can puncture or cut skin
“Sharps”
Where should all sharps go after use?
The Sharps container a puncture resistant, non breakable sealed container
How should you place a needle in a sharps container?
Put it in using one hand only, needle facing down or away from you.
Before injecting, know
- The volume of medication to administer
- The characteristics and viscosity of the medication
- The location of anatomical structures underlying the injection site
Minimize patient discomfort
- Use a sharp-beveled needle in the smallest suitable length and gauge.
- Position a patient as comfortably as possible to reduce muscular tension.
- Select the proper injection site, using anatomical landmarks.
- Divert the patient’s attention from the injection through conversation using open-ended questioning.
- Insert the needle quickly and smoothly to minimize tissue pulling.
- Hold the syringe steady while the needle remains in tissues.
- Inject the medication slowly and steadily.
Subcutaneous injection
Occurs in the fatty Layer of skin below the dermis above the muscle and is given at a 90 to 45 degree angle
Medications commonly administered SQ:
Insulin
Heparin
Lovenox (Enoxaparin)
Review the steps to preparation for subcutaneous injection
Slide 99
Review how to perform subcutaneous injection
Slie 101
What are some Subcutaneous injection sites?
- Back of arm
- Abdomen
Intramuscular injection
injection occurs in the muscle which means faster absorption than subQ
What are some Common intramuscular injections
- Vaccines
- Antibiotics
- Glucagon
- Sedatives
Review Steps for Intramuscular Injections
Slide 110
What is the Z-track method for intramuscular injection?
Performed with larger muscle groups to prevent leakage of medication into sensitive tissues (such as subcutaneous tissue)
Review Aspiration technique for intramuscular injections
Slide 112
When selecting an IM site, consider the following:
- Is the area free of infection or necrosis?
- Are there local areas of bruising or abrasions?
- What is the location of underlying bones, nerves, and major blood vessels?
- What volume of medication is to be administered?
Review Intramuscular injection Site : Ventrogluteal
Slide 116
Review Intramuscular injection Vastus laterals
Slide 119
assessment after medication administration
- After administering various medications, you may need to follow up with your patient and assess them
- Depending on the patients initial presentation and medication route depends on when you should reassess
General rule
- Oral medications: Reassess 30 mins to 1 hour later
- Parenteral medications: Reassess within 30 minutes
