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MSS PCM Exam 2 > Skin and Joint Injections > Flashcards

Skin and Joint Injections Flashcards

1
Q

universal precaution

A

system of infection control used in the US

endorsed by OSHA and the CDC

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2
Q

what should be treated as if bloodborne?

A

all human and blood and OPIM

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3
Q

OPIM

A

other potentially infectious material

-all other bodily fluid

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4
Q

risk of infection depends on what?

A

type of pathogen
type/route of exposure
amount of virus in infected blood
amount of infected blood involved in the exposure
whether post-exposure treatment was taken
specific immune response of infected individual

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5
Q

needle use

A

very common but can cause lots of unnecessary stress

**must wear gloves!!

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6
Q

proper way to remove contaminated gloves?

A

yeah, there actually is.
-just don’t touch that shit

and clean yo hands afterwards!

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7
Q

needlestick

A

break in skin from needle or other sharp

-ex scalpel

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8
Q

how many needlestick injuries occur immediately after use or before disposal?

A

40%

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9
Q

what can be acquired by needlesticks?

A

Hep B/C and HIV

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10
Q

two common problems with injections?

A

fainting and allergic reactions

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11
Q

what is required for all injections?

A

aseptic technique

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12
Q

purpose of injections?

A
  • prevention and treatment of disease and pain
  • allow for some control in distribution of medication
  • reserved for meds that cannot be administered by other routes
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13
Q

contraindications to injections?

A
  • known hypersensitivity
  • skin is inflamed, irritated, excoriated, or infected
  • pregnancy or breastfeeding
  • stopper is latex and patient is allergic to latex
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14
Q

informed consent

A

required for ALL procedures

  • includes injections
  • involves a consent form!
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15
Q

what discuss for informed consent

A 
1 indications
2 potential risks
3 complications and side effects
4 alternatives
5 potential outcomes for injection procedure
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16
Q

three types of cutaneous injections?

A

intradermal (ID)
subQ (SQ)
intramuscular (IM)

**difference is DEPTH of needle

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17
Q

intradermal injection

A

directly under epidermis

10-15 degree angle

primarily for diagnostic purposes
-allergy, TB, candida)

or local anesthetics

small syringe and small gauge needles

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18
Q

syringe

A

tube holding substance

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19
Q

needle gauge

A

number based on size of hole in needle
-larger number is smaller needle

number based on length of needle

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20
Q

wheal

A

created by intradermal injection

little bump

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21
Q

subQ injection

A

into subQ at 45-90 degree angle

for testing - know 45 DEGREES!

slow, sustained absorption of medications
-insulin, hormones, opiates

variety of syringe and needle sizes

22
Q

common sites for subQ injections

A

abdomen, lateral and posterior upper arm, anterior thigh, ventral gluteal region

-where there is a layer of subQ

23
Q

intramuscular injection

A

well perfused muscle at 90 degree angle and aspiration

  • rapid systemic action of large dose
  • with least amount of tissue damage

vaccines:
-Hep A/B, MMR, DPT Pentacel, tetanus, B12, epinephrine, opiates, promethazine

syringe and needle size can vary greatly

24
Q

location of IM injections?

A

Deltoid, Gluteus Medius, Vastus Lateralis, Rectus Femoris, Gluteus Maximus

25
Q

skin injection site reactions

A

irritation
inflammation
infection

26
Q

prevention of skin site reactions?

A 
cool pack
clean and dry
cotton ball or gauze pad
not injecting into skin that is tender, red, or hard
rotating injection sites
27
Q

Mantoux Skin Test

A

for TB

28
Q

after injections

A

needle is no CONTAMINATED

  • put er in the sharps container
  • don’t recap
29
Q

complications of injections?

A

vasovagal syncope
infection
??

30
Q

vasovagal syncope

A

fainting

-have them lay down

31
Q

indications for joint injections

A

diagnostic
-aspiration or arthrocentesis of synovial fluid for analysis

therapeutic

  • aspiration/arthrocentesis of fluid from grossly swollen joint
  • delivery of local anesthetic
  • delivery of corticosteriods or visco-supplementation (hyaluronic acid) for suppression of inflammation and improved ROM
32
Q

contraindications for joint injections**

A 
ABSOLUTE
local cellulitis
septic arthritis
acute fracture
bacteremia
joint prosthesis
achiles or patellar tendinopathies
allergy from injectables
more than 3 corticosteriods within past year in single joint***

RELATIVE
minimal relief after 2 previous
coagulopathies
etc.

33
Q

timing of joint injections

A

important ??

34
Q

supplies for injection

A

make sure you have everything you need

35
Q

anesthesia needle

A

30 gauge
half inch
1-3 cc

36
Q

injection needle

A

22-25
1.5 inch
1-10cc

37
Q

aspiration needle

A

18-25 gauge

38
Q

lidocaine

A

aka xylocaine

acts instantly

short duration**

39
Q

bupivacaine

A

aka marcaine
quick onset

long duration (up to 7-8 hours)**

**can be mixed

40
Q

epinephrine

A

vasoconstrictor
-often combined with lidocaine or bupivacaine

used in very vascular areas

41
Q

where not use EPI?

A

fingers, nose, penis, toe, earlobe

42
Q

types of corticosteroids

A

don’t worry about this now

**know the anesthetics

43
Q

corticosteroids

A

great for people with articular conditions

-RA, OA, gout, ankylosing spondylitis

44
Q

MISSED SLIDES

A

on corticosteroids

45
Q

site preparation

A

place patient in supine position**

sterile technique
ice or topical vapo-coolant spray to skin
aspirate before injecting
injection should flow easily
small quantity of anesthetic can be injected subQ

46
Q

aspirate

A

during IM injection
-to see if you are in a vessel

if you are in a vessel
-take it back and shift around

47
Q

post procedure care

A

adhesive dressing to wound 8-12 hours
instruct patient to ice
use of NSAIDs ok for first 24-48 hours

48
Q

good NSAID

A

naprosen 500mg

49
Q

prescription of ibuprofen?

A

higher dosage is for anti-inflammatory

-600mg

50
Q

procedure note

A

description of procedure performed

MSS PCM Exam 2 (4 decks)

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