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nursing 20030 > subq and intramuscular injections > Flashcards

subq and intramuscular injections Flashcards

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1
Q

what forms do parenteral meds come in

A

liquid or powder

powder must be reconsituted

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2
Q

what are some supplies used for injections

A

-syringe
-ampules
-vials
-cartidges
-pens
-prefilled syringes

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3
Q

where should you draw up medications

A

at the bedside, immediately prior to administration

will need barcode on vial

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4
Q

who administers the medication?

A

only the person who prepares the medication

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5
Q

should you leave meds at the bedside?

A

nope

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6
Q

how do you dispose of unused meds?

A

per policy

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7
Q

after administering a med, what do you do with the needle?

A

immediately engage the safety mechanism and dispose use equipment in sharps container

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8
Q

describe parenteral med administration

A

-invasive
-sterlie/aseptic technique
-requires precise calculation of the dose
-requires accurate site identification
-requires careful technique
-provides rapid response

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9
Q

what are the med administration essentials?

A

-triple check
-three checks
-six rights
-patient rights
-pre administration assessment
-evaluation

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10
Q

describe the process of withdrawing meds from a vial

A

-disinfect stopper on the vial
-pull back plunger on syringe equal to the desired amount of fluid
-remove cap from needle, place on table
-pierce stopper with the needle using a 90 degree angle
-keep the tip of the needle in the air at the top of the vial
-inject air into the vial. keep thumb on plunger
-invert the vial and syringe, keeping thumb on the plunger
-retract needle, so that it remains in the fluid
-aspirate the plunger to withdraw the desired amount of fluid

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11
Q

describe mixing medications

A

-determine compatibility of the medications
-do not contaminate one medication with the other
-ensure the final dose is accurate
-mainatin aspetic technique

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12
Q

what should NPH insulin look like?

A

cloudy

if its not, roll vial between palms

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13
Q

what happens if you overdraw while mixing medications?

A

discard and start all over

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14
Q

what order should you draw up the meds when mixing regular insulin and NPH?

A

regular first, then NPH

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15
Q

describe minimizing discomfort when giving injections

A

-use smallest suitable needle
-position client comfortably
-select proper site
-use distraction as appropriate
-stabilize the skin
-hold syringe steady
-insert the needle quickly and smoothly
-inject the medication slowly

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16
Q

angle of injection

intramuscular

A

90 degrees

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17
Q

angle of injection

subQ

A

-45 degrees or 90 degrees
-depends on the length of the needke and amount of subQ available

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18
Q

angle of injection

intradermal

A

15 degrees

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19
Q

what syringe is used for subQ injections

A

insulin
1-3ml syringe

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20
Q

what needle is used for subQ injections

A

-often pre-attached to syringe
-gauge 25-31
-length 3/8” to 1” (usually 3/8”-5/8”)
-some insulin syringes may have 5/16” needle

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21
Q

where can you find subQ administration sites

A

-abdomen (at least 1-2” away from the umbilicus)
-outer aspects of upper arms
-outer thigh
-upper buttock
-scapular area

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22
Q

what can you do to prevent tissue damage with subQ administration

A

-rotate sites
-do no aspirate
-do not massage
-avoid sites with bruising, pitting, and lumps
-use a volume of 1ml or less

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23
Q

what are the symptoms of hyperglycemia

A

-flushed
-warm to touch
-thirsty
-hungry
-frequent urination

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24
Q

what are some symptoms of hypoglycemia

A

-sweaty
-cold
-drowsy
-HA
-sweaty
-irritable

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25
Q

what are some generic names of rapid acting insulin

A

-aspart
-glulisine
-lispro

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26
Q

whats the generic name of short acting insulin

A

regular

27
Q

what are some generic names of intermediate acting insulin

A

-NPH
-isophane

28
Q

what are some generic names of long acting insulin

A

-detemir
-glargine

29
Q

what is the onset of rapid acting insulin?

A

15-30 mins

30
Q

what is the peak of rapid acting insulin?

A

30 mins-2.5hrs

31
Q

what is the duration of rapid acting insulin?

A

3-6 hrs

32
Q

what is the onset of short acting insulin?

A

30-60 mins

33
Q

what is the peak of short acting insulin?

A

1-5hrs

34
Q

what is the duration of short acting insulin?

A

6-10hrs

35
Q

what is the onset of intermediate acting insulin?

A

1-2 hrs

36
Q

what is the peak of intermediate acting insulin?

A

4-12hrs

37
Q

what is the duration of intermediate acting insulin?

A

16 hrs

38
Q

what is the onset of long acting insulin?

A

3-4hrs

39
Q

what is the peak of long acting insulin

A

continuous (none)

40
Q

what is the duration of long acting insulin?

A

24hrs

41
Q

what type of insulin gives less chance to experience a hypoglycemic event?

A

long acting

42
Q

what equipment is needed for intramuscular injections?

A

-gloves
-skin antiseptic
-syringe (3-5ml)
-needle (another card)

43
Q

what size needle should be used for IM injections?

A

-gauge 18-25
-length: 5/8”-1.5”

usually 21-23g, 1’-1.5”

44
Q

how do you determine the gauge and length of needle when giving IM injections?

A

determine by:
-weight and muscle mass
-age
-injection site
-medication viscosity
-residual effects of the medications

45
Q

name some approved IM sites?

A

-deltoid
-ventrogluteal
-vastus lateralis

46
Q

how much fluid can you inject into the deltoid?

A

no more than 1 ml

47
Q

how much fluid can you inject into the ventrogluteal?

A

up to 3ml

48
Q

how much fluid can you inject into the vastus lateralis?

A

up to 2 ml

49
Q

describe finding the deltiod

A

-smallest site
-feel for chromium process then go two finger beadths down below
-barely posterior to midline

50
Q

describe finding the ventrogluteal site

A

-this is the preferred injection site
-pt should be on side
-place hand on greater trochanter of hip with thumb pointing midline and middle and pointer finger on pelvic bone, inject in between those two fingers
-after finding site you can move your fingers if not comfotable injecting between them

51
Q

describe finding the vastus lateralis site

A

middle third of lateral side of thigh

52
Q

describe z track technique for IM injections

A

-pull skin to one side over injection site
-put needle in there and inject med
-one plunger is done, let go of skin at same time you remove needle
-causes less irritation to the skin

53
Q

what are the steps of injectable med administration

A

-indetify pt, hand hygiene, provide privacy
-review allergies, order, med expiration
-verify 6 rights
-don clean gloves
-select injection site
-clean skin and allow to dry
-remove cap from needle
-stabilize skin
-inject needle into skin
-inject med
-withdraw needle and immediately activate safety using only one hand
-dispose of syringe and needle in sharps container
-document administration

54
Q

what is evaluation of med administration dependent on?

A

type of med, changes what needs to be evaluated

55
Q

what are some types of meds administered via injection?

A

-anticoagulants
-antibiotics
-antiemetics
-antipsychotics
-immunizations
-insulins
-opioids

56
Q

what is infiltration of peripheral IV site?

A

iv fluids surrouding space around venipuncture site

57
Q

what are the signs and symptoms of infiltration?

A

-swelling
-pallor
-coolness around site
-pain

58
Q

what shold you do if you see inflitration of IV site?

A

infusion must be disconnected, raise extremity, and apply warm compress

59
Q

what is phlebitis

A

inflammation of vein

60
Q

what are some signs and symptoms of phlebitis

A

-pain
-edema
-errythema
-increase skin temp
-redness travelling path of vein

61
Q

what should you do if you see phlebitis

A

infusion must be disconnected, raise the extremity, apply warm compress

62
Q

what are some risks associated with phlebitis and how do you reduce risk

A

-risk of developing blood clot
-risk reduced by routine removal and rotation of sites

63
Q

name two basic peripheral IV site complications

A

infiltration and phlebitis

nursing 20030 (31 decks)

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