Test #3 Recons, Some Insulins Flashcards
Some meds are stable for only ___ periods in the ___ state.
short; liquid
Once meds are mixed, a medication is good for only __ to ___ days
1 to 14
The mixing process is called ___
reconstitution
Nurses may have to ___ medications just before administration or in the home setting
admix
Medications may be ___, injectable, or for ____
oral; injection
____ diluents are always used for injectables
sterile
The powder is the _____
solute
The liquid is the ____ or ____
diluent or solvent
The mixture is called the ____
solution
What are the 7 principles for Reconsitution
- Manufacturer provides directions
- Diluents (check exp date before use)
- Must identify information (type&amt of diluent, exp. period of admixture)
- If components in #3 are unavailable, consult PDR or other reliable source
- Single dose or Multi-dose after admixture-label clearly
- If multiple doses are possible, you must label concentration of new mixture
- Powder often adds significant substance to the total volume of solution
Manufacturer provides directions including…
mL, diluent, storage instructions, concentration after admixture, how long it is good for (10-14 days)
What do you check before using diluents
expiration date
What are the most common diluents we use? Others?
Sterile water or saline
others: D5W or special solution provided
What info must be identified w/ reconstitutions?
Type of diluent, amount of diluent, exp. period after admixture
If components (type of diluent, amt. of diluent, or exp. period after admixture) is unavailable, what do you consult? What do you not use in this case?
PDR or other reliable source
*do not use drug guide book
What needs to be on the label after admixture of single dose/multi-dose?
- Date & Time
- Mixture Strength
- Exp. Date & Time
- Storage instructions (fridge or room temp)
- Nurse’s initials
- Apply label so that medication information is not obscured
- Discard if labeled inappropriately
What medications do you keep even if the medication is labeled inappropriately?
Keep patients meds from home
What medications do you throw away if the medication is labeled inappropriately?
Throw away hospital meds (inappropriate labeled meds)
If you have multiple strengths on a medication label, after mixing you must…
Label the concentration of new mixture (ex. 500mg/mL)
Powder often adds significant substance to ____
The total volume of the solution
The label of a reconstitution powder medication should indicate ___ & ___.
The total volume & concentration after admixture
Directions of reconstitution med. may not state___
final concentration in unit measure per mL
Some solutions can be mixed to ____
varying concentrations
This must be considered when choosing appropriate concentrations?
Route
What should be considered with an IM route?
amount can not exceed the capacity of the target muscle but should not be irritating
What should be considered with an IV route?
large amt. & is usually further diluted after recon. (add 50 or 100 mL to another diluent like NS)
Volumes are smaller for pediatrics
If you have an order from the prescriber & need to choose a concentration, how would you do this? Why?
Choose the concentration closest to the order from the prescriber
*it is more accurate if you get it close to the DR order
What does “respectively” mean?
in the order given
What do you write on the vial after admixture?
dosage strength you prepared
If directions are not on the label, what do you do?
read the insert
What do you look at when reconstituting from package insert?
- look closely at amount in the vial & route
- insert may give directions for different sized vials, read closely.
- directions may vary according to route (IM,IV), read closely
What is the broad classification for insulin?
agents used to correct endocrine imbalance
What is the specific classification for insulin?
agents used to treat hyperglycemia
Insulin is classified by ___ & ____
origin & action
These types of insulins are all clear solutions?
Rapid-Acting
These insulins are called NPH
Intermediate
Name the insulins that are Long-Acting?
Lantus & Levemir
Can you mix Long-Lasting Insulins?
NO
Insulin is measured & given with ____
insulin syringes
Insulin doses are measured in ____
Units
Concentration of insulin is almost always ____
100 units per mL
What is the measurement of Lo-Dose syringe (2 measurements)? Which one is more accurate?
capacity of 0.5 mL to deliver 50 units
capacity of 0.3 mL to deliver 30 units
-0.3 mL is more accurate than 0.5 mL
What are the two types of 1 mL syringes?
Single scale & odd-even scale
What is a single scale syringe?
delivers 100 units but just by 10’s on one-side (10, 20, 30 w/ even little tick marks)
What is a odd-even scale syringe?
read on appropriate side for the dose being delivered (16, 18 even side, 17, 19 odd side)
Insulin orders must be written clearly & must include…
Brand name Name of units to be administered Route Time Strength of Solution
What should never be used when writing units?
” U “
Do not round, give to the ___ place.
hundredths
When mixing insulin you always mix ___ to ____
clear to cloudy
What can you use to administer insulin if you do not have an insulin syringe?
TB syringe
Insulin doses are always checked by ____
2 nurses
Ask the second nurse to tell you what you have, do not ____
Tell the nurse what you have drawn up
Show the second nurse ____ & _____
your syringe & the vials
TB syringes are calibrated in ____
hundredths & mL (cc)
How many units of insulin equals 1 mL?
100 units equals 1 mL
What is a sliding scale?
when you take the patient’s blood glucose (done at certain hours), you look at a sliding scale (all facilities have different ones) and whatever the number you received from the blood glucose reading you inject that much insulin
If the reading is very low/high, you send a venous sample to lab & treat with ____
Treat with insulin or PO or D50W
Insulin promotes two things?
- Glucose to transport across the cell membrane
- Converts glucose out of the blood into glycogen (in the liver)
What does insulin utilize & inhibit?
Utilizes fatty acids & inhibits lipolysis
What does insulin enhance & inhibit?
Enhances protein synthesis & inhibits protein breakdown
