Week 1 and 2 Flashcards
Parenteral Routes
outside of the GI system
List the Parenteral Routes
ID, Subcut, IM and IV
Intradermal Injections
small volume injections
admin skin test
What is the syringe size for ID injections
1 mL syringe
What is the needle gauge for ID injections
25-30 guage
Subcutaneous Injections
nonirritating substances
injected into fatty tissue sites
Insulin and Anticoagulants
How much can be administered with a Subcut injection
1 mL
what is the gauge of the needle for a subcut injection
25-30 gauge
Intramuscular injections
deliver medications for faster absorption
tolerate more concentrated substances
How much can be administered via IM
up to 3 mL depending on patient skin integrity and muscle size
How far away from the umbilicus must you be when giving an injection
at least two inches
Why is the dorsogluteal are not recommended for injections
because of the potential for nerve and vessel damage
What is the basis for selecting a needle
type of medication
size and condition of patient
are of injection
* larger the gauge the smaller the diameter the needle
What is the approximate length for an ID needle
3/8-1/2 inch
What is the approximate length for subcut needle
3/8-5/8 inch
what is the approximate length for an IM injection
5/8-2 inches
What are some examples of diseases that could be contracted because of a needle stick
Hepatitis B, C, and HIV
What must you do before mixing medications
always consult a reference for compatibility or the pharmacist
Where must all liquid medications be measured
at the meniscus
If the vial is multi-dose what must the nurse do
must label it with date, time and amount of diluent used and their initials
When giving IM injections what must you always do
always aspirate
What happens if blood is returned while aspirating
reject the dose and start over
What is the maximum single injection for adults
3 mL
What should you do before administering antiinfectives
check the patients medication history of drug sensitivity
Insulin
an aqueous solution
principal hormone of the pancreas
Diabetes mellitus
deficiency of insulin
Type 1 DM
occurs before age 30
pancreatic beta cells do not produce insulin
insulin injections must be taken daily
Type 2 DM
usually occurs after age 30
pancreas produces some insulin
only 40% take insulin regularly
what is the most common complication of insulin therapy
Hypoglycemia
what is used to treat hyperglycemia
glucose tablets
glucose gel
and glucagon injections
If a patient is over 20 Kg how much glucagon can be injected
1 mL
If a patient is under 20 Kg how much glucagon can be injected
0.5 ml
What is the preferred area for insulin injections
abdomen
what are alternative areas for insulin injections
upper arms, back, or thighs
What are the signs of hypoglycemia
rapid onset cold and clammy skin diaphoretic nervous blood glucose below 70mg/dL
What are the signs of hyper glycemia
several hour onset warm skin flushed dry skin lethargic blood glucose above 300 mg/dL
Rapid Acting Insulin
Aspart (Novolog)
Lispro (Humalog)
Glulisine (apidra)
Aspart characteristics
5-15min, 1-3hr, 3-5hr
when do you take rapid acting
15 min before meals
what can be mixed with rapid acting
NPH
Characteristics of Lispro and Glulisine
15 min, 1-2hr, 3-4 hours
Short- Acting Insulin
Regular (novolin R)
Regular (humulin R)
Regular (Novolin R) characteristics
30-60min, 2-5hr, 6-8hr
Regular (humilin R) charateristics
40-60min, 2-3hr, 4-6hr
What can short-acting insulin mix with
NPH
When should you take short-acting insulin
30min before a meal
Intermediate actin Insulin
NPH (Novolin N)
NPH (humulin N)
NPH Novolin N
90min, 4-12hr, up to 24 hr ** cloudy
NPH Humulin N
2-4hr, 4-10hr, 14-18hr *** Cloudy
When should you take intermediate insulin
30min before a meal
what can be mixed with intermediate insulin
Regular and rapids
Long-acting insulin
Glargine (lantus)
Detemir (levemir)
Glargine (lantus)
3-5hr, peakless, 22-26hr
Detemir (Levemir)
2-4 hr, Peakless, 13-20hr
When should you take Glargine
bedtime
When should you take Detemir
Bedtime or supper time
What can you mix with long-acting
NOTHING DO NOT MIX
How often are premixed insulins taken
Twice a day
Short and intermediate acting 70/30 or 50/50
1-4hr, 2-4hr/6-10hr, 3-4hr/10-16hr, *** cloudy
When do you take short and intermediate mix
30min before a meal