Week 3 - 5 Flashcards
If you had to mix a medication and draw up from a vial and an ampule, which would you draw up from first?
The vial and then the ampule because the ampule is single use
What parenteral medication delivery provides the quickest medication absorption and why?
IM because of the increased amounts of blood vessels
At what angle do you insert an IM injection?
90 degrees
At what angle do you insert a SCBF?
30 degrees
At what angle do you insert a SC injection?
45 degrees
At what angle to do insert an intradermal injection?
5-15 degrees
When would be the only instance when you DO NOT aspirate during an IM injection?
If it is a vaccination/immunization
For IM injections, which site is appropriate for a large and more irritating medication?
Ventrogluteal
Which muscle is best for pediatrics of all ages?
Vastus lateralis
What site should not be used in children who have not yet started walking?
The Ventrogluteal as this muscle will be under developed
How do you landmark the deltoid muscle?
It is three finger widths below the acromion process
How do you landmark the vastus lateralis muscle?
It is one hand length above the knee or one hand length below the greater trochanter
What is a risk of using the Ventrogluteal site for a pediatric patient who has not yet started walking?
The sciatic nerve takes up much of the dorsogluteal space, if hit temporary or permanent paralysis may occur
Where do you dispose of a needle after use?
Sharps container
What type of needle should you use when drawing up from an ampule?
A blunt tip filter needle
What type of needle should be used when drawing up from a vial?
A blunt tip needle
What length of needles should be used for IM injections?
1 - 1 1/2 “
What length of needle should be used for subcutaneous injections?
5/8 - 1/2 “
What method is best practice for IM injections?
The Z track method
What is the Z track method and why is it important?
When you pull on the skin near the injection site before injection is given, creates a Z pattern where the needle was inserted and prevents the medication deposited in the muscle from entering and irritating the subcutaneous tissue
True or false: bevel down
False
Why is rotating injection sites important?
To prevent lipohypertrophy
Approximately what gauge should be used for an IM injection, what sizes for viscous, and what sizes for aqueous solutions?
A larger gauge for viscous- about 18-21 and a bit smaller for aqueous about 20-25
How much medication is being deposited in an intradermal injection?
0.01-0.1 mL
What size needles are ID needles?
3/8 - 5/8” usually
In IM injections; how much medication can safely be deposited in a well-developed muscle?
2-5 mL (usually 3)
How do you landmark the Ventrogluteal muscle?
Place heel of hand over greater trochanter, thumb points towards groin and point index finger to anterior superior iliac spine and middle finger toward iliac crest
What is it important to do before administering a parenteral medication?
Palpate for any lumps or bumps and clean site with antiseptic swab
What sites are used for subcutaneous injections?
The abdomen (2.5 inches away from belly button), the anterior thigh and the lateral aspect of the upper arm
What areas are used for the SCBF?
Abdomen, upper lateral arm, anterior thigh, below the collar bones
How many mLs are needed to prime the one link needle free Iv connector?
0.28 mL
How many mLs are necessary to prime the maxzero needle-free iv connector?
0.4 mL
What is lipohypertrophy?
The scar tissue that forms from continuously using the same injection site over time
How do you prevent a needle stick injury?
Activate the safety and dispose immediately
What precautions do you need to take post-needle stick injury?
Let wound bleed freely
Contact supervisor
Go to hospital within two hours
Where is a common infusion pump site in children?
Abdomen
Which drugs are often given via infusion pump?
Insulin
Heparin
Deferoxamine
How often do infusion pump sites need to be changed?
Every 1-2 days
How old can kids be to use auto inject syringes?
5-6 years old
What is the purpose of ID injection?
TB and allergy testing
Why is TB and allergy testify done ID?
Minimal blood vessels which means very slow medication absorption, the medications are very potent
How do you know if you’ve entered subcutaneous tissue during an ID injection?
No bleb forms or the site bleeds when the needle is withdrawn
What forms from an ID injection?
A 1/4” bleb
What is the parenteral route of choice for chronic pain?
SCBF
How often should the SCBF be changed?
Once per week
What information should be included on the label of the SCBF?
Date, drug and drug concentration, initials
What length of IM needle should be used for a thin person?
5/8 - 1/2”
What length IM needle should be used for an average person?
1”
What length needle should be used for a patient over 70kg?
1 - 1 1/2”
What length IM needle should be used for a patient over 90kg?
1 1/2”
What are advantages to using the Ventrogluteal site?
It is deep and situated away from any major blood vessels
What speed should you inject IM injections at?
10 sec / mL
How long do you leave the needle in the skin to allow proper dispersion of med?
5-10 sec
When preparing insulin, what do you do with the medication first?
Roll the vial in hand to suspend medication
Can you mix insulin? If so which medication do you pull up first?
If compatible, pull up rapid acting or short acting insulin first to prevent contaminating it with long acting
Complications from IM injections include:
Pain
Scar tissue
Hitting nerve/blood vessel
To reduce pain associated with IM injection:
Bevel up, Z track, ensure muscle relaxation
