Week-3 Parenteral Meds

Question 0

Discuss the following r/t ID

• use
• site(s)
• needle length
• gauge
• angle of insertion
• considerations

Answer 0

TB testing
Forearm or upper back
10-16mm length
26-27mm G
5-15 degrees
Bevel of the needle up
If no bleb appears, or blood appears, you may have entered SQ = restart

Question 1

Discuss the following r/t IM

• use
• site(s)
• needle length
• gauge
• angle of insertion
• considerations

Answer 1

Immunizations
Ventrogluteal, deltoid, vastus lateralis
25-28mm length
18-27mmG
90 degrees
45 degrees for thin patients
Aspirate for blood; if blood discard and restart
Pull skin laterally for ztrack

Question 2

Discuss the following r/t SQ

• use
• site(s)
• needle length
• gauge
• angle of insertion
• considerations

Answer 2

Insulin or heparin 
Posterior upper arm, thigh, abdominal (away from umbilicus)
12-16mm length
22-25mmG
45-90 degrees depending on patient size
Pinch skin fold to insert

Question 4

What is the FITechnique and its principles?

Answer 4

Safe and painless medication admin based on insulin inj. 
Give least drug and least needles
Avoid hair roots, scars, etc.
Inspect and palpate area
Medications to be given at room temp
Use small needles 
Use new needles and new sites for eah inj
Inj quickly and smoothly

Question 5

Which type of insulin is mixed first when admin two?

Answer 5

Fast first; clear before cloudy

Question 6

what is the appropriate needle for drawing up medication from vials? reconstitute meds? ampules?

Answer 6

• blunt tip
• blunt tip
• filter needle

Question 7

Of the syringe, you should not touch

Answer 7

needle, plunger

Question 8

What is crucial to check for in injection medications, that differs from oral meds?

Answer 8

• colour and clarity

- the injection site

Question 9

What is the IM deltoid site used for? Landmark the site.

Answer 9

• <1mL injections

- 2-3 fingers below the acromial process

Question 10

Landmark the ventrogluteal IM site.

Answer 10

locate the greater trochanter with the heel of your hand; spread index finger. <3mL

Question 11

True or False: after use of a needle recap to avoid needle-stick injuries

Answer 11

False; dispose in sharps, use safety mechanism, recap like a pen (IF NEEDED)

Question 12

Explain the Z-track method. Why is it used?

Answer 12

• pull skin laterally (with SQ tissue), hold taut, insert needle, inject (following aspiration), withdrawal, release skin.
• minimizes local irritation by sealing medication in muscle; less discomfort and fewer injection sites

Question 13

True or False: SQ has a lower risk of striking a blood vessel than IM?

Answer 13

True. Also less risk of striking a nerve

Question 14

True or False: if you can grasp more than 2.5cm of tissue for SQ injections, inject at a 90degree angle.

Answer 14

False. >5cm = 90degrees; less is generally an implication for 45 degree angle injection.

Question 15

True or False: you should always aspirate for blood when giving heparin, insulin, and IM injections.

Answer 15

False. NEVER aspirate when giving insulin or heparin. Aspirate for blood in IM injections.

Question 16

True or False: You should not massage the site after giving an injection.

Answer 16

True. Instead, cover the site with an alcohol swab and apply gentle pressure

Question 17

What should you do if you obtain a cloudy insulin vial prior to preparing your patients medication?

Answer 17

Roll the vial, it may need to be reconstituted. Confirm the consistency of the medication. Check the expiry date.

Question 18

Where is insulin absorbed the fastest? slowest?

Answer 18

the abdomen. the buttocks

Question 19

What is the effect of injection insulin into an exercising limb?

Answer 19

faster action

Question 20

What is Lipodystrophy? How is insulin absorption affected? How can you prevent it?

Answer 20

• thickened lesions, hard when palpated.
• caused by repeated injections and no inspections
• results in decreased absorption
• rotate sites, use needles once, inspect and palpate sites

Question 21

How can you help children during an injection?

Answer 21

• ask them WHERE they want the injection
• provide ELMA cream
• obtain healthcare team to ‘control’ (do not use parents)
• make sure child is awake

Question 22

True or False: 100 units of insulin is the equivalent to 10mL or 100cc

Answer 22

True.