WEEK 3 SC INJECTIONS Flashcards
1
Q
What are the most common size of syringes?
A
1 cc and 3 cc
2
Q
What unit are syringes usually calibrated in ?
A
mL
3
Q
Which syringes are calibrated in Units?
A
Insulin syringes
4
Q
Name the 3 parts of a syringe
A
- Tip
- Barrel
- Plunger
5
Q
What are the two types of syringe tips, and which tip is most common?
A
Slip tip and luer lock (most common)
6
Q
Which part of the needle is the sharp and slanted tip?
A
Bevel
7
Q
Which part of the needle is the long and narrow portion?
A
Cannula / shaft
8
Q
Which part of the needle is the part that connects to the barrel of the syringe?
A
Hub
9
Q
What does the colour of the hub indicate?
A
The gauge of the needle
10
Q
What kind of needle has a blunted bevel and is used for preparing but not injecting medication?
A
Blunt fill needle
11
Q
What kind of needle has a blunted bevel, but also has a filter inside the hub?
A
Blunt filter needle
12
Q
What is the gauge of a needle?
A
The diameter
13
Q
What does a higher gauge mean?
A
Finer needle
14
Q
What unit are needle lengths measured in?
A
Inches
15
Q
What determines how long of a needle you should use for injection?
A
Where you are depositing the injection
16
Q
What are 3 things to keep in mind when attaching a needle to a syringe?
A
- Have a clean and hard surface to work with
- Keep the syringe and the needle in the packaging
- Turn in a counter clockwise direction
17
Q
What on the outside of the needle and syringe packaging is important to check?
A
Expiration date
18
Q
Which parts of the needle can you touch and not touch?
A
You can touch the cap but not the hub
19
Q
Which parts of the syringe can you touch and not touch?
A
You can touch the barrel and the plunger but not the tip
20
Q
Which parts of the syringe can you touch and not touch?
A
You can touch the barrel and the plunger but not the tip
21
Q
What are 2 ways to avoid needle stick injuries due to the rebound effect when removing the cap from the needle?
A
- Using two hands, continue to pull the cap away from the needle
- Using one hand, loosen the cap at the base first
22
Q
When drawing up medication, which part of the syringe should you avoid touching?
A
The inside of the plunger
23
Q
Which part of the plunger should be used to measure the medication volume?
A
The top ring at the base of the rubber triangle
24
Q
What are 3 steps to determining the volume in a syringe?
A
- Determine the increments of visible numbers
- Count the steps to the next visible number
- Divide the increment by the number of steps
25
What is the most important thing to remember about sharps safety?
Never recap a dirty needle
26
What are 2 things to do if you puncture yourself with a dirty needle?
1. Let the wound bleed freely and wash with soap and water
2. Notify your instructor
27
How are safety needles different from regular needles?
They have an initial cap that is removed, and a safety cap attached to the side
28
What is important to keep in mind when using safety needles?
Recapping must be does with a one-handed technique or the risk for needle stick injuries can increase
29
How is a vial different from an ampoule?
A vial has a rubber diaphragm that is pierced with a needle which maintains sterility of the container.
A vial holds multiple doses of medication
30
Do you need to wear gloves when preparing a medication from a vial?
No
31
Name 8 steps in withdrawing medication from a vial
1. Remove lid from vial and clean with alcohol
2. Attach blunt fill needle to syringe
3. Draw air into syringe equal to volume of med to be given
4. Inject air into the vial pointing straight down
5. Invert vial, hold to eye level, and draw up medication to correct dose
6. Expel air bubbles back into the vial and remove needle
7. Recap blunt fill needle and remove from the syringe
8. Attach standard needle to syringe to administer medication to patient
32
What are two harmful consequences of not removing air from a syringe?
1. Incorrect dosage
2. Large amounts of air can cause tissue abscess and infection
33
What should be done with an unlabelled syringe that has been out of eyesight?
It should be discarded
34
When are the 3 medication checks performed when withdrawing medication from a vial?
1. When removing the medication from the drawer
2. Just prior to drawing up the medication with the syringe
3. When returning unused medication to the drawer or discarding
4. Also perform a check at the patient's bedside by comparing the MAR to the pt nameband
35
What are 2 ways ampoules are different from vials?
1. Made only of glass
2. For single dose only
36
What safety issue should be kept in mind when using ampoules?
Snapping the neck may produce glass shards
37
What kind of needle should be used when withdrawing medication from an ampoule?
Filter needle
38
What are 2 methods of getting all of the medication out of the ampoule neck?
1. Tap the neck
2. "Around the world" method
39
What are 2 methods of opening an ampoule?
1. With an alcohol swab package
2. With an ampoule opener
40
Which way should you bend the neck to break it the ampoule open?
Away from you (bring thumbs together)
41
What are two methods of withdrawing medication from an ampoule?
1. With needle straight down into ampoule sitting on a flat surface
2. Inverting the ampoule to withdraw the medication
42
Why should you insert the needle into the ampoule before inverting it to withdraw the medication?
Inserting the needle into the ampoule after inverting it will break the surface tension and the medication will spill out
43
Why is it important that the needle not touch the sides of the ampoule?
It is considered contaminated
44
What does parenteral mean?
By injection
45
What are the 4 different parenteral routes?
Intradermal, subcutaneous, intramuscular, intravenous
46
Why is medication absorption rate from the subcutaneous route slower than from the intramuscular and intravenous routes?
Subcutaneous tissue has less blood vessels
47
What length of needle is used for SC injections?
5/8"
48
What gauge of needle is used for SC injections?
25-50 gauge
49
What is the maximum volume of medication you can give SC?
1 mL
50
What size syringe should you use for a medication less than 1 mL?
1 cc
51
What size syringe should you use for a medication exactly 1 mL?
3 cc
52
What is the "pinch an inch" rule?
If you can pinch an inch of subcutaneous fat, then you can use a 90 degree angle for injection. If you can't, then use a 45 degree angle.
53
What should be kept in mind when inserting a needle at any other angle besides 90 degrees?
Bevel up
54
What are 3 most common SC injection sites?
1. Side and back of upper arms
2. Abdomen at least 1 inch away from navel
3. Front of upper thighs
55
What are 2 uncommonly used SC injection sites?
1. Scapular areas of upper back
2. Upper buttocks
56
What should be assessed at SC injection sites?
1. Amount of SC tissue
2. Bruising
3. Scar tissue
4. Tenderness
57
What is the term for scar tissue that forms when an SC injection site is overused?
Lipoatrophy
58
What are the 8 steps for administering an SC injection?
1. Grasp a skin fold to estimate the amount of SC tissue
2. Clean the area with alcohol
3. Place a piece of gauze between the 3rd and 4th finger of your nondominant hand
4. Uncap the needle and grasp the syringe in your dominant hand like a dart
5. Pinch up the skin with your nondominant hand and insert the needle
6. Release the skin, and stabilize the syringe by the barrel with your non dominant hand
7. Inject the medication with your dominant hand
8. Remove the needle, apply gauze to area, and apply pressure
59
When should the needle be changed in order to minimize patient discomfort?
1. If irritating medication has coated the outside
2. If the top of the vial has been pierced more than twice
60
What are 4 things to remember when giving injections to minimize patient discomfort?
1. Insert the needle quickly and smoothly
2. Inject the medication slowly
3. Stabilize the syringe
4. Withdraw the needle at the same angle it was inserted
61
What are 5 kinds of clients that may need heparin?
1. Immobile
2. Decreased blood flow
3. Increased blood pooling
4. Postoperative
5. Clotting disorders
62
What should be assessed for in clients on heparin?
Signs of bleeding: increased bruising, bleeding gums, melena, coffee-ground emesis
63
What labs should be monitored for clients on heparin?
Hemoglobin, PTT, INR
64
What is the Langara policy about heparin?
The dosage must always be checked by your instructor
65
What are 5 special considerations regarding heparin?
1. It is very irritating to the tissues
2. It must be given to the deep sc tissue (90 degree angle preferred)
3. Abdomen is the site of preference due to more sc tissue present
4. Continue to pinch the skin fold while injecting the medication
5. Apply pressure for 30-60 seconds after injection
66
How long are subcutaneous butterfly catheters left in place?
About 7-9 days depending on policy
67
What is the brand of sc butterfly being used in class?
Safe-T Intima
68
What are 2 indications for sc butterfly use?
1. Patients requiring frequent sc injections, such as palliative patients
2. Hypodermoclysis -- continuous fluid admin via sc route (rare)
69
How many medications can be administered at an sc butterfly site?
One only
70
Which two medications should not be administered via sc butterfly?
Heparin and insulin
71
What are 3 steps to administer medication through an sc butterfly?
1. Disinfect valve for 30 seconds and let dry
2. Attach syringe and slowly infuse the medication
3. Do not flush
72
What is important to remember when administering the initial dose through an sc butterfly?
You will have to draw up extra medication to account for the air within the tubing and the adaptor
73
How do you find out how much extra medication to add to an initial sc butterfly dose?
Health authority policy
74
How often should sc butterfly sites be assessed?
Once per shift
75
What should be assessed for an sc butterfly site?
1. Appearance: redness, bruising, bypassing
2. Pain
3. Feeling: firmness, edema
4. Dressing: intact, change date
5. Label
76
What should be documented under the action section of your documentation?
Drug given, patient teaching provided (including side effects), and plan to monitor
