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4007PM > WEEK7- Drug administration > Flashcards

WEEK7- Drug administration Flashcards

1
Q

what are the 6d’s of drug administration

A

drug - the name of drug, allergies
dose - check dose (grams, milligrams, micrograms) and quality/volume
date- check expiry date
duration(timing)- how often can the drug be given, patient’s history of drugs, w the time now
distance(route)- how should drug be taken, are you competent of the route
documentation- document drug,dose,date time and route

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2
Q

what are the routes of admin that a first year can conduct

A

inhaled, oral, nebulised, sublingual (tongue) buccal (check) rectal, intranasal, intramuscular and subcutaneous

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3
Q

which drugs are parental and which drugs are non-parental

A

non parenteral:
inhaled
oral
nebulised
sublingual
buccal
rectal
intra nasal

parenteral:
subcutaneous
intraosseous
intravenous

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4
Q

how do you conduct nebuliser

A
  1. add medication to chamber of nebuliser
  2. attach chamber to the oxygen mask
    connect the mask using some tubing to 6-8 litres of oxygen. fine mist should be generated
  3. place mask over face
  4. get patient to breath in slowly and deeply over 3-5 seconds
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5
Q

how do you conduct intranasal

A
  1. draw up liquid drug from container.
  2. check 6d’s and that equipment is intact
  3. attach drawing up needle to a syringe- 4. use ampoule breaker to open drug.
  4. draw up drug, insert syringe to exposed liquid and pull back on plunger of the syringe.
    REMEMBER: extra 0.1ml of liquid should be drawn up to allow dead space in device
  5. remove any air in syringe
  6. place blunt needle in sharps bin immediately
  7. attach to atomiser device to the syringe
  8. hold head back and insert tip of device into one nostril. Aim device up and out towards ear
  9. briskly press plunger to administer half syringe of medication
  10. swap to other nostril and deliver other half of medication
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6
Q

what is the recommended needle depth for IM

A

5/8 inches to 1.5 inches.
depends on adipose (fat) tissue on the arm
most adults over 60kg will need a 1inch needle

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7
Q

what are the 2 most common places to conduct IM

A

deltoid muscle
anterolateral thigh

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8
Q

how to conduct IM

A
  1. draw up drug from ampoule
  2. check 6d’s and ensure drugs are intact
  3. attach blunt (drawing up) needle to a syringe- used to filter any glass which may have entered liquid
  4. use ampoule breaker to open drug
  5. draw up drug, insert blunt needle/syringe into exposed liquid and pull back on the plunger of the syringe.
  6. remove any air in syringe
  7. place blunt needle in the sharps bin immediately.
  8. select current site, prepare skin with alcohol wipe
  9. select appropriately sized intramuscular needle and attach to the syringe.
  10. verbalise you have removed cap from needle
  11. pull skin and subcutaneous tissue downwards and sideways with one hand
  12. insert the needle at 90 degrees angle into the skin until muscle is reached
  13. draw back the plunger on the syringe. if no blood is seen then no vein has been entered
  14. push drug in
  15. wait 10 seconds then remove needle
  16. push against an object to engage the safety cap on the needle and put in sharps bin
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9
Q

how do you conduct subcutaneous

A
  1. use same technique to draw up the medication using blunt needle
  2. smaller depth syringe (3/8 to 5/8 of an inch)
  3. check needle is correct size by pinching tissue with thumb and finger. needle should be half of the depth of the fold
  4. select correct site, wipe skin with alcohol wipe with a circular motion
  5. verbalise that cap is removed from needle
  6. pinch skin together using index finger and thumb
  7. inject needle between 45-to-90-degree angle then remove needle and release skin
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10
Q

what considerations must be conducted before administering drugs

A

presentation
indications
actions
contraindications
cautions
side effects
dose and admin

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11
Q

indications and contraindications of aspirin

A

given to query MI or ischemia
or suspected TIA (when symptoms fully resolved, isn’t being conveyed to hospital, referred into a local TIA pathway

known allergies/ sensitivity to drug
children under 16
active gastrointestinal bleeding
haemophilia or other known clotting disorders
severe hepatic failures with jaundice

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12
Q

what’s the route of admin for aspirin

A

oral- to be chewed

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13
Q

indications and contraindications of gtn

A

cardiac chest pain due to angina/ myocardial infarction
when the systolic blood pressure is more than 90mmHg
breathlessness due to pulmonary oedema in acute heart failure when systolic blood is greater than 110mmHg
patient with cocaine toxicity with chest pain

hypotension
head trauma
hypovolemia
cerebral haemorrhage
unconscious patient
know severe aortic. mitral stenosis
if Viagra has been taken in past 24 hours

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14
Q

whats the route of admin for gtn

A

sublingual (under the tongue)

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15
Q

indications and contraindications of adrenaline

A

anaphylaxis
life threatening asthma with failing ventilation and continued deterioration despite nebuliser therapy

no indications

1:1000

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16
Q

whats the route of admin for adrenaline

A

intramuscular (IM)

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17
Q

indications and contraindications of chlorpenamine

A

allergic reactions falling short of anaphylaxis but causing the patient distress
alleviating distressing cutaneous symptoms in anaphylaxis only after emergency treatment with adrenaline and patient is stable

known hypersensitivity
treatment with MAOI’s- old style of anti-depressants

18
Q

whats the route of admin for chlorpenamine

A

intramuscular (IM) or oral

19
Q

indications and contraindications for hydrocortisone

A

severe/life threatening asthma
acute exacerbation of COPD
adrenal crisis- long term steroid therapy.
patients who have established adrenal crisis/ patients with suspected adrenal insuffiency on long term steroid therapy that have become unwell
pregnant woman with Addisons disease who are in labour

known allergies

20
Q

whats the route of admin for hydrocortisone

A

intramuscular

21
Q

indications and contraindications of ipratropium bromide

A

acute, severe or life-threatening asthma
asthma unreasonable to salbutamol
exacerbation of COPD unresponsive to salbutamol
expiratory wheezing

none in emergency situation

22
Q

route of admin for ipratropium bromide

A

nebuliser

23
Q

indications and contraindications of naloxone

A

reversal of acute opioid or opiate toxicity for respiratory arrest/respiratory depression
unconsciousness associated with respiratory depression of unknown cause where opioid overdose is a possibility
cardiac arrest where opioid toxicity is the likely cause
patients exposed to high patency anaesthesia if consciousness is impaired

neonates born to opioid addicted mothers

24
Q

route admin for naloxone

A

intramuscular or intranasal

25
Q

indications and contraindications of oxygen

A

critical illness required high levels of supplemental oxygen
serious illness requiring moderate levels of supplemental oxygen if hypoxaemic

explosive environments

26
Q

route of admin for oxygen

A

inhaled

27
Q

when administering oxygen when do you reduce it

A

administer oxygen dose until vital signs are normall then reduce oxygen dose to aim for target saturations

28
Q

what is Fi02

A

the fraction of inspired oxygen. this is an estimation of the oxygen content a person inhales and is thus involved in gas exchange at the alveolar level

29
Q

what are the different types of oxygen masks

A

simple mask (hudsons mask, flow 6- 10LPM, Fi02 35/50%)
face tent (flow 10-15LPM, Fi02 30/40%)
venturi mask (flow 2-15 LPM, Fi02 24/60%)
partial rebreather (flow 10-15LPM, Fi02 60/80%
non-rebreather (flow 10-15LPM, Fi02 80+)

30
Q

when would u put 15 litres of oxygen on straight away

A

cardiac arrest/resuscitation (15 litres until vital signs are normal- through bag valve mask)
carbon monoxide poisoning (maximum dose ONLY don’t reduce 02 at all- through high concentration 02 mask)
Major trauma, anaphylaxis, decompression illness, major pulmonary haemorrhage, sepsis, shocking, drowsiness (15 litres per minute- high concentration mask)
active convulsion, hyperthermia (15 litres until reliable SP02 reading- high concentration 02 mask)

31
Q

when would you put moderate oxygen on straight away

A

acute hypoxemia with SP02 reading below 85% (10-15 LPM- bag valve mask)
deterioration of lung fibrosis or acute asthma with SPO2 between 85-83 (2-6 LPM- high concentration 02 mask)
acute heart failure, pneumonia, lung cancer, pulmonary embolism, postoperative breathlessness, severe anaemia, sickle cell crisis (5-10 LPM high concentration 02 mask)

32
Q

when to give low dose of oxygen straight away

A

copd, exacerbation of cystic fibrosis, chronic neuromuscular disorder, morbid obesity, chest wall disorders (4LPM- 28% venturi mask)
if oxygen saturation remains below 88% increase dose and change mask (5-10LPM- simple face mask

REMEMBER: critical illness and COPD- if copd develops a critical illness/injury then target saturations of 94-98% should be aimed.
Unless this causes decreased conscious level. decrease oxygen and aim for 88-92%

33
Q

indications and contraindications of glucagon

A

hypoglycaemia clinically suspected hypoglycaemia or an unconscious patient where hypoglycaemia is considered a likely cause (below 4.0 millimoles per litre)
should be administered when oral glucose administration isn’t possible/ is ineffective and then iv administration of glucose isn’t possible

pheochromocytoma- type of neuroendocrine tumour that grown in adrenal gland
dont inject iv

34
Q

route of admin for glucagon

A

intramuscular

35
Q

glucose (40% oral gel) indications and contraindications

A

known or suspected hypoglycaemia in a conscious patient where there’s no risk of choking or aspiration

none

36
Q

route of admin for glucose

A

buccal

37
Q

indications and contraindications of paracetamol

A

relief of mild to moderate pain or high temperature with discomfort (not just high temp)

known allergy
don’t give if further paracetamol containing products have been taken in last 4 hours (6 hours in patients with renal impairment) or if the maximum cumulative daily dose has already been given

38
Q

route of admin for paracetamol

A

oral-swallowed

39
Q

aindications and contraindications of nitrous oxide

A

moderate to severe pain
labour pains

severe head injury with reduced LOC
chest injury and clinically suspected pneumothorax
abdominal pain where intestinal obstruction is suspected
violently disturbed psychiatric patients
if patient has had an intraocular injection of gas within the last 8 weeks
decompression sickness, consider anyone that has been diving in last 24 hours

40
Q

route of admin for nitrous oxide

A

inhaled

41
Q

drugs that i can’t physically administer but need to know

A

clopidogrel:- given as oral- swallowed. used for the treatment of an ST-elevation Myocardial infarction (STEMI)

dexamethasone:- given as oral solution- tablet. used for the treatment of moderate to severe croup

diazepam:- given rectally. used for the treatment of prolonged convulsions or symptomatic cocaine toxicity

midazolam:- given buccal. used for the treatment of prolonged convulsions

benzylpenicillin:- given as IM. used for suspected meningococcal disease in patients with a non-blanching rash or signs and symptoms

ondansetron;- given as IM, used for treating nausea and vomiting

morphine sulphate:- given as IM injection/orally. used for the treatment of severe pain management, pain associated with MI or ed of life are

4007PM (16 decks)

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