35 Flashcards by Kensia Saintluc

Please list the principal for safe, effective administration of parenteral medication

Know No the medication you will be a administering

Check for a drug allergies

Use only sterile needles

Select appropriate length of the needle

Label the syringe with the patient name, name of the drug, and dose

Obtain assistance if needed with a child

Rotate injection site

Avoid major nerves, blood vessel, and underlining organs

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IM- usually 90 degree

Intramuscular

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Below the skin usually 45 degree

Subcutaneous

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ID-Between the dermis

Intradermal

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Routes require a syringe or needle

Injection iv

Parental

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Bump

Visible elevation of the epidermis usually 15 degree

Bleb

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Thick and sticky

Oil solution

Viscous

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Solid material

Solute

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Specified fluid to dissolve the solute

Diluent

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What are the reasons why medication are given by injection

When the patient can’t Take meds by mouth

To hasten the action of the drug

When a continuous infusion of meds is necessary

When digestive juice would not counteract the effect of the drug if given by the oral route

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What are the units of measurement for a needle

Gauges

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The more_____the tissue, the____the medication is absorbed

Vascular, quicker

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The wrong____or____may cause____to a major nerve or blood vessel or death

Site or route, damage

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90°

Intramuscular

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Intramuscular syringe

3 mL syringe

Maybe 5 mL

When the dosage is more than 3 mL it is split it into two different muscles

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What is the size for intramuscular needle

1 to 1.5 in long

Up to 3 inches needle although that is less common

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What size gauge for intramuscular

21 to 23

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Sites for intramuscular

Deltoid only 1 mL

VENTROGlUTEAL

VASTUS Laterails for peds

Rectus

Femoris of the thigh

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45° to 90° based on the size of the patient then patient gets the smaller angle

Subcutaneous

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Types of syringe for subcutaneous

Tuberculin or 3 mL syringe

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Size of the gauge and needle for subcutaneous

27 or 25 gauge

1/2–5/8 inches

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Site for subcutaneous injection

Lateral surface of upper arm or

anterior lateral surface of the thighs.

abdomen

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5° to 15°

Intradermal

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Type a syringe for intradermal injection

Tuberculin syringe up to 1 mL

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Type of needles and gauges for intradermal injection

1/4 to 1/2 for needles 25–29 gauge

Sites for intradermal injection

forearm

What are the most frequently used IM sites for injection

VENTROGlUTEAL Dorsogluteal (only if ordered) Deltoid Vastus laterails (peds)

How many milliliters can safely be injected into the ventrogluteal, vastus laterails al, and rectus femoris site in most adult patients

1 to 3 mL Divide larger volume into two syringe and use two sites

Which part of the syringe must be kept sterile

The needle The Tip The inside of the barrel The side of the plunger

Popular because it is large enough for subcutaneous and moles intramuscular injection Measures 10th of a milliliter 0.1

3 mL

Generally universal use do not use it for injection

10 mL and 12ml

Are 1 mL in size and are calibrated to measure drug doses as small as 0.01 mL it is used to measure doses in hundred

TB syringe

100 calibrated to measure 100 units of insulin syringe should not be used for anything other than insulin

Insulin unit hundred

For lower doses u-50 Insulin is calibrated for 50 units

Insulin you – 50

Is used for intramuscular injection because it locks and prevent the needle from separating the syringe

Luerlock

For intradermal injection because little pressure is needed

The slip tips

Consist of a vial with an attached needle four use with the carpuject holder

Unit-dose cartilage

Parts of the needle

Bevel, needle shaft needle protector

The slanted part of the needle for the tip ending in sharp points with a whole

BEVEL

A safety device that retracts the needle after the use to prevent accidental stick

Needle protector

The length of the needle

Needle shaft

The____the number of gauge the___the needle

Larger, smaller

How would you remove the medication from the neck of an ampule into the body

Tap or flick the stem several times with a finger to Free the trap solution

How can you safely break open a AMPULE

AMPULE breaker or wrap the neck with a gauze or an alcohol swab Please both times together at the neck and apply outward pressure to snap your neck away from you

What method can be used to recap a clean needle

Use a one hand scoop technique Place the needle cap on a flat, farm surface, with one hand holding the syringe barrel inside the needle into the needle cat cap

What info should be on a syringe in which you have drawn up medication before taking it into the patient room

Patient name, the measurement for the medication dosage, date time and your initial

What type of needle should be used to withdraw the medication from an ampule

A filter needle should be used because small particles of glass may fall into the medication when the AMPULE neck is removed

Should you inject air into the AMPULE before drawing up the medication

No, the medication will bubble up and out of the aMPULE

Where should the tip of the needle be in reference to the solution to withdraw the solution

The bevel of the needle should be below the surface of the solution

Why is air injected into a VIAL before withdrawing the medication

To prevent a vacuum in the VIAL, which may inhibit withdrawal of solution

Two type of insulin economics cannot make

Lantus and Levemir

Why should injection sites be rotated

To promote the best absorption of the medication and to decrease tissue irritation or fibrosis

When should a tuberculin skin test be read

48–72 hours after injection

How do you know if it’s positive or negative tuberculin

Positive is more than 5MM Negative is less than 5MM

Which route of administration absorbs more quickly subcutaneous or intramuscular

Intramuscular

What are the common site used for subcutaneous injection

Lateral surface of the upper arm or anterior/lateral part of die

What sites are the most commonly Use for heparin injection why

On the abdomen below the costal margin, because this area is not involved in muscular activities love handle are 2-3inches away from the umbilicus

Why is this right now massage after administration of heparin

This may cause bruising of the tissue, bleeding are severe ecchymosis

What are some medication that should be checked by two nurses before administration

Insulin heparin injectable heart medication chemo drugs

What is the technique that can be used to find the deltoid site for intramuscular injection

Please four fingers across the deltoid muscle, with the little finger on the acromion process

Why is the dorsogluteal say avoided for intramuscular injection

The high potential for injury to the sciatic nerve in the blood vessel

What is the preferred site for intramuscular injection in infants under 12 months

vastus laterails

What is the Z- track Technique Why is this technique used What common medication are given this way

It is a IM injection Medication can leak upward into the subcutaneous tissue, causing staining, bruising, and significant pain for several weeks or longer with some medication It must be used whenever a deep IM injection or Iron DEXTRAN and other irritating solution such as hydroxyzine or hydrochloride and several antipsychotic agents are given

What position can be used for I am injection to help relax the muscle

Prone or Sim’s position

When giving a deltoid injection to a child, give the injection in the_____part of the muscle; the needle should point out a slight____ towards the shoulder

thickest, angle

What is the appropriate age for a deltoid side to be used for immunization and in a child

Over 13 months unless the muscle is poorly developed then you avoid it still

How soon after a new medication is given should the nurse assess for side effects

Observe the patient for 30 minutes after the drug has been given for the first time

Is a 29G needle bigger or smaller than a 24G needle

Smaller

Why is the abdomen a good place to administer certain subcutaneous medication

It provides the most reliable, steady absorption

What intramuscular injection can cause SCAIATIC nerve injury if the medication is not a minister correctly

Dorsogluteal

What is the maximum volume for most intramuscular injection site What would you do if the amount you need to minister is more than the maximum amount

3 mL It is more than 3 mL divided dose in half and give it into two different large muscle sites

What needle size and length would you use when administering a medication using the truck method

At least a 1 1/2 -3 Inch needle 22 to 23 gauge needle

What should be done with any unused medication from an AMPULE

Waste it and have another nurse witness

What information must be placed on the label for multidose vial

Date, time and initials

How would you know if a drug is compatible with another medication

There will be a different reaction in the medication are not compatible. The reaction range from color change precipitation, and clouding to to invisible chemical changes rendering the drug inactive ask pharmacy and look in the drug book

How quickly can IM injection provide Onset action

Within 15 minutes

What is the maximum amount of medication that can safely be injected into deltoid of an adult

1 mL

When administering any parental medication, how long should you observe the patient after a ministration of an anaphylactic reaction

30 minutes after the drug has been given for the first time Some allergic reaction may occur up to two weeks after the medication has been administer 2.2 pounds = 1 L of retained water