Chapter 37

Question 1

A small, sealed glass drug container that must be broken to withdraw medication

Answer 1

Ampule

Question 2

Instillation of 0.1-0.2 mL of air following the injection of the medication for the purpose of reducing tissue irritation along the path of the needle.

Answer 2

Air-Lock

Question 3

An injection into the dermis (skin)

Answer 3

Intradermal (ID)

Question 4

An injection into the subcutaneous layer below the skin and above the muscle layer

Answer 4

Subcutaneous (Subcut)

Question 5

An injection into the muscle

Answer 5

Intramuscular (IM)

Question 6

The metabolism of oral medication by the liver, decreasing the effect of the medication. Can be passed using sublingual, buccal, and parenteral routes.

Answer 6

First-Pass Metabolism

Question 7

4 Advantages of Parenteral Administration

Answer 7

1. Bypasses the GI Tract; No irritation
2. Rapid onset time compared to the oral route
3. Ease of admin to uncooperative or unconscious patients
4. Better absorption of drugs that are otherwise poorly absorbed via the oral route

Question 8

5 Disadvantages of Parenteral Administration

Answer 8

1. Invasive and uncomfortable for the patient
2. Expensive
3. Requires additional supplies and equipment
4. Requires qualified personnel to administer
5. Carries a risk of infection and nerve injury

Question 9

used for intramuscular or subcutaneous injections

Answer 9

Standard Syringe

Question 10

Used only for injecting insulin

Answer 10

Insulin Syringe

Question 11

Used for small volumes of meds and TB Test

Answer 11

Tuberculin Syringe

Question 12

Single dose, ready to use syringes

Answer 12

Prefilled Syringe

Question 13

What are the parts of a syringe?

Answer 13

Barrel
Plunger with flange on the end
Tip for connecting to the needle

Question 14

Has threaded grooves that screw into the needle hub and lock it in place

Answer 14

Luer-Loc Tip

Question 15

Has a smooth, slightly tapered tip that inserts into the needle hub

Answer 15

Slip-Tip

Question 16

Parts of a needle

Answer 16

Angled bevel on the tip of the needle
Cannula or shaft
Plastic Hub
Safety Guard

Question 17

To prevent accidental needle sticks you should?

Answer 17

Never Recap a Used Needle

Question 18

What should you do following removal of a needle from an insertion site?

Answer 18

Immediately activate the Needle Guard

Question 19

The bevel should always face which direction when piercing the skin?

Answer 19

Bevel should always be upward

Question 20

Refers to the diameter of the needle and is indicated by numbers: The larger the number, the seller the diameter

Answer 20

Gauge of a needle

Question 21

Gauge used depends on?

Answer 21

Viscosity of the medication
Route of medication
Size of patient and muscle mass

Question 22

Length of intradermal needle?

Answer 22

1/4’’ to 5/8’’ in length with a very tiny diameter between 25 G and 30 G

Question 23

Length of subcutaneous needle?

Answer 23

Between 3/8’’ and 7/8’’ in length with a diameter between 24 G and 29 G

Question 24

Length of a intramuscular needle?

Answer 24

1’’ to 1.5’’ in length, with a diameter between 20 G and 22 G

Question 25

A glass or plastic container of medication with a rubber stopper that must be punctured with needle

Answer 25

Vial

Question 26

What should you do after opening a multi-dose vial?

Answer 26

Write date, time, and initials on label

Question 27

What do multi dose vials contain?

Answer 27

Bacteriostatic Preservatives

Question 28

What is it crucial to do before mixing meds?

Answer 28

Check the compatibility

Question 29

Visual reaction such as color changes, precipitate formation, cloudiness, gas formation or haze

Answer 29

Physical Med Incompatibility

Question 30

Involves degradation of the drug resulting from a chemical reaction

Answer 30

Chemical Med Incompatibility

Question 31

Occurs within the patient, as the result of two concurrently administered drugs that interact

Answer 31

Therapeutic Med Incompatibility

Question 32

Maximum volume to inject intradermally?

Answer 32

0.1 to 0.2 mL (Generally testing for TB or allergies)

Question 33

Maximum volume to inject subcutaneously?

Answer 33

1 to 2 mL

Question 34

Administering an intradermal injection: 5 Parts

Answer 34

1. Position needle with angled bevel upward 2. Use a 15 degree angle for insertion of needle 3. Do not aspirate 4. Instill the medication between layers of the dermis to create a bleb 5. Do not apply pressure to or massage injection site

Question 35

Sites for subcutaneous injections?

Answer 35

``` Back of upper arms Abdomen Anterior aspect of the thighs Area of back just below scapulas Upper buttocks ```

Question 36

Administering a subcutaneous injection

Answer 36

Administer injection at 45 degree angle Pinch or bunch up the skin and underlying fat into a fold between your finger and thumb Insertion should be swift, piercing the skin subcutaneous layer in one quick motion Do not aspirate Apply gentle pressure to the site after removing needle and gently massage to distribute medication

Question 37

2 medications requiring dosage verification with another nurse

Answer 37

Insulin | Heparin

Question 38

Site of choice for those 7 months and older

Answer 38

Ventrogluteal Site

Question 39

Common site for injection of small volumes

Answer 39

Deltoid Site

Question 40

Second choice for injections larger than 1mL - 1st choice for infants

Answer 40

Vastus Lateralis

Question 41

Last choice of sites, used only in adults

Answer 41

Rectus Femoris

Question 42

ONLY if no other site is accessible - Never in infants or small children

Answer 42

Dorsal Gluteal

Question 43

Max volume for injecting large gluteus medium or gluteus minimum of the vfntrogluteal site or a very large vests laterals muscle of the leg, in an adult

Answer 43

3 mL

Question 44

Max volume for the vests laterals muscle in a trim, avg sized adult, over children with adequate muscle development, older adults, and thin patients

Answer 44

1 to 2 mL

Question 45

Max volume for the deltoid muscle in small children up through older adults. Not infants

Answer 45

1 mL

Question 46

Max volume for the vfntrogluteal site and the vests laterals muscle in infants older than 7 months and small children

Answer 46

0.5 to 1 mL