INjectable med admin

Question 1

filter needles use

Answer 1

filter certain meds when drawing up like ampules; NEVER for administrations of meds

Question 2

safe way of recapping needle

Answer 2

scoop up cap with needle and press against the wall or something flat

Question 3

ID needle angle

Answer 3

5-15 degrees

Question 4

SubQ needle angle

Answer 4

45-90 degrees

Question 5

SubQ insulin needle angle

Answer 5

45-90 degrees

Question 6

IM needle angle

Answer 6

90 degrees

Question 7

ID needle diameter

Answer 7

25-27G

Question 8

SubQ needle diameter

Answer 8

25-27G

Question 9

SubQ insulin needle diameter

Answer 9

28-31G

Question 10

IM needle diameter

Answer 10

18-25G

Question 11

should contaminated needles be recapped

Answer 11

NO

Question 12

how to withdraw soln from vial

Answer 12

1. draw air into syringe - same air amount as soln needed
2. cleanse rubber stopper & insert air
3. invert vial and draw up soln
4. flicker syringe as needed to get rid of air

Question 13

withdraw meds from 2 vials - mixing

Answer 13

inject air into both vials
withdraw meds from vial B
withdraw meds from A with B in syringe

Question 14

landmarks for deltoid muscle

Answer 14

acromion process and axillary line
2-3 fingers (1-2 inches) below

Question 15

landmarks for vastus lateralis

Answer 15

head of the greater trochanter - one hand below
knee - one hand above

Question 16

when to use deltoid muscle

Answer 16

2mL of meds
NOT for infants and toddlers younger than 3 yrs

Question 17

when to use vastus lateralis

Answer 17

3mL of meds
YES for infants

Question 18

when to do 45 or 90 degrees for SubQ injections

Answer 18

45 if can pinch 1 inch (2.5cm) of skin
90 if can pinch 2 inch (5cm) of skin

Question 19

landmark for ventrogluteal

Answer 19

heel of hand on greater trochanter and index finger on anterior superior iliac crest

Question 20

mechanical causes of phlebitis

Answer 20

inserting at areas of flexion;
excessively large IV catheter;
not stabilizing it enough

Question 21

other causes of phlebitis besides mechanical

Answer 21

irritating solns;
break in asepsis and bacterial invasion

Question 22

how often to assess IV sites

Answer 22

q4hrs for AxO4 adults;
1-2hrs for all other pts

Question 23

what to do if phlebitis is found

Answer 23

stop infusion and remove;
new one inserted different area; document

Question 24

S/O of infiltration

Answer 24

pallor, swelling, pain

Question 25

S/O of extravasation

Answer 25

blistering, tissue necrosis, ulceration

Question 26

infiltration vs. extravasation

Answer 26

IV slips out of vein or fluid leaks into tissues from another puncture site close to site; extravasation is with vesicants (vancomycin, dopamine, digoxin)

Question 27

what to do with infiltration

Answer 27

stop IV, elevate, apply warm moist or cold compresses

Question 28

what is speed shock

Answer 28

systemic rxn when IV meds is administered too quick -> causing blood lvls of meds to rise to toxic lvls

Question 29

S/O of speed shock

Answer 29

chest pain, lightheadedness, palpitations, tachycardia; shock and cardiac arrest if untreated

Question 30

how to treat speed shock

Answer 30

stop meds, change IV fluid to isotonic soln, notify PCP, treat effects and monitor vital signs, documents

Question 31

how to prevent speed shock

Answer 31

use electronic infusion pump; administer IV bolus over at least 1 min; dilute prn;

Question 32

what to do in case of severe allergic rxn

Answer 32

have another nurse call RRT, stop meds and start O2 at 90-100% via nonrebreather mask, replace IV tubing and infuse 0.9% NaCl. Elevate bed to help with SOB. may need to give epinehrine/diphenhydramine; DONT REMOVE IV in case to administer emergency meds

Question 33

what's IV catheter embolism

Answer 33

part of IV breaks off in a vein due to damage or too much force; can travel to other places in body

Question 34

what to do in case of IV catheter embolism

Answer 34

remove and inspect damage to the tip, apply tourniquet above IV site and see if can palpate; notify PCP and get x-ray

Question 35

preventing IV embolism

Answer 35

inspect for damage before inserting; never reinsert after removal; inspect after removal

Question 36

what can lactated ringer's treat

Answer 36

acidosis; liver metabolizes lactate into bicarbonate

Question 37

what fluid to use and NOT use with blood transfusions and why

Answer 37

use NS DON'T use LR (leads to clots), Dextrose (leads to hemolysis)

Question 38

what to always do with IV tubing

Answer 38

labeled with date, time, and initial

Question 39

what does the Y-port do in PB infusions

Answer 39

back-check valve that prevents primary infusion flow while PB infusion and opens again once is done

Question 40

placement of PB infusion

Answer 40

it should be hanged higher than the primary infusion

Question 41

where to administer IV bolus

Answer 41

existing IV line or saline/IV lock

Question 42

what to do before and after IV bolus administeration

Answer 42

flush of 0.9% NaCl

Question 43

what's tandem administration of IV

Answer 43

primary and secondary IV bags are infusing at the same time; they are hang at the same level

Question 44

where are tandem secondary IV bags plugged into

Answer 44

lower port on the primary IV tubing

Question 45

between 20 & 60 gtt/mL which is the micro-drop calibration

Answer 45

60

Question 46

which side of the needle should be inserted

Answer 46

bevel up in and out same angle of insertion

Question 47

needle length general rule for subQ

Answer 47

use needle length 1/2 width of injection site skin fold; 1 inch or less -> 45degrees otherwise 90 degrees

Question 48

larger muscles can receive how much meds in diff age groups

Answer 48

1mL in kiddos 2mL for older kiddos and adults 3mL in muscle people

Question 49

where are nontunneled central venous catheters inserted

Answer 49

subclavian vein or internal jugular vein

Question 50

what does insulin promote

Answer 50

entry of glucose, K, amino acids into cells convert glucose into glycogen in the liver

Question 51

list the 3 types of rapid-acting insulin

Answer 51

insulin lispro, insulin aspart, insulin glulisine

Question 52

why is intermediate-acting insulin cloudy

Answer 52

has protein that delays the onset and duration

Question 53

what is intermediate acting insulin called

Answer 53

insulin NPH