Medicine Mangement

Question 1

What four reasons why drugs are administered by injection?

Answer 1

• Rapid action is required
• When a drug is not absorbed by the gastro-intestinal tract
• If the patient is unable to take oral form
• If oral form is unavailable

Question 2

Routes of Injection:

What is…

• Intradermal
• Subcutaneous (SC)
• Intramuscular (IM)
• Intravenous
• Intrathecal
• Intra articular
• Intra pleural

Answer 2

• Just under the skin
• Into the fat tissue under the skin (used when the drug needs to be absorbed slowly)
• Into the muscle (used when the drug needs to be absorbed quickly, between 15 and 20 minutes)
• Into the vein
• Into cerebral spinal fluid
• Into the joints
• Into the pleural space

Question 3

What are the two most common routes of injection?

Answer 3

Subcutaneous

Intramuscular

Question 4

What 4 risk are there when administrating subcutaneous and intramuscular drugs?

Answer 4

• Infection
• Leakage of injection fluid
• Pain and tissue trauma
• Overdose of medication

Question 5

What needle size is used for an IM injection?

Answer 5

For adults, 21g (green)

Question 6

What size needle is used for SC injections?

Answer 6

For adults 25g (orange)

Question 7

What are 4 reasons for IV infusions?

Answer 7

• Correct dehydration
• Correct blood loss
• Correct electrolyte imbalance
• Replace specific blood components

Question 8

What are the 6 rights?

Answer 8

Right patient
Right drug
Right dose
Right route
Right time
Right documents

Question 9

What are the 7 routes of medicine administration?
Parental...
Rectal...
Inhalation...
Topical...
Ear....
Nasal...
Vaginal...

Answer 9

Parenteral - injection
Rectal - absorbed via the rectal mucosa
Inhalation - absorbed via the respiratory system
Topical - absorbed via the skin
Ear and eye drops
Nasal - sniffed through mucosa
Vaginal - absorbed via the vagina

Question 10

What does the misuse of drugs act do?

Answer 10

Dictates precautions that should be taken with drugs that have addicted properties

Question 11

What 3 ways can medicine be sold and supplied?

Answer 11

Prescription from authorised practitioner

Non-prescription sold by a pharmacy under the control of a pharmacist

General sale list (GSL) sold in general retail outlets with no supervision

Question 12

What year was the misuse of drugs act and legislation?

Answer 12

Act - 1971

Legislation - 2001

Question 13

What year was the humans medicines regulation?

Answer 13

2012

Question 14

What does therapeutics mean?

Answer 14

To treat disease e.g. antibiotics

Question 15

What does prophylaxis mean?

Answer 15

To prevent disease e.g. vaccination

Question 16

How can a student nurse administer medication? What must they never administer?

Answer 16

Under the direct supervision of a registered nurse, who counter signs the documents

Intravenous drugs

Question 17

How many macrodrops in a…

Blood giving set?
Standard giving set?
Paediatric/ micro brunette giving set?

Answer 17

15
20
60

Question 18

How many microdrops in a macrodrops

Answer 18

60

Question 19

How do you calculate the ml of IV fluid per hour?

E.g. 1 litre of dextrose over 8 hours

Answer 19

Prescription of volume (ml)/ time (hours) = ml per hours

1000/8 = 125ml per hour

Question 20

When doing long decision which number goes on the outside of the division house?

Answer 20

The bottom number, the number you are dividing by

Question 21

How do you move up and down the chain?

Kilogram
Gram
Milligram
Micrograms

Answer 21

Divided by 1000 to go up

Times by 1000 to go down

Question 22

How do you work out the volume of liquid to give?

E.g. 60mg has been prescribed. 80mg of liquid in 2ml

Answer 22

What is prescribed/ the dose i have x the amount of liquid i have

E.g. 60/80 = 1.25
1.25 x 2 = 2.5ml

Question 23

How do you work out the number of tablets to give?

E.g. 20mg prescribed with 4mg tablets

Answer 23

What is prescribed/ the dose i have

E.g. 20/4 = 5 tablets

Question 24

How many grams in a kilogram?

Answer 24

1000

Question 25

Which is the biggest gram, micrograms, kilogram or milligram? Which is the smallest?

Answer 25

``` Kilogram = biggest Micrograms = smallest ```

Question 26

How do you calculate the IV flow rate? E.g. 1 litre of normal saline is charted over 9 hours. The drop factor is 15. Calculate the number of drops per minute

Answer 26

Ml of liquid / minutes x drop rate E.g. 1000/ 540 x 15 = 28 drops per minute

Question 27

When should you clean the skin before an injection?

Answer 27

If the skin is visibly dirty

Question 28

How do you do a subcutaneous injection?

Answer 28

1) Put on non-sterile gloves after hand hygiene 2) Pick up syringe and remove the needle guard 3) Pinch the skin, hold the syringe like a dart, and go into the skin at 90 degrees 4) discard the needle immediately

Question 29

Where is a SC injection?

Answer 29

Into the subcutaneous tissue

Question 30

What are 3 common sites for SC injections?

Answer 30

1) Lateral aspects of the upper arm 2) Anterior aspects of the thighs 3) Abdomen

Question 31

Where are the two main sites IM injections occur?

Answer 31

1) Ventroguteal | 2) Lateral aspect of the vastus lateralis

Question 32

How do you give a Intramuscular injection?

Answer 32

1) Put on non-sterile gloves 2) Pick up the syringe like a dart, allow the needle cover to fall into the tray 3) Stretch skin between fingers 4) Insert needle at 90 degrees 5) Using your non-dominant hold the bottom of the needle 6) Slowly insert the medicine 7) Wait 10 seconds then move the needle 8) Discard the needle immediately

Question 33

What colour needle do you use for drawing up medicine?

Answer 33

Red - because it is blunt