module 3 (part A- parenteral meds)

Question 1

parenteral=

Answer 1

administered in a manner than is not through the digestive tract

• enter body tissues and circulatory system by injection
• more quickly absorbed than oral
• invasive, pose greater risk

Question 2

what kind of technique for parenteral meds?

Answer 2

aseptic technique!

Question 3

when is parenteral used?

Answer 3

faster (emergencies), when pts are vomiting, cannot swallow, and/or restricted from fluids

Question 4

four routes of parenteral?

Answer 4

subcutaneous
intramuscular
intradermal
intravenous

Question 5

subcutaneous injection is into..

Answer 5

tissue under dermis of the skin

Question 6

intramuscular is into

Answer 6

the muscle

Question 7

intradermal is into

Answer 7

the dermis just under epidermis

Question 8

intravenous is into

Answer 8

a vein

Question 9

ethnicity, genetics, and culture influence:

Answer 9

drug response, pharmacokinetics, pharmacodynamics, and patient adherence and education

Question 10

how do you prevent contamination of solution?

Answer 10

ampules should not sit open, meds should be removed quickly

Question 11

how do you prevent needle contamination?

Answer 11

avoid letting needle touch contaminated surface, avoid touching the length of the plunger or inner part of barrel

Question 12

prepare skin of person to avoid infection when giving injection by?

Answer 12

• washing skin soiled with dirt, drainage, or feces with soap and water
• swab from centre of site and move outward in a 5 cm radius

Question 13

how can you minimize a patients discomfort when giving an injection (many thiiings!)

Answer 13

• use sharp, beveled needles in the shortest length and smallest gauge
• change needle if liquid med coats its shaft
• position and flex patients limbs to reduce muscular tension
• divert pts attention away from injection
• apply vapocoolant spray or topical anesthetic
• insert needle at proper angle
• inject med slow but smooth
• gently apply antiseptic pad to site
• apply gentle pressure
• rotate injection sites to prevent formation of indurations and abscesses

Question 14

recommendations for prevention of needlestick injuries?

Answer 14

avoid using needles when effective needleless systems or SESIP devices avail

• immediately dospose of used needles
• maintain a sharps injury log
• report all needlestick injuries immediately
• attend education offerings regarding bloodborne pathogens
• do not recap needles after med admin

Question 15

where is the most frequent route of exposure to bloodborne disease for HCWs?

Answer 15

needlestick injuries!

Question 16

what is SESIP?

Answer 16

sharp with engineered sharps injury protection- device that is effective in preventing needlesticks

Question 17

appropriate size, length, and gauge of needle is based on?

Answer 17

quantity and type of medication prescribed and body size of patient

Question 18

infusion pumps ensure ?

Answer 18

a constant and accurate delivery of medication

Question 19

types of syringes?

Answer 19

either Luer-Lok or non Leur-lok

Question 20

leur lok syringe?

Answer 20

• needles or needleless devices that are twisted onto the tip and lock themselves in place
• prevent accidental removal of a needle from syringe

Question 21

non-leur lok syringe?

Answer 21

needles or needleless devices that slip onto the tip

also known as leur slip

Question 22

variety of syringe sizes?

Answer 22

0.5-60ml syringes, use smallest size possible

Question 23

Needles?

Answer 23

• some come attached to syringes, others packed individually
• disposable, made of stainless steel

Question 24

three parts of a needle?

Answer 24

• hub (fits onto top of syringe)
• shaft (connects to the hub)
• bevel or slanted tip

Question 25

never use filtered needles when?

Answer 25

administering a med!! it is big

Question 26

tip of needle or bevel is always

Answer 26

slanted

Question 27

most needles vary in length from

Answer 27

3/8 to 3 inches

Question 28

smaller the needle gauge?

Answer 28

larger the needle diameter

Question 29

needles are color coded for

Answer 29

ease of selection!

Question 30

longer needles for?

Answer 30

IM injections

Question 31

ampules contain?

Answer 31

single doses of injectable medication in liquid form - 1 to 10ml or more - made of glass with a neck that is snapped off to access med

Question 32

what needle is used with ampules?

Answer 32

filter needles to prevent glass particles from being drawn up into the syringe

Question 33

a vial is?

Answer 33

a single- or multi dose plastic or glass container with a rubber seal at the top - after u open a single dose you must discard it regardless of amt used - if a multi dose write the date it is opened on it

Question 34

how do you prepare a ampule (steps)?

Answer 34

- tap top of ampule lightly until fluid moves from neck - place small quaze around neck and snap - draw up med quickly with filter needle long enough to reach the bottom of ampule - hold ampule upside down or set it on flat surface - to expel excess air bubble, remove needle from ampule, hold syringe with needle pointing up and tap side of syringe - use sink for disposal if excess fluid in syringe - replace filter needle with regular sharps

Question 35

how do you prepare vial containing a solution?

Answer 35

- remove cap covering top - alcohol swab surface of rubber seal, allow to dry - remove needle cap on syringe, pull back on plunger to draw amount of air into syringe equivalent to volume of med to be aspirated - vial flat on surface, insert tip of needle through center of rubber seal - inject air into air space of vial - invert vial, keep tip of needle below fluid level - allow air pressure from vial to syringe gradually with med - when you obtain desired volume, position nedle into air space of vial, tap side of syringe gently, eject any air remaining at top into vial - remove needle - hold syringe eye level 90 degree angle to ensure correct volume and no air bubbles - if needed change needle to appropriate gauge and length

Question 36

mixing parenteral meds in one syringe?

Answer 36

some meds need to be mixed from two vials or a vial and a ampule - avoids need to give more than one injection - do not contaminate contents of vial with med from another vial or ampule

Question 37

when you mix meds from vial and ampule, which do you prep first?

Answer 37

-prep meds from vial first, then withdraw med from ampule using same syringe and a filter needle

Question 38

reasons to give a med by parenteral?

Answer 38

-client is vomiting, client cannot swallow

Question 39

important safety guidelines for prepping any meds?

Answer 39

-avoid distractions, verify medication not expired, strict aseptic techniques, educate client about med and side effects

Question 40

what step helps to minimize clients discomfort when giving an injection?

Answer 40

-inject med slow and smoothly

Question 41

do you use sharp beveled needles with the smallest length and smallest gauge?

Answer 41

yes! when you can always the smallest size

Question 42

what gauge is smallest?

Answer 42

the largest number is actually the smallest diameter for gauges! so 25 is smaller than 18

Question 43

what needles should never be injected into a client?

Answer 43

blunt fill needle and filter needle | -both used for prepping the meds

Question 44

can ampules be used for multi-dose meds?

Answer 44

no! only single dose. | vials can be used for multi dose for one client only!

Question 45

what is the formulary LWMH for the prevention and treatment of VTE as of June 2019

Answer 45

enoxaparin! | -unrestricted, mainly used to treat/prevent VTE and also used in acute coronary syndrome

Question 46

format of enoxaparin and dalteparin?

Answer 46

- multidose vials | - prefilled safety syringes

Question 47

dosing of enoxaparin and dalteparin is based on?

Answer 47

bodyweight and renal function

Question 48

dalteparin is restricted to?

Answer 48

- cancer associated thrombosis - trauma - acute spinal cord injury - clotting in hemodialysis or renal extracorporeal systems

Question 49

enoxaparin dosage is in...

Answer 49

MILLIGRAMS | whereas dalteparin is UNITS