MP & S - Injections & IV's Flashcards Preview

1. Exams - Semester 3 > MP & S - Injections & IV's > Flashcards

Flashcards in MP & S - Injections & IV's Deck (26):
1

How hight above site should you attach tourniquet?

3-5in above

2

What site section should you Avoid drawing blood from?

• Same side as a Masectomy or edema
• Above an IV site or at least 5in below it
• On an arm w/ cannula, fistula, or vascular graft, or hematoma

3

About vacutainer?

• Uses vacuum to withdraw blood
• Low cost / fast
• Can’t see flashback, not good for small veins
• No transfer needed to lab, ↓ risk of self stick

4

About syringe?

• Can control amount of pressure
• Higher cost / slower
• Can see flashback & better for small veins
• Transfer to lab, ↑ risk of self stick

5

Needle sizes?

Length & diameter
• Diameter = gauge = ># = smaller diameter
• 19g – largest-mainly for large volume draws
• 21g – moderate amnt-draw from AC space
• 22g – most frequently used with vacutainer/ 1-3 tubes to draw/ AC space
• 23g – most versatile
• 25g – small veins

6

About Order of draw?

• Depends on types of tests ordered
o Blood culture → must use Betadine
o Na Citrate coagulation tubes
o Serum tubes, Additive tubes

7

About Site preparation?

• Clean site w/ 70% isopropyl alcohol
• Betadine is alternative
• Allow to air dry!!!

8

About Needle stick?

• Reapply tourniquet, Disinfect
• Position bevel up, Pull skin taut
• Enter skin at 15 degree angle
• Stabilize needle and insert tubes
• Untie tourniquet → as the last tube is filling - before withdrawing the needle
• Withdraw needle and apply gauze and pressure for 3 – 5 min (folding the arm up isn’t enough pressure)

9

Intradermal injection - Procedure?

- Entire bevel penetrates skin
- Raise a “bleb”
- Insert needle at 35-40 degrees

10

Intradermal injection - Purposes?

- PPD testing,
- Anesthesia
- Cosmetic,
- Allergy test
- Vaccine,
- Sentinal node biopsy

11

Intradermal injection - Equipment Sites?

- 24-30 gauge,
- ½ inch length
- 1cc small amounts (syringe)
- Alcohol & gauze

12

Intradermal injection - RFs?

- ***Hematoma,
- Inf
- Hypersensitivity rxn
- Granulomatous rns

13

SQ injection procedure?

- Prep w/ EtOH,
- Pinch SC tissue,
- roll between thumb & forefinger.

- Insert needle at 45-degree angle,
- Extend ¾ total length
- Aspirate.

*If blood appears = remove!!
*Inject slow, w/draw, apply pressure & bandage

14

SQ injection - Purposes?

Drugs requiring
- Slow absorption + long duration of action

- i.e. Insulin, Hormones, Vaccines

15

SQ - Equipment Sites?

23-25 gauge = adults
25-27 = children
5/8 – ¾ inch length

Infants = thigh
Adults = deltoid, upper outer thigh, abdomen

16

SQ - RFs?

Dermatitis
Cellulitis

17

IM - Procedure?

- Prep w/ EtOH,
- Hold like a dart @ 90-degree angle,
- Hold muscle firm,
- Insert needle quickly,
- Hold barrel w/ weak hand,
- Aspirate,
- Inject slow,
- W/draw,
- Gentle pressure

Gluteal:
- Use UOQ,
- Avoid sciatic

Deltoid:
- Avoid radial in kids

18

IM - Purposes?

- Drugs not absorbed well orally
- Intermediate rate of onset + duration preferred.
- When parental delivery necessary.

- Abx
- Narcotics
- Pain meds
- Hormones

19

IM - Equipment & Site?

- 19-22 gauge,
- 1 ½ inch - Long enough to pass SQ tissue.
- EtOH wipes
- Sterile gauze & dressing

- Size depends on muscle size, depth, viscosity, substance

Infants
- buttocks, deltoid
Adults
- ant thigh, butt, deltoid

20

IM - RFs?

Inject to a vessel:
- Toxic rxn, injury, hematoma

Inject to a nerve:
- Pain, parasthesia,
nerve damage

Needle can break off into muscle
Sterile/septic abscess

21

Venous Cath - Procedure?

Use largest vein in area where movement around joint wont be disrupted

22

Venous Cath - Purposes

- Fluid replacement,
- Delivers meds,
- Blood sampling

Consider length of time cath to be in place.

23

Venous Cath - Equipment / Sites

Size depends on purpose + vein:
- 18-20 gauge = small vn
- 12-18 gauge = lg veins

Smaller # = larger catheter

Need:
- Betadine,
- EtOH sponge,
- Tourniquet,
- Gloves,
- 2 IV caths,
- Tape,
- Sterile dress,
- IV solution,
- Tubing, pole

24

Venous Cath - RFs

Phlebitis = if use small vn in hand

Infiltration
Infection

25

Venous Cath - procedure part I?

Procedure Part I:
• Place extremity in dependent position
• Plan for mess
• Apply tourniquet to constrict venous return
• Prepare the equipment
• Prepare the site
• Enter skin and advance catheter until blood return seen – advance plastic sheath into vein – withdraw needle; release tourniquet

26

Venous Cath - procedure part II?

Procedure Part II:
• Connect the tubing to the catheter sheath
• Tape the tubing to the skin
• Cover the catheter with dressing (semipermeable dressing / Tegaderm)