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parental injections Flashcards

1
Q

parental equipment when you go into a room:

A

exam gloves, medication (vials/ampules), alcohol swabs, appropriate syringes and needles (needle to withdraw and needle to inject), medication labels, and clean medication drawer

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2
Q

medication vials, always check and document on the vials what?

A

expiration and always date and initial multi-dose vials

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3
Q

the ____ is also referred to as the “diameter”

A

gauge (g)

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4
Q

dermis (ID) length of needle:

A

1/2” to 5/8”n

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5
Q

subcut (SQ) anticoagulant length of needle:

A

3/8” to 5/8”

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6
Q

Subcut (SQ) insulin length of needle:

A

1/2” to 5/16”

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7
Q

muscle (IM) length of needle:

A

1” to 1 1/2” (most common in adults)

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8
Q

smaller gauge needles for ____ solutions (27-20g)

A

thinner solutions - less painful

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9
Q

larger gauge needles for _____ solutions (21-18 g)

A

thicker solutions

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10
Q

non-parental needles are used for ______ ONLY

A

withdrawing medications

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11
Q

filter needle:

A

smaller filter in hub catches debris and always use with ampules for best practice

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12
Q

blunt fill needle:

A

use with vials (rubber stopper)

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13
Q

if blunt fill or filter needle are not available use what?

A

smallest gauge available

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14
Q

syringes are calibrated in ___

A

mL (mililiters)

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15
Q

first calibration line is near the ___

A

tip of the hub

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16
Q

on syringes reading from ____ to ____

A

zero to volume ordered

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17
Q

leading ring is ___

A

volume ordered (by rubber stopper)

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18
Q

how do you decide which syringe to use?

A

depends on volume ordered, ALWAYS use the smallest syringe needed to correctly deliver the rx’d volume of medication ordered

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19
Q

preparing your medications:

A

acknowledge HCP (health care provider) orders FIRST, prepare only one patient’s meds at a time, clean medication drawer and place a cloth, remove meds from Pyxis and verify against eMAR on computer screen 2ND CHECK, syringe/needle, hand hygiene, check expiration/date multi-dose, label syringes

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20
Q

label syringes with a “____ ____”

A

blue label

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21
Q

clean injection port for ___ secs with alcohol swab (single use)

A

15 seconds

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22
Q

third check (exception is insulin)

A

take original vial/ampule with syringe to verify/scan at the bedside

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23
Q

preparing a medication: single dose vial

A

select appropriate syringe and blunt fill needle, after cleaning top of vial, inject air equal to amount of medication to be withdrawn if needed, withdraw entire amount, prepare to deliver the exact amount of medication ordered, & remove BF needle and attach appropriate sterile needle

24
Q

charging means:

A

injecting air equal to amount of medication to be withdrawn from single dose vial

25
Q

combining two medications in one syringe: vial A and vial B

A

cannot exceed acceptable volume for intended syringe/site and medications must be compatible

26
Q

combining two medications in one syringe: vial and ampule

A

same as two vials, but prepare from the vial first then ampule

27
Q

air & bubbles: troubleshooting

A

make sure needle is below fluid level, withdraw med slowly

single dose vials: withdraw entire volume from vial - except air to follow, then expel the air and medication if more than required is in the syringe to ensure exact dose

multi-dose vials: withdraw more med than you need, leave needle in vial, then push med back into the vial via plunger to exact dose, if having issues, can tap or thump syringe gently to move air to top of syringe then purge air back into vial

28
Q

ampules:

A

single dose medication, made of glass (clear/dark), wear gloves, need a syringe and filter needle (NOT BF NEEDLE)

29
Q

on ampules where do you place the glass ampule and syringe/needle when finished in a patient’s room?

A

sharps box

30
Q

drugs in ___ form retain potency only for a short period of time once reconstituted and need to be administered soon

A

powder

30
Q

reconstitution is the process of:

A

adding a liquid (diluent) to a dry or liquid concentrated ingredient (solute)

31
Q

reconstituted volumes __ ___ always equal the amount of ____ because the medication itself has volume

A

do not, diluent

32
Q

IM injection guidelines:

A

select appropriate muscle site (deltoid, ventrogluteal, vastus-lateralis), palpate for “belly” of well-developed , relaxed muscle (avoid scars, irritated area, bruises, lesions), assess all parts of the injection equipment before, dispose properly

33
Q

inject at a rate of _____ before removing needle for IM injection

A

1 mL/10 secs – wait 3 to 5 sec (want medication to stay in the targeted tissue)

34
Q

post injection for IM, do not ____ or ____, you can ____

A

rub or massage; apply pressure (rubbing or massaging can displace med in an area it doesn’t need to be)

35
Q

angle for ALL IM injections

A

90 degree angle

36
Q

IM injections in deltoid:

A

smaller volumes, less irritating, max volume is 1 mL, recommended needle length is 1”, recommended syringe is 3mL

37
Q

IM injections in ventrogluteal or vastus lateralis:

A

ventrogluteal 1st, vastus lateralis 2nd - for thicker, painful, or irritating meds (Deep IM), max volume is 3 mL, recommended needle length is 1” to 1 1/2”, recommended syringe is 3 mL

38
Q

what is the objective/purpose of Z-track method?

A

minimizes pain and makes sure medication stays in place

39
Q

Deep IM Z-track technique

A

position patient (sims position), select VG or VL site (rotate sites), landmark, quickly assess equipment

40
Q

avoid the ____ MUSCLE

A

dorsogluteal (bottom of buttocks) because it can cause loss of function or paralysis

41
Q

subcutaneous injections (SQ, Sub-Q, subcut)

A

insulin: multi-dose vials of medication - short, intermediate, long acting, fragile needle and permanently attached to the insulin syringe, can inject in multiple locations

anticoagulant: 3/8-5/8” needle and appropriate syringe in the abdomen as the primary/main location (ANTERO-LATERAL)

42
Q

SQ injection rule of thumb

A

inject at 90 degree angle if you can “bunch” the skin more than 2”, otherwise 45 degree angle

43
Q

SQ tissue can accommodate up to ___ mL

A

1.5

44
Q

rules of administering insulin:

A

know/verify blood glucose levels or trends FIRST before, administer in units not mL and within minutes of preparation, do not shake

45
Q

SQ insulin guidelines:

A

administer in adipose (SQ) “fatty” areas (rotate)

46
Q

absorption rate for SQ is typically faster in the ___

A

abdomen

47
Q

lipodystrophy feels like ____

A

little beads (hard, scarred tissue) if not rotated

48
Q

DO NOT _____, _____, or ____ ANY SQ injection

A

aspirate, rub, or massage

49
Q

aspirate on _____ IM

A

deep

50
Q

SQ insulin administration what must match?

A

syringe size (U-100 or U-50) must match the vial, leave insulin vial in Pyxis

51
Q

SQ - enoxaparin injection
(anticoagulant)

A

always abdominal site (love handle), position in reclining/supine, 90 degree angle is recommended for deep SQ - never administer IM, bunch entire time, do not aspirate or expel nitrogen bubble

52
Q

intradermal injection:

A

allergy testing and TB testing, select site (free of tattoos if possible, blemishes, hair, scarring, bruises, etc), cleanse area, check equipment, stretch middle 1/3 of forearm relatively taut, insert almost parallel angle (5-15 degree) until bevel (facing up) of needle barely disappears, inject med ensuring a “bleb or wheal” so you know medication is in the right area

53
Q

injectable rates of absorption: fastest to slowest

A

IV (IVP), IM, SQ, ID

54
Q

ID injection needle & syringe

A

25 g x 5/8”

1 mL tuberculin with needle or 1 mL syringe with attached needle

55
Q

IM injection gauge size

A

deltoid: 25 g to 20g
ventro: 21g to 18g
depending on viscosity

56
Q

SQ injection gauge size and syringe size:

A

27g to 25g

1-3 mL, max volume is 1.5 mL

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