Parenteral Injections

Question 1

Is subcutaneous or IM injection absorbed faster?

Answer 1

IM injection

Question 2

With what injection do you aspirate before giving the medication?

Answer 2

IM injection (but not vaccines)

Question 3

What angle do you put the needle in for subcutaneous?

Answer 3

45 or 90 degree angle depending on the patient

Question 4

What sites would you be able to insert over 2 mL of medications to subcutaneously?

Answer 4

Abdomen, outer thigh..

Question 5

When inserting SubQ injection to outer upper arm, what is the maximum amount of med to give?

Answer 5

2 mL

Question 6

What is the subQ injection inserting the medication to?

Answer 6

Loose connective tissue underlying the dermis (not as many BV as muscle, therefore it absorbs more slowly)

Question 7

Where is an IM injection inserting medication to?

Answer 7

Body of a muscle

Question 8

When would you use the “Z tract technique” when inserting medication?

Answer 8

When inserting medication to the muscle
Pull skin 1 1/2 inch over, insert med, hold for 10 seconds, let skin move back.
Z tract prevents leakage of medication, and locks medication in.

Question 9

What size needle would you use for a IM in an adult?

Answer 9

1 - 1 1/2 inches (site depending..)

Question 10

When inserting a medication to IM, what are you trying to avoid?

Answer 10

Nerves and major BV

Question 11

Where to insert IM med to infant?

Answer 11

Vastuslateralis

Question 12

What is the maximum dose to administer IM to deltoid?

Answer 12

2 mL

Question 13

Why do you not administer meds to infants in deltoid?

Answer 13

Not well developed muscle

Question 14

How do you landmark the deltoid?

Answer 14

3 finger length from acromion proccess

Question 15

At what age would you start injecting vaccines to the deltoid?

Answer 15

18 months +

Question 16

Is drug absorption rapid in the muscle?

Answer 16

Yes.

Question 17

When would ID injections be used?

Answer 17

Testing for allergies and TB

Question 18

What do you expect to see when giving ID injection?

Answer 18

Bleb appear. 6 mm or 1/2 an inch.

Question 19

What angle would you insert for ID?

Answer 19

5 - 15 degrees

Question 20

What angle would you insert needle for subQ for obese pt.?

Answer 20

90 degrees.

Question 21

Maximum amount of medication to give ID?

Answer 21

0.01-0.1 mL

Question 22

What way should the bevel face when inserted into the skin?

Answer 22

Bevel up!

Question 23

To minimize pt. discomfort, what would you do?

Answer 23

Use sharp needles in the shortest length and gauge possible

Question 24

If you insert a needle at 45 degrees, at what angle would you then take the needle out at?

Answer 24

45 degrees

Question 25

What is the range for capacity in a syringe?

Answer 25

0.5 - 60 mL

Question 26

Are syringes ever reused?

Answer 26

Heck no.

Question 27

Needles contain three parts. What are they?

Answer 27

The hub (fits into the syringe) the shaft (connects to the hub) the bevel creates a narrow slit that closes after needle is removed)

Question 28

When is a filter needle used?

Answer 28

When preparing medication from an ampule.

Question 29

Needles vary in what lengths?

Answer 29

3/8 of an inch to 3 inches

Question 30

A gauge that is 25 is thiner or thicker than a gauge that is 27?

Answer 30

Thicker.

Question 31

What size needle used for subQ?

Answer 31

5/8 inch to 1/2 an inch (normally, unless patient has lots of adipose, then may use 1 inch)

Question 32

Viscous meds require a larger or smaller gauge?

Answer 32

Larger.

Question 33

Ampules are single use or reusable?

Answer 33

single use.

Question 34

How do you mix meds in a vial?

Answer 34

Roll in your palms

Question 35

T or F: Vials only contain liquid meds.

Answer 35

F. Vials can also contain dry meds

Question 36

What is the first step of preparing a medication from a vial?

Answer 36

Put the amount of air equal to the amount of med you will be taking from the vial, into the vial.

Question 37

What should you do if you can see air bubbles in the syringe?

Answer 37

Tap with a pen. Make sure all air bubbles are gone before inserting med.

Question 38

What would be the factors in selecting a needle length for subQ injection

Answer 38

pt.s weight / estimate of subQ tissue

Question 39

When injecting low molecular weight heparin, how far must you stay away from the umbilicus?

Answer 39

2 inches away.

Question 40

What are you palpating for before administering a subQ?

Answer 40

Hardness and tenderness

Question 41

What are you assessing for 30 minutes post med admit?

Answer 41

pain, numbness, burning, tingling

Question 42

Can subQ injections be done at home?

Answer 42

After proper teaching, yes.

Question 43

Maximum pediatrics subQ injection ?

Answer 43

0.5 mL

Question 44

When mixing meds from vial and ampule, which med would you prepare first?

Answer 44

The vial.

Question 45

Maximum IM injection for: Adult: Kids 6 - 12: 0 - 6 years:

Answer 45

Adult: 5 mL Kids 6 - 12: 2 mL 0-6: 1 mL

Question 46

Doses less than one mL, round to what?

Answer 46

The nearest hundredth.

Question 47

giving 0.7 mL of a med, what size syringe would you use?

Answer 47

1 mL

Question 48

When giving medications over 1 mL, round to what?

Answer 48

Nearest tenth.

Question 49

Insulin is measured in what form?

Answer 49

Units.

Question 50

What is the most commonly used diluents for reconstituting medications?

Answer 50

0.9% NaCl (normal saline) and water

Question 51

What would you label on a multi dose vial that has been reconstituted?

Answer 51

``` Date / Time of prep Strength or concentration of volume Potency expiration Recommended storage Your initials Example of insturctions ```

Question 52

When the nurse would select the strength of the reconstitution... what would they be deciding this on?

Answer 52

Depends on the patients dose.

Question 53

When reconstituting medications.. if you add less solvent the final solution will be more or less concentrated?

Answer 53

More concentrated.

Question 54

D X Q = X means what? | When reconstituting medications

Answer 54

The desired solution strength multiplied by the quantity of the desired solution = amount of the solute

Question 55

SubQ butterfly should be changed how often?

Answer 55

Once a week

Question 56

When priming a subQ butterfly using Maxzero, what do you prime it with?

Answer 56

Additional 0.4 mL to the dose of the med

Question 57

When priming SubQ butterfly using clearlink, prime it with what?

Answer 57

Additional 0.28 mL to the dose of the med

Question 58

Insulin is classified on what?

Answer 58

Rate of action: Short, moderate, and long

Question 59

T or F: a subQ butterfly can have meds of various concentrations?

Answer 59

F. Different concentrations and different meds require different subQ butterfly.

Question 60

What are you assessing the site of a subQ butterfly for?

Answer 60

Irritation, swelling, redness

Question 61

What site is preferred IM injection site for adults?

Answer 61

Deltoid

Question 62

How do you landmark the vasutslateralis?

Answer 62

One hand from above knee, one hand below hip. Anywhere in the muscle here

Question 63

How would you decrease a patients pain when inserting med to deltoid?

Answer 63

Have pt. relax the arm

Question 64

Is inserting a 3 mL med to the deltoid okay?

Answer 64

No. No more than 2 mL

Question 65

Ampules are opened how?

Answer 65

Breaking the neck off.

Question 66

What angle do you insert a SubQ butterfly at?

Answer 66

30 - 45 degree angle

Question 67

When would you aspirate?

Answer 67

Before IM, accept for vaccines

Question 68

Where would you document that you inserted a SubQ butterfly?

Answer 68

PPN

Question 69

Where is the site for a ID injection?

Answer 69

Front and back of forearm

Question 70

Why would you not insert med to atrophied muscle?

Answer 70

Med will not absorb well

Question 71

Why would "literature" believe that ventrogluteal = best site for IM injection?

Answer 71

Deep, situated far away from BV and major nerves. Easily identifiable by prominent bony landmarks (hand over the greater tronchanter, point index finger towards the superior ilic spine, extend the middle finger back along the iliac crest. V shaped triangle then formed: this is the injection site.

Question 72

What is important when inserting to an IM?

Answer 72

The muscle is well developed.

Question 73

The Z tract is helpful in what?

Answer 73

Decreasing pain, decreasing leaking, helps to lock the medication in.

Question 74

Why hold an IM needle in the site for 10 seconds after injection?

Answer 74

Allows the med to spread evenly.

Question 75

When would you insert a SubQ at 90 degree angle?

Answer 75

When the pt. has a lot of subQ tissue

Question 76

Why do we rotate injection sites?

Answer 76

To avoid Lypohypotrophy