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Nursing Fundamentals Exam 3 > Parenteral Medications > Flashcards

Flashcards in Parenteral Medications Deck (38)
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1

What gauge and size needle should be used for intradermal, subcutaneous, and intramuscular injections?

1) Intradermal - Guage: 26 or 27; Size: 1/4" to 1/2"
2) Subcutaneous - Gauge: 25 to 30; Size: 3/8" to 1"
3) Intramuscular - Gauge: based on medication being administered (aqueous solutions = 20 to 25 & oil-based solutions = 18 to 25); Size: 5/8" to 1 1/2"

2

What is the maximum amount of medication (mL) that can be injected intradermally, subcutaneously, and intramuscularly?

1) Intradermal - 0.5mL
2) SQ - 1mL
3) IM - 4mL (1mL for deltoid)

3

What site should you absolutely avoid when giving intramuscular injections? Why?

Dorsogluteal site, because it's too close to the sciatic nerve.

4

What does the term "wheal" mean?

It is a pocket of fluid that forms when medication is given intradermally with the bevel upwards.

5

What angle should be used when giving injections
1) intradermally?
2) subcutaneously?
3) intramuscularly?

1) intradermal - 15 deg
2) subcutaneously - 45 to 90 deg
3 intramuscular - 72 to 90 deg

6

What type of needle is used to withdraw medication from an ampule?

A filtered needle

7

When mixing the following medication, which one is drawn up into the syringe first?
1) NPH and regular insulin
2) Single-Dose vial and Multidose-Vial
3) Ampule and Vial

1) Regular insulin is drawn up into the syringe before NPH (think clear then cloudy)
2) Multidose vial is drawn up into the syringe before the single-dose
3) Draw up medication in the Ampule before drawin up the vial

7

(T/F) Insulin dosages must be checked by two nurses?

True

8

What are the two different methods of administering IV fluids and drugs? What is the difference between the two?

1) Continuous - Replaces or maintains fluid and electrolytes and serve as a vehicle for drug administration.
2) Intermittent (aka saline or heparin lock) - Used for IV administration of drugs and supplemental fluids (i.e., IVPB & IV push).

9

Which parenteral route has the 2nd fastest absorption rate, next to IV?

Intramuscular - muscles have a large vascular network that ensures rapid absorption into the bloodstream.

11

Name two reasons why you would choose to use the IV route to deliver medications? Name two disadvantages of this route?

1) Indications - Immediate effect, Only route available (PT may be NPO) or tissue absorption is poor.
2) Disadvantages - Least safe of all medication routes, instant drug Rx (no recall), infiltration into tissue

12

Why do we flush IVs with normal saline at regular intervals, before and after medications, and PRN?

Flushing ensures patency so there is no clotting or air in the line. It also clears the vein of any residual medication.

13

Why are medications such as nytroglicerin and albumin packaged in glass vials instead of plastic IV bags?

Because medications such as these react with plastic to form a precipitate.

14

How often are IV bags, IV tubes, and IV catheters changed?

IV bags are changed every 24 hrs, IV tubes and catheters are changed every 48 to 96 hrs.

15

What is the formula used to calculate gtt/min?

Gtt/min = (Volume in mL x drop factor [gtt/mL]) / Time in mins

16

What is the primary cause of air in the IV tubing?

Priming the tubing too quickly

17

Why do you warm cold IV medications

Because giving cold IV medications can cause venous spasms.

18

List at least 3 complications that can result from IVs.

1) Infiltration
2) Phlebitis
3) Fluid Overload
4) Air Embolus
5) Speed Shock - Delivering medication too fast via an IV
6) Thrombus

19

What is the drip rate of macrodropper and microdroppers? why select one over the other?

1) Macrodroppers - 10 drops in 1mL (used for adults)
2) Microdroppers - 60 drops in 1mL (used for pediatrics)

20

How is it possible for a patient to have excess fluid volume and still have low BP?

The fluid may be outside of the vascular space (i.e., edema)

21

When do most medication errors occur?

During shift to shift transitions

22

How drugs in hospitals generally classified?

By body systems

23

What is an example of a class of drugs that the FDA do not have oversight of?

Herbals

24

Because many drugs are still metabolized by the liver, regardless of the route, Dr.s write dosages based on what patient variable?

Based on the patient's liver functioning

25

What is the worst/most severe adverse effect a person could have to a drug?

An anaphylactic reaction

26

What 3 things happen during anaphylaxis? Name 6 different methods used to treat anaphylaxis.

Anaphylaxis results in respiratory distress, sudden severe bronchospasms, and cardiovascular collapse.
This reaction is treated with:
1) Vasopressors
2) Bronchodilators
3) Corticosteroids
4) Oxygen Therapy
5) IV fluids
6) Antihistamines

27

(T/F) Antibiotics are the most important drugs to maintain serum levels in order to achieve a therapeutic level.

True

28

(T/F) Half-Life affects dosage (how often a drug will be given, I.e., a.4h, bid, etc.,)

True

29

What are the 7 parts of a medication order?

1) Patient's name
2) Date and time order was written
3) Name of drug
4) Dosage of drug
5) Route
6) Frequency of administration
7) Signature of prescriber

30

List the three times a medication label should checked during preparation and administration

1) When the nurse reaches for the medication
2) Immediately before pouring or opening the medication
3) Before giving the medication to the patient

31

What are the 7 "rights" of medication administration?

1) Right patient
2) Right medication
3) RIght dosage
4) Right route
5) right time
6) Right reason
7) Right documentation

32

Name the 5 sites on the body where SQ injections can be given

1) Upper arm
2) Abdomen
3) Anterior Thigh
4) Upper back
5) Upper ventral or dorsogluteal area

33

What steps should be taken if a patient refuses to take a medication?

1) Explore why
2) Educate the PT why the medication is beneficial
3) Document
4) Inform the physician

34

What kinds of medications are administered intradermally, SQ, and IM?

1) Intradermal - Tuberculin and allergy tests
2) SQ - Insulin and LMWH
3) IM - Antibiotics, hormones, and vaccines

35

Name the 6 complications that can happen from an IM injection

1) Abscesses
2) Cellulitis
3) Injury to blood vessels, bones, and nerves
4) Lingering pain
5) Tissue necrosis
6) Periostitis

36

What are the 3 sites on the body where IM injections can be given?

1) Ventrogluteal
2) Vastus Lateralis
3) Deltoid

37

What is an actovial?

A vial containing diluent and powder but separated by a rubber stopper. The rubber stopper is activated when the nurse is ready to reconstitute the med.

38

Why should you give potassium-based IVs in larger veins? What can you do if the problem persists in the larger vein?

Potassium irritates the vein and causes a burning sensation. If the problem persists when you switch to a bigger vein, try slowing the rate of infusion.