subq and intramuscular injections Flashcards

1
Q

what forms do parenteral meds come in

A

liquid or powder

powder must be reconsituted

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2
Q

what are some supplies used for injections

A

-syringe
-ampules
-vials
-cartidges
-pens
-prefilled syringes

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3
Q

where should you draw up medications

A

at the bedside, immediately prior to administration

will need barcode on vial

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4
Q

who administers the medication?

A

only the person who prepares the medication

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5
Q

should you leave meds at the bedside?

A

nope

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6
Q

how do you dispose of unused meds?

A

per policy

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7
Q

after administering a med, what do you do with the needle?

A

immediately engage the safety mechanism and dispose use equipment in sharps container

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8
Q

describe parenteral med administration

A

-invasive
-sterlie/aseptic technique
-requires precise calculation of the dose
-requires accurate site identification
-requires careful technique
-provides rapid response

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9
Q

what are the med administration essentials?

A

-triple check
-three checks
-six rights
-patient rights
-pre administration assessment
-evaluation

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10
Q

describe the process of withdrawing meds from a vial

A

-disinfect stopper on the vial
-pull back plunger on syringe equal to the desired amount of fluid
-remove cap from needle, place on table
-pierce stopper with the needle using a 90 degree angle
-keep the tip of the needle in the air at the top of the vial
-inject air into the vial. keep thumb on plunger
-invert the vial and syringe, keeping thumb on the plunger
-retract needle, so that it remains in the fluid
-aspirate the plunger to withdraw the desired amount of fluid

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11
Q

describe mixing medications

A

-determine compatibility of the medications
-do not contaminate one medication with the other
-ensure the final dose is accurate
-mainatin aspetic technique

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12
Q

what should NPH insulin look like?

A

cloudy

if its not, roll vial between palms

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13
Q

what happens if you overdraw while mixing medications?

A

discard and start all over

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14
Q

what order should you draw up the meds when mixing regular insulin and NPH?

A

regular first, then NPH

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15
Q

describe minimizing discomfort when giving injections

A

-use smallest suitable needle
-position client comfortably
-select proper site
-use distraction as appropriate
-stabilize the skin
-hold syringe steady
-insert the needle quickly and smoothly
-inject the medication slowly

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16
Q

angle of injection

intramuscular

A

90 degrees

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17
Q

angle of injection

subQ

A

-45 degrees or 90 degrees
-depends on the length of the needke and amount of subQ available

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18
Q

angle of injection

intradermal

A

15 degrees

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19
Q

what syringe is used for subQ injections

A

insulin
1-3ml syringe

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20
Q

what needle is used for subQ injections

A

-often pre-attached to syringe
-gauge 25-31
-length 3/8” to 1” (usually 3/8”-5/8”)
-some insulin syringes may have 5/16” needle

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21
Q

where can you find subQ administration sites

A

-abdomen (at least 1-2” away from the umbilicus)
-outer aspects of upper arms
-outer thigh
-upper buttock
-scapular area

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22
Q

what can you do to prevent tissue damage with subQ administration

A

-rotate sites
-do no aspirate
-do not massage
-avoid sites with bruising, pitting, and lumps
-use a volume of 1ml or less

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23
Q

what are the symptoms of hyperglycemia

A

-flushed
-warm to touch
-thirsty
-hungry
-frequent urination

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24
Q

what are some symptoms of hypoglycemia

A

-sweaty
-cold
-drowsy
-HA
-sweaty
-irritable

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25
what are some generic names of rapid acting insulin
-aspart -glulisine -lispro
26
whats the generic name of short acting insulin
regular
27
what are some generic names of intermediate acting insulin
-NPH -isophane
28
what are some generic names of long acting insulin
-detemir -glargine
29
what is the onset of rapid acting insulin?
15-30 mins
30
what is the peak of rapid acting insulin?
30 mins-2.5hrs
31
what is the duration of rapid acting insulin?
3-6 hrs
32
what is the onset of short acting insulin?
30-60 mins
33
what is the peak of short acting insulin?
1-5hrs
34
what is the duration of short acting insulin?
6-10hrs
35
what is the onset of intermediate acting insulin?
1-2 hrs
36
what is the peak of intermediate acting insulin?
4-12hrs
37
what is the duration of intermediate acting insulin?
16 hrs
38
what is the onset of long acting insulin?
3-4hrs
39
what is the peak of long acting insulin
continuous (none)
40
what is the duration of long acting insulin?
24hrs
41
what type of insulin gives less chance to experience a hypoglycemic event?
long acting
42
what equipment is needed for intramuscular injections?
-gloves -skin antiseptic -syringe (3-5ml) -needle (another card)
43
what size needle should be used for IM injections?
-gauge 18-25 -length: 5/8"-1.5" | usually 21-23g, 1'-1.5"
44
how do you determine the gauge and length of needle when giving IM injections?
determine by: -weight and muscle mass -age -injection site -medication viscosity -residual effects of the medications
45
name some approved IM sites?
-deltoid -ventrogluteal -vastus lateralis
46
how much fluid can you inject into the deltoid?
no more than 1 ml
47
how much fluid can you inject into the ventrogluteal?
up to 3ml
48
how much fluid can you inject into the vastus lateralis?
up to 2 ml
49
describe finding the deltiod
-smallest site -feel for chromium process then go two finger beadths down below -barely posterior to midline
50
describe finding the ventrogluteal site
-this is the preferred injection site -pt should be on side -place hand on greater trochanter of hip with thumb pointing midline and middle and pointer finger on pelvic bone, inject in between those two fingers -after finding site you can move your fingers if not comfotable injecting between them
51
describe finding the vastus lateralis site
middle third of lateral side of thigh
52
describe z track technique for IM injections
-pull skin to one side over injection site -put needle in there and inject med -one plunger is done, let go of skin at same time you remove needle -causes less irritation to the skin
53
what are the steps of injectable med administration
-indetify pt, hand hygiene, provide privacy -review allergies, order, med expiration -verify 6 rights -don clean gloves -select injection site -clean skin and allow to dry -remove cap from needle -stabilize skin -inject needle into skin -inject med -withdraw needle and immediately activate safety using only one hand -dispose of syringe and needle in sharps container -document administration
54
what is evaluation of med administration dependent on?
type of med, changes what needs to be evaluated
55
what are some types of meds administered via injection?
-anticoagulants -antibiotics -antiemetics -antipsychotics -immunizations -insulins -opioids
56
what is infiltration of peripheral IV site?
iv fluids surrouding space around venipuncture site
57
what are the signs and symptoms of infiltration?
-swelling -pallor -coolness around site -pain
58
what shold you do if you see inflitration of IV site?
infusion must be disconnected, raise extremity, and apply warm compress
59
what is phlebitis
inflammation of vein
60
what are some signs and symptoms of phlebitis
-pain -edema -errythema -increase skin temp -redness travelling path of vein
61
what should you do if you see phlebitis
infusion must be disconnected, raise the extremity, apply warm compress
62
what are some risks associated with phlebitis and how do you reduce risk
-risk of developing blood clot -risk reduced by routine removal and rotation of sites
63
name two basic peripheral IV site complications
infiltration and phlebitis