Test #3 Recons, Some Insulins

Question 1

Some meds are stable for only ___ periods in the ___ state.

Answer 1

short; liquid

Question 2

Once meds are mixed, a medication is good for only __ to ___ days

Answer 2

1 to 14

Question 3

The mixing process is called ___

Answer 3

reconstitution

Question 4

Nurses may have to ___ medications just before administration or in the home setting

Answer 4

admix

Question 5

Medications may be ___, injectable, or for ____

Answer 5

oral; injection

Question 6

____ diluents are always used for injectables

Answer 6

sterile

Question 7

The powder is the _____

Answer 7

solute

Question 8

The liquid is the ____ or ____

Answer 8

diluent or solvent

Question 9

The mixture is called the ____

Answer 9

solution

Question 10

What are the 7 principles for Reconsitution

Answer 10

• Manufacturer provides directions
• Diluents (check exp date before use)
• Must identify information (type&amt of diluent, exp. period of admixture)
• If components in #3 are unavailable, consult PDR or other reliable source
• Single dose or Multi-dose after admixture-label clearly
• If multiple doses are possible, you must label concentration of new mixture
• Powder often adds significant substance to the total volume of solution

Question 11

Manufacturer provides directions including…

Answer 11

mL, diluent, storage instructions, concentration after admixture, how long it is good for (10-14 days)

Question 12

What do you check before using diluents

Answer 12

expiration date

Question 13

What are the most common diluents we use? Others?

Answer 13

Sterile water or saline

others: D5W or special solution provided

Question 14

What info must be identified w/ reconstitutions?

Answer 14

Type of diluent, amount of diluent, exp. period after admixture

Question 15

If components (type of diluent, amt. of diluent, or exp. period after admixture) is unavailable, what do you consult? What do you not use in this case?

Answer 15

PDR or other reliable source

*do not use drug guide book

Question 16

What needs to be on the label after admixture of single dose/multi-dose?

Answer 16

• Date & Time
• Mixture Strength
• Exp. Date & Time
• Storage instructions (fridge or room temp)
• Nurse’s initials
• Apply label so that medication information is not obscured
• Discard if labeled inappropriately

Question 17

What medications do you keep even if the medication is labeled inappropriately?

Answer 17

Keep patients meds from home

Question 18

What medications do you throw away if the medication is labeled inappropriately?

Answer 18

Throw away hospital meds (inappropriate labeled meds)

Question 19

If you have multiple strengths on a medication label, after mixing you must…

Answer 19

Label the concentration of new mixture (ex. 500mg/mL)

Question 20

Powder often adds significant substance to ____

Answer 20

The total volume of the solution

Question 21

The label of a reconstitution powder medication should indicate ___ & ___.

Answer 21

The total volume & concentration after admixture

Question 22

Directions of reconstitution med. may not state___

Answer 22

final concentration in unit measure per mL

Question 23

Some solutions can be mixed to ____

Answer 23

varying concentrations

Question 24

This must be considered when choosing appropriate concentrations?

Answer 24

Route

Question 25

What should be considered with an IM route?

Answer 25

amount can not exceed the capacity of the target muscle but should not be irritating

Question 26

What should be considered with an IV route?

Answer 26

large amt. & is usually further diluted after recon. (add 50 or 100 mL to another diluent like NS) Volumes are smaller for pediatrics

Question 27

If you have an order from the prescriber & need to choose a concentration, how would you do this? Why?

Answer 27

Choose the concentration closest to the order from the prescriber *it is more accurate if you get it close to the DR order

Question 28

What does "respectively" mean?

Answer 28

in the order given

Question 29

What do you write on the vial after admixture?

Answer 29

dosage strength you prepared

Question 30

If directions are not on the label, what do you do?

Answer 30

read the insert

Question 31

What do you look at when reconstituting from package insert?

Answer 31

- look closely at amount in the vial & route - insert may give directions for different sized vials, read closely. - directions may vary according to route (IM,IV), read closely

Question 32

What is the broad classification for insulin?

Answer 32

agents used to correct endocrine imbalance

Question 33

What is the specific classification for insulin?

Answer 33

agents used to treat hyperglycemia

Question 34

Insulin is classified by ___ & ____

Answer 34

origin & action

Question 35

These types of insulins are all clear solutions?

Answer 35

Rapid-Acting

Question 36

These insulins are called NPH

Answer 36

Intermediate

Question 37

Name the insulins that are Long-Acting?

Answer 37

Lantus & Levemir

Question 38

Can you mix Long-Lasting Insulins?

Answer 38

NO

Question 39

Insulin is measured & given with ____

Answer 39

insulin syringes

Question 40

Insulin doses are measured in ____

Answer 40

Units

Question 41

Concentration of insulin is almost always ____

Answer 41

100 units per mL

Question 42

What is the measurement of Lo-Dose syringe (2 measurements)? Which one is more accurate?

Answer 42

capacity of 0.5 mL to deliver 50 units capacity of 0.3 mL to deliver 30 units -0.3 mL is more accurate than 0.5 mL

Question 43

What are the two types of 1 mL syringes?

Answer 43

Single scale & odd-even scale

Question 44

What is a single scale syringe?

Answer 44

delivers 100 units but just by 10's on one-side (10, 20, 30 w/ even little tick marks)

Question 45

What is a odd-even scale syringe?

Answer 45

read on appropriate side for the dose being delivered (16, 18 even side, 17, 19 odd side)

Question 46

Insulin orders must be written clearly & must include...

Answer 46

``` Brand name Name of units to be administered Route Time Strength of Solution ```

Question 47

What should never be used when writing units?

Answer 47

" U "

Question 48

Do not round, give to the ___ place.

Answer 48

hundredths

Question 49

When mixing insulin you always mix ___ to ____

Answer 49

clear to cloudy

Question 50

What can you use to administer insulin if you do not have an insulin syringe?

Answer 50

TB syringe

Question 51

Insulin doses are always checked by ____

Answer 51

2 nurses

Question 52

Ask the second nurse to tell you what you have, do not ____

Answer 52

Tell the nurse what you have drawn up

Question 53

Show the second nurse ____ & _____

Answer 53

your syringe & the vials

Question 54

TB syringes are calibrated in ____

Answer 54

hundredths & mL (cc)

Question 55

How many units of insulin equals 1 mL?

Answer 55

100 units equals 1 mL

Question 56

What is a sliding scale?

Answer 56

when you take the patient's blood glucose (done at certain hours), you look at a sliding scale (all facilities have different ones) and whatever the number you received from the blood glucose reading you inject that much insulin

Question 57

If the reading is very low/high, you send a venous sample to lab & treat with ____

Answer 57

Treat with insulin or PO or D50W

Question 58

Insulin promotes two things?

Answer 58

- Glucose to transport across the cell membrane | - Converts glucose out of the blood into glycogen (in the liver)

Question 59

What does insulin utilize & inhibit?

Answer 59

Utilizes fatty acids & inhibits lipolysis

Question 60

What does insulin enhance & inhibit?

Answer 60

Enhances protein synthesis & inhibits protein breakdown