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Nursing 317 > Week 1 and 2 > Flashcards

Week 1 and 2 Flashcards

1
Q

Parenteral Routes

A

outside of the GI system

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2
Q

List the Parenteral Routes

A

ID, Subcut, IM and IV

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3
Q

Intradermal Injections

A

small volume injections

admin skin test

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4
Q

What is the syringe size for ID injections

A

1 mL syringe

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5
Q

What is the needle gauge for ID injections

A

25-30 guage

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6
Q

Subcutaneous Injections

A

nonirritating substances
injected into fatty tissue sites
Insulin and Anticoagulants

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7
Q

How much can be administered with a Subcut injection

A

1 mL

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8
Q

what is the gauge of the needle for a subcut injection

A

25-30 gauge

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9
Q

Intramuscular injections

A

deliver medications for faster absorption

tolerate more concentrated substances

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10
Q

How much can be administered via IM

A

up to 3 mL depending on patient skin integrity and muscle size

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11
Q

How far away from the umbilicus must you be when giving an injection

A

at least two inches

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12
Q

Why is the dorsogluteal are not recommended for injections

A

because of the potential for nerve and vessel damage

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13
Q

What is the basis for selecting a needle

A

type of medication
size and condition of patient
are of injection
* larger the gauge the smaller the diameter the needle

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14
Q

What is the approximate length for an ID needle

A

3/8-1/2 inch

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15
Q

What is the approximate length for subcut needle

A

3/8-5/8 inch

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16
Q

what is the approximate length for an IM injection

A

5/8-2 inches

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17
Q

What are some examples of diseases that could be contracted because of a needle stick

A

Hepatitis B, C, and HIV

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18
Q

What must you do before mixing medications

A

always consult a reference for compatibility or the pharmacist

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19
Q

Where must all liquid medications be measured

A

at the meniscus

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20
Q

If the vial is multi-dose what must the nurse do

A

must label it with date, time and amount of diluent used and their initials

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21
Q

When giving IM injections what must you always do

A

always aspirate

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22
Q

What happens if blood is returned while aspirating

A

reject the dose and start over

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23
Q

What is the maximum single injection for adults

A

3 mL

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24
Q

What should you do before administering antiinfectives

A

check the patients medication history of drug sensitivity

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25
Q

Insulin

A

an aqueous solution

principal hormone of the pancreas

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26
Q

Diabetes mellitus

A

deficiency of insulin

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27
Q

Type 1 DM

A

occurs before age 30
pancreatic beta cells do not produce insulin
insulin injections must be taken daily

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28
Q

Type 2 DM

A

usually occurs after age 30
pancreas produces some insulin
only 40% take insulin regularly

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29
Q

what is the most common complication of insulin therapy

A

Hypoglycemia

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30
Q

what is used to treat hyperglycemia

A

glucose tablets
glucose gel
and glucagon injections

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31
Q

If a patient is over 20 Kg how much glucagon can be injected

A

1 mL

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32
Q

If a patient is under 20 Kg how much glucagon can be injected

A

0.5 ml

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33
Q

What is the preferred area for insulin injections

A

abdomen

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34
Q

what are alternative areas for insulin injections

A

upper arms, back, or thighs

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35
Q

What are the signs of hypoglycemia

A 
rapid onset
cold and clammy skin
diaphoretic
nervous
blood glucose below 70mg/dL
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36
Q

What are the signs of hyper glycemia

A 
several hour onset
warm skin
flushed dry skin
lethargic
blood glucose above 300 mg/dL
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37
Q

Rapid Acting Insulin

A

Aspart (Novolog)
Lispro (Humalog)
Glulisine (apidra)

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38
Q

Aspart characteristics

A

5-15min, 1-3hr, 3-5hr

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39
Q

when do you take rapid acting

A

15 min before meals

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40
Q

what can be mixed with rapid acting

A

NPH

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41
Q

Characteristics of Lispro and Glulisine

A

15 min, 1-2hr, 3-4 hours

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42
Q

Short- Acting Insulin

A

Regular (novolin R)

Regular (humulin R)

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43
Q

Regular (Novolin R) characteristics

A

30-60min, 2-5hr, 6-8hr

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44
Q

Regular (humilin R) charateristics

A

40-60min, 2-3hr, 4-6hr

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45
Q

What can short-acting insulin mix with

A

NPH

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46
Q

When should you take short-acting insulin

A

30min before a meal

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47
Q

Intermediate actin Insulin

A

NPH (Novolin N)

NPH (humulin N)

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48
Q

NPH Novolin N

A

90min, 4-12hr, up to 24 hr ** cloudy

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49
Q

NPH Humulin N

A

2-4hr, 4-10hr, 14-18hr *** Cloudy

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50
Q

When should you take intermediate insulin

A

30min before a meal

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51
Q

what can be mixed with intermediate insulin

A

Regular and rapids

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52
Q

Long-acting insulin

A

Glargine (lantus)

Detemir (levemir)

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53
Q

Glargine (lantus)

A

3-5hr, peakless, 22-26hr

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54
Q

Detemir (Levemir)

A

2-4 hr, Peakless, 13-20hr

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55
Q

When should you take Glargine

A

bedtime

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56
Q

When should you take Detemir

A

Bedtime or supper time

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57
Q

What can you mix with long-acting

A

NOTHING DO NOT MIX

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58
Q

How often are premixed insulins taken

A

Twice a day

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59
Q

Short and intermediate acting 70/30 or 50/50

A

1-4hr, 2-4hr/6-10hr, 3-4hr/10-16hr, *** cloudy

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60
Q

When do you take short and intermediate mix

A

30min before a meal

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61
Q

Rapid and intermediate acting

A

75/25 and 70/30 Novolog mix

62
Q

75/25 mix-

A

15min-4hr, 1-2hr/60-10hr, 3-4hr/10-16hr *** cloudy

63
Q

70/30Novolog Mix

A

15min-4h, 30-90min/ 6-10hr, 4-5hr/10-16hr ***cloudy

64
Q

When do you take the rapid and intermediate acting mix

A

15min before a meal

65
Q

Why is the combination of NPH and Regular insulin given

A

give a 24 hour effect

66
Q

What types of syringes are used when giving insulin

A

1 ml or 0.5mL

67
Q

When giving insulin what must you do before administration

A

Insulin dosage requires two nurses to double check for accuracy

68
Q

How are insulin dosages drawn up

A

they are drawn up exactly as ordered

69
Q

In what order do you draw up insulin

A

Clear to cloudy

70
Q

What do insulin pumps do?

A

Supply a continuous infusion of insulin

71
Q

What may happen if the insulin is interrupted involving an insulin pump

A

ketoacidosis

72
Q

What should you do to prevent ketoacidosis when using a pump

A

have supplemental insulin ready

73
Q

how often should blood sugars be checked when using an insulin pump

A

before meals and at betime

74
Q

What is the best type of diabetes management

A

Carbohydrate ratio technique

75
Q

What type of insulin can be given IV

A

only clear regular insulin

76
Q

Sulfonylureas

A

stimulate the pancreas to make more insulin

77
Q

Biguanides

A

decrease the amount of glucose made by the liver

78
Q

Alpha-glucosidase inhibitors

A

slow the absorption of the starches you eat

79
Q

Thiazolidinediones

A

make you more sensitive to insulin

80
Q

Meglitinides

A

stimulate the pancreas to make more insulin

81
Q

D-phenylalanine

A

help your pancrease make more insulin quickly

82
Q

DPP-IV inhibitors

A

boost incretin gut hormone production to help lower blood glucose levels

83
Q

Heparin sodium injections

A

interrupt the clotting process

affects the ability of blood to coagulate

84
Q

What is Heparin used for

A 
to treat deep vein thrombosis
pulmonary embolism
cardiac surgery
during hemodialysis
MI 
disseminated intravascular coagulation
85
Q

how is heparin administered

A

IV or subcut

86
Q

What is heparin’s half-life

A

1-6 hours

87
Q

How is heparin titrated

A

on the basis of Partial thromboplastin time levels (taken every 6 hours)

88
Q

what counteracts heparin

A

protamine sulfate

89
Q

Lovenox and Framin

A

are low-molecular-weight anticoagulants

90
Q

Why are lovenox and framin prescribed

A

for the prevention and treatment of
DVT
PE
and also after knee and hip surgery

91
Q

What is the preferred site of administration for lovenox and framin

A

in the “love-handles” or anterolateral abdominal wall

92
Q

What must you always do when administering an anticoagulant

A

always verify dosage with a second nurse for accuracy

93
Q

Where must lovenox and fragmin never be given

A

in the deltoid

94
Q

why must lovenox and fragmin never be given in the deltoid

A

because they leave large hematomas

95
Q

Arixtra

A

non-heparin anticoagulant, not animal origin,

specific inhibitor of activated factor X

96
Q

what is Arixtra used for

A

prophylasis of venous thromboembolism, DVT, PE

97
Q

What can be administered in conjunction with Arixtra

A

Warfarin to treat acute DVT

98
Q

Arixtra is not intended for what?

A

IM use

99
Q

Why should you not massage the injection sites

A

because it increases risk of bleeding and hematoma development

100
Q

What should the subcut dose be for Heparin

A

dosage should not exceed 1mL

101
Q

what is heparin made from

A

pork and beef, CHECK Patients allergies

102
Q

why are elderly given large doses of heparin

A

because heparin resistance may occur

103
Q

What are symptoms of overdose in heparin

A

nosebleed, bleeding gums, tarry stools, petechiae, and easy bruising

104
Q

When intermittent or continuous Heparin IV therapy is used what needs to be done

A

blood should be drawn for PTT and hematocrit levels to determine course of therapy

105
Q

How are therapeutic anticoagulant dosage regulated

A

according to PTT results and patients weight

106
Q

Warfarin

A

used as prophylaxis after an episode of thrombolytic complications and for atrial fibrillation to prevent blood coagulation.

107
Q

What is the action of warfarin

A

it inhibits the activity of vitamin K- which is required for activation of clotting factors

108
Q

how is the level of warfarin measured in a patient

A

by International normalized ratio (INR)

109
Q

What is the normal range for an INR

A

2-3

110
Q

what is the antidote for warfarin

A

Vitamin K, plasma or whole blood

111
Q

What should a patient taking warfarin avoid

A

foods rich in vitamin K until INR is stabilized

112
Q

Clopidogrel (plavix)

A

an antiplatelet agent that blocks the formation of blood clots by preventing the clumping of platelets

113
Q

what is plavix used for

A

prevention of heart attacks, unstable angina, recent stroke or peripheral vascular disease

114
Q

what is the only PPI safe to use with plavix

A

Pantoprazole (protonix)

115
Q

Acetylsalic Acid (aspirin)

A

prevents the formation of blood clots

116
Q

Dosing of Aspirin

A

can be prescribed concurrent with warfarin

117
Q

at what angle can you give subcut injection

A

45-90

118
Q

what angle can you give IM injections

A

90

119
Q

what angle can you give ID

A

5-15

120
Q

What is the length of the needle for an IM given to the deltoid

A

1-1.5

121
Q

What is the length of the needle for an IM given to the VL

A

5/8-1

122
Q

What is the length of the needle for an IM given to the VG

A

1-1.5

123
Q

What is the most common way to get air into the syringe

A

by pulling too fast

124
Q

what can dull a needle

A

puncturing the vial

125
Q

how long do you need to clean surfaces before puncturing them

A

15 seconds

126
Q

How many rotations must be completed before drawing up insulin

A

20 rotations

127
Q

how do you use an insulin pen

A

prime the needle with 2 units and inject at a 90 degree angle

128
Q

What are the IM sites

A

Ventrogluteal
Deltoid
Vastus Lateralis

129
Q

Ventrogluteal

A

Good for large volume viscous and irritating medication

130
Q

What are the sites for Ventrogluteal

A

gluteus medis and minimus, and greater trochanter, anterior superior illiac crest and dorsal crest of illiac spin

131
Q

What is the site for Vastus Lateralis

A

anterior lateral aspect of thigh, greater trochanter or femur, lateral femoral condyle

132
Q

Deltoid

A

acromin process

below 1-2 inches

133
Q

z track method

A

pull skin to the side of injection with non-dominant hand
insert needle and aspirate
maintain traction for 10 seconds before withdrawing needle
release skin

134
Q

how fast can you inject a person with medication

A

10seconds/mL

135
Q

how is intermittent medication given

A

through a saline or heparin lock

136
Q

what things are important for the person administering the IV to know

A

action of medication, flow rate, adverse reactions and antidotes

137
Q

Types of IV lines

A

peripheral
peripheral inserted central catheter
central line

138
Q

Describe the Peripheral IV line

A

is usually used for fluid replacement and temporary intermittent medication administration
given in hand, arm or possible leg

139
Q

describe Peripheral Inserted Central Catheter

A

longer than a central line,

usually the vein in the antecubital region of the arm

140
Q

What can the osmolarity be for a PICC line

A

10% or less osmolarity

141
Q

Describe central line

A

inserted by MD or DO directly into the jugular or subclavian vein into the superior vena cava

142
Q

What type of syringe should be used when flushing Peripheral IV lines

A

a 10mL syringe - a smaller syringe creates a greater pressure within the line

143
Q

macrodrops in mL

A

10 macrodrops in one mL

144
Q

microdrops in mL

A

60 drops in mL

145
Q

how often should you check the IV bag with a pt

A

every hour

146
Q

Hypotonic Solution

A

fluid shifts out of intravascular compartment, hydrating cells
(250 mOsm/L)

147
Q

Isotonic solution

A

osmolarity equal to that serum

250-375 mOsm/L

148
Q

Hypertonic solution

A

fluid is drawn into the intravascular compartment from the cells
(375 mOsm/L)

149
Q

What must you do to every port before puncture

A

clean with antiseptic

150
Q

what are patient-controlled analgesia (PCA)

A

allows a specified amount of narcotic to be available to the patient on demand

151
Q

Total Parenteral Nutrition Device

A

delivery mode allows the infusion of nutritional elements slowly at the beginning of the administration
this keeps the glucose level from rising too rapidly

152
Q

Pressure- Flow infusion device

A

the ambulatory infusion device system was developed for ambulatory use

Nursing 317 (1 decks)

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