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38 Cards in this Set
- Front
- Back
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Parenteral route
how is it given? |
Given by injection
› Use of syringe, needle or IV catheter to administer medications into the body’s tissue or into the bloodstream |
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Purposes for Injections
is what? |
When a patient is unable to swallow medications by mouth.
› When medication effect is needed fast. › When digestive enzymes are counteract any effects of any medications. |
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Preparations for injections is what ?
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ACCURATE dosage calculating!
› Correct site for administration › Keeping equipment sterile prior to injection › Using aseptic technique to prevent infection › Protect the surfaces that must remain sterile. |
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Parenteral Administration
is what routes? |
Intravenous piggyback
› Intravenous › Intradermal › Intramuscular › subcutaneous |
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When giving and Intradermal Route what type of syringe,needle, and insertion is used? And what is formed?
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› 1 mL syringe
› Calibrated 0.01 mL (and minims) › 25 – 29 gauge needle › 1/4 inch or 1/2 inch › Insertion angle – Bevel facing upward – 5-15 degrees – Creates a bleb underneath the thin layer of skin |
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When giving a Subcutaneous Route what type of syringe,needle, and insertion is used?
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› 1 – 3 mL syringe
› Calibrated 0.1 mL (insulin in units) › 27 gauge, 3/8 – ½ inch › 25 gauge 5/8 inch › Injection angle – 45 -90 degrees – Between skin and muscle – Bunch skin |
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When giving an Intramuscular Route what type of syringe,needle, and insertion is used?
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› 3 mL syringe
› Calibrated 0.2 mL › 20 – 23 gauge › 1 – 3 inch in length › Injection angle – 90 degrees – In the muscle for absorption – MUST aspirate! |
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What does the SYRINGES consist of ?
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– Barrel
Holds medication – Plunger Within the barrel. Moves back and forth to withdraw and instill the medication – Tip Needle is attached |
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Syringes are Calibrated how?
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– mL
– Cubic centimeters – Units – Minims (Rare) – 1 mL, 3 to 5 mL most commonly used |
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NEEDLES (13-30 GAUGE)
what is it? |
› Metal tube that liquid medication can go through
› Tip of the shaft is beveled or slanted › Filter needles provide a barrier for debris |
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What would you do if a needle stick occurs ?
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Report the stick IMMEDIATELY to your charge nurse/supervisor
The punctured area should be cleaned thoroughly with soap and water. Identify the client/patient if possible. An incident or occurrence report made There is always a facility policy, become familiar with the policy. |
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What else do you do if a needle stick occurs ?
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ž Receive the most appropriate post exposure prophylaxis
ž Get tested for presence of antibodies at appropriate intervals ž Monitor for potential symptoms and be sure to get medical follow-up |
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MODIFIED SAFETY INJECTION EQUIPMENT what are they?
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Glass ampule
› Single dose vials › Mix-o-vial › Multiple-dose vials These medications should all be kept sterile! |
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Ampules
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Glass or polyurethane
› Single dose › Pre-scored on the neck so it will break evenly. › Remove medication from neck before neck is removed |
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Withdrawing Medication from an Ampule
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– Select appropriate syringe and needle
– Tap on top of ampule – Snap neck of the ampule – Insert filter needle into ampule – Withdraw the medication from ampule – Expel any air – Scoop needle or use safety mechanism – Remove filter needle and apply sterile needle |
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Single dose or multiple dose glass or plastic vial
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Contains self-sealing rubber stopper that must be pierced with a needle or a needleless adapter to remove medication.
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What would you do when preparing the syringe for use?
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Use aseptic technique in handling the syringe and needle. Protect the areas that need to remain sterile: the needle, tip, inner barrel, and plunger.
discard if it becomes contaminated. label syringe with patient's name, name of med. and dose. |
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Mix-o-vial
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Powder in the base portion of the vial
– Solution in the top portion of the vial – They must be mixed prior to use of the medication |
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Prefilled Syringe
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Mixing Medications in one Syringe
– Remember NOT all parenteral medication are compatible. – Reaction could occur – Color change – Inactivation of one or both of medications – Remove exact amounts from the vials |
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Reconstitution of a Medication
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Medications that can be unstable in solution form are prepared in a powder or solid form (solute)
› It is mixed with a diluent before it can be administered. › Commonly used diluents are sterile NS or sterile water. › The medication container should have directions on how to mix the medication and what diluent to use Mix thoroughly › The label should indicate medication per volume after reconstitution › Direction for storage are also included |
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How do you know if the med. is compatible?
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a reaction will occur when a drug combines with an incompatible drug which are: color change, precipition, and clouding to invisible chemical changes rendering the drug inactive.
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Intradermal Route
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Diagnostic purposes - most frequently used for tuberculosis or allergy testing.
ž Smaller volumes › 0.01 to 0.05 ž Injection site › Inner aspect of forearm › Back or upper chest |
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Subcutaneous Route
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ž Volume up to 1 mL
ž Slower absorption than intramuscular ž Insulin syringe ž TB syringe ž Prefilled syringe |
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Administering Insulin
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Insulin is a hormone that is needed by patients/clients with diabetes
ž Insulin syringe is calibrated in units ž Insulin syringes can hold 0.3, 0.5, or 1 mL ž Standard is 100U/mL ž Low doses are given with the 30U or 50U syringes |
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Mixing Insulin
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Insulins tend to bind and become equilibrated
› Within 15 minutes of being combined there unique characteristics are offset by each other › Regular is additive free, is combined with intermediate acting insulin NPH |
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Administering Heparin
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Heparin is a anticoagulant
ž Additional precautions needed ž Rotates sites ž Massaging the site is contraindicated |
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Intramuscular Route
Dorsogluteal |
UOQ of the buttocks
› Large muscle › Gluteus maximus › Be careful in identifying site incorrectly, wrong site could result in sciatic nerve damage. › This site is not recommended |
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Intramuscular Route
Ventrogluteal |
› Safe site for adults and children
› Uses the gluteus medius in the hip area › Less painful › No large blood vessel or nerves |
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Intramuscular Route
Vastus lateralis |
› Outer thigh
› No large blood vessel or nerves › Recommended for infants, small children, thin or debilitated patients › Middle third of the lateral quadriceps |
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Intramuscular Route
Rectus femoris |
› Middle third of the anterior quadriceps.
› Used for infants |
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Deltoid
Intramuscular Route |
› Lateral aspect of upper arm
› Smaller of the muscles › Up to 1 mL can be given in this site › Intramuscular Route |
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Air lock technique
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› Used to clear the needle of medication
› To seal the track, so no back flow into subcutaneous tissue › Draw medication, then 0.2 mL of air › Injection at 90 degree angle › Air follows medication › Controversial › Check facility policy |
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Z-track technique
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› For irritating solutions to seal in the muscle
› Manipulate tissue |
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What can you do to reduce discomfort?
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ž Use the smallest needle appropriate for injection
ž Change needle with irritating medication before administration ž Check area for injection for irritation ž You can numb area with ice pack ž Insert needle steadily ž Use Z-track with IM ž Massage site if not contraindicated |
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Nursing Diagnosis
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ž Acute pain
ž Anxiety ž Fear ž Risk for trauma ž Deficient knowledge |
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Special Consideration
Elderly |
› Less SQ tissue
› May need assistance when needing to self administer insulin › May need assistance with identifying landmarks for IM injections |
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Intramuscular Route
the wrong site selection could lead to what ? |
damaged nerves, abscesses, necrosis, and sloughing of skin, and pain.
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If you need to administer more than 3mL at one time what should you do?
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The med. should be divided in half and given in two different large muscle sites.
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