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19 Cards in this Set
- Front
- Back
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Ventrogluteal site |
1. left palm on right greater trochanter 2. thumb pointed toward anterior pelvic region (groin) 3. index finger towards anterior superior iliac spine 4. spread index and middle finger (points toward posterior superior iliac crest) 5. give injection in between index and middle fingers |
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Dorsogluteal site |
1. draw an imaginary line from posterior superior iliac spine to the greater trochanter 2. give injection above line 3. in the outer corner 4. avoiding sciatic nerve
Or divide buttock into 4 quadrants and give in the upper outer quadrant |
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Vastus Lateralis |
1. one hand over top of thigh (greater trochanter) 2. other hand above the knee 3. inject into the lateral side central third of the thigh |
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Rectus Femoris |
1. one hand over the top of the thigh (greater trochanter) 2. other hand above the knee 3. inject into the anterior (top) part of the tghit |
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Deltoid |
palpating the lower edge of the acromion process 2. inject the medication 1-2 finger breadths below the acromion process |
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Identifying Subcutaneous sites (5) |
45-90 degrees 1. Back of upper arms 2. side of thighs 3. upper back 4. abdomen 5. love handles on back
90 degrees if enough subcutaneous fat 45 degrees if not enough (primarily) |
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Needle side for IM |
90 degrees 1. 20-25 gauge unless the medication is viscous, then a larger gauge needle should be selected, such as 18 gauge
Length - must consider size of pt and site "1-1 1/2" |
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Needle Size for Sub-q |
25-27 guage
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Needle Size for Intradermal |
(5-15 degrees)
26-27 gauge, 1/2-1/2 length |
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Obtaining a capillary blood sample for glucose testing |
1. wash hands, 2 identifiers (name=DOB), while looking at armband, explain procedure, provide privacy, put on gloves 2. turn on monitor and remove test strip, place strip in monitor and compare code 3. Milk patients hand and run under warm water 4. wipe patients finger with alcohol pad and allow to dry 5. pierce skin with lancet 6. wipe first drop of blood off with cotton ball 7. cover sample are on test strip 8. apply pressure to puncture with a cotton ball 9. read glucose level and document 10. turn off meter, place lancet in sharps 11. remove gloves an wash hands, closing over riders |
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Removing Medications from Ampule |
1. gather equipment 2. check medication order 3. wash hands 4. move medication cart outside of patient's room 5. read MAR and select medications 6. compare lables with MAR and expiration dates 7. tap stem of ampule or twist to assure all medication is out of the neck 8. wrap a gauze pad around neck 9. break away from you at scored line and discard neck in sharps container 10. attach filter needle to correct syringe 11. remove cap of needle 12. place vial on flat surface 13. insert needle into ampule and withdrawl fluid being careful not to touch sides (state that if you do touch sides you must discard and obtain a new needle) 14. remove needle and check for air bubbles 15. check amount of medication in syringe with order and discard any surplus 16. check label with MAR 17. discard ampule in sharps and gauze in trash 18. lock medication cart 19. wash hands 20. go into patients room with injection and discard needle into sharps after injection |
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Removing Medication From Vial (pg. 23-24) |
1. gather equipment, check medication order, wash hands, move med cart outside patients room 2. read MAR and select Meds 3. compare labels with MAR and expiration dates 4. remove cap from vial 5. clean rubbber stopper with alcohol wipe 6. remove cap from needle 7. draw back amount of air equal to amount of medication 8. put vial on flat surface 9. insert needle and inject air 10. invert vial and syringe at a vertical position at eye level 11. withdraw medication 12. remove needle and put vial back on flat surface 13. check for air bubbles 14. place cap back on needle 15. change needles (throw used one in sharps) 16. check MAR with amount in syrgine 17. check label with MAR 18. if multidose, label it with date and time opened, lock cart, wash hands, patients room for admin, discard immediately into sharps |
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Mixing Medications from 2 Vials in one Syringe (pg 25-26) |
1. gather equipment and have another nurse watch since you are mixing 2 medications, check medication order, wash hands, move cart outside room 2. read the MAR and select meds, compare labels with MAR and expiration dates 3. if you have stock vial, use that first 4. remove cap from vial 5. if NPH insulin, roll vial between hands to mix well, dont shake, clear before cloudy 6. clean rubber top with alcohol wipe 7. select correct needle (orange syringe for insulin, TB for heparin) 8. remove cap of needle 9. draw back amount of air for 1st medication (if insulin this would be NPH cloudy) 10. put vial on flat surface with vial sitting flat 11. draw back amount of air for 2nd medication, (if insulin this would reg clear) 12. put vial flat on surface and insert needle into rubber stopper 13. inject air into vial 14. invert vial 15. draw up amount of medication ordered from 2nd medication with vial in syringe inverted ( if insulin this would be reg clear) 16. turn vial over and remove needle 17. check for air bubbles 18. check MAR 19. insert needle into 1st medication with vial sitting flat on surface 20. invert vial and syrgine 21. draw up medication amount (careful not to go over) and explain that if you do you must discard and start over ( if insulin this would be cloudy 22. turn vial back over and place on flat surface 23. remove needle 24. check for air bubbles 25. recap needle 26. remove needle and replace with new (old in sharps) 27. check the amount with MAR 28. label vials 29. lock cart, wash hands, admin injection, throw away in sharps when done |
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Mixing Medications from Ampule and Vial |
1. gather equipment, check medication order, wash hands, move med cart outside room 2. read MAR and select meds 3. compare labels with MAR and Expiration Dates 4. Vial First 5. inject amount of air equal to amount to be withdrawn from vial 6. with vial on flat surface, inject air into vial 7. recap needle 8. discard into sharps 9. put on filter needle 10. ampule next 11. with ampule on flat surface withdraw appropriate medication 12. discard ampule into sharps 13. recap filter needle 14. discard needle into sharps container 15. back to vial 16. invert vial and syringe 17. put vial back on flat surface and remove needle 18. recap needle 19. discard needle into sharps 20. apply appropriate needle 21. check medication in syringe with amount on MAR 22. check mar again 23. if multidose vial label with date and time opened 24. lock medication cart 25. admin meds, discard into sharps
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PDTDRD |
right patient, drug, time, dose, route, documentation |
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Liquid Meds |
1. place palm of hand over label (spillage dosnt get on label) 2. measure at miniscus (lower part) 3. put cap up
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Inhaler note |
rinse and spit after so as to not get systemic response |
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Eye drops |
1. 45 degree angle 2. clean eye, use separate everything (two conditions 3. put hand on patient's forehad 4. hold intercanths so its not absorbed systemically |
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Patches |
date time and initials, gloves take old patch off first wipe old medication residue away put on new patch in new location |
