Mosby Ch 9: Venus Access And Medication Administration Objectives

Front 1

Convert selected units of measurement between the household, apothecary, and metric systems.

Back 1

1 kilogram (kg) =2.2 pounds (lbs), 1 milliliter (ml) =1 cubic centimeter (cc), 1 quart (qt) =960 milliliters (ml), 1 teaspoon (t) =5 milliliters (ml), 1 tablespoon (T) =3 teaspoons (t)

Front 2

Describe how to convert from Fahrenheit to Celsius and back again

Back 2

Fahrenheit to Celsius: subtract 32 then multiply by 5 and divide by 9. Celsius to Fahrenheit: multiply by 9 then divide by 5 and add 32.

Front 3

Identify items to remember to perform drug dosage calculations.

Back 3

Convert all units of measure to the same unit and system, Assess the computed dose to determine whether it’s reasonable, Use one method of dose calculation consistently

Front 4

Compute the correct rate for an infusion of drugs or intravenous fluids.

Back 4

Must first know: the volume to be infused, the period of time (in minutes) over which the fluid is to be infused, number of drops per ml the set delivers. Drops/min=volume*drop factor/total time of infusion (min)

Front 5

List the five rights of the safe administration of medications.

Back 5

Correct patient, correct medication, correct time, correct dosage, correct route, correct documentation

Front 6

Describe actions the paramedic should take if a medication error occurs.

Back 6

Accept professional responsibility, immediately advise medical direction and supervisor, carefully assess and monitor patient, Document, Modify personal practice to avoid future errors, Follow agency procedures

Front 7

Describe how to compute infusion rate

Back 7

P*F/E Where P = prescribed dose, F = drop factor, and E = effective concentration

Front 8

Describe the risks associated withparental routes of medication administration

Back 8

Lipodystrophy, cellulitis or abcess formation, necrosis, skin skoughing, nerve injury, prolonged pain, periostitis

Front 9

State the advantages of central venous access

Back 9

Availability when peripheral vessels collapse, provision of access to central pressure measurements, safer vasopressor administration

Front 10

State the disadvantages of central venous access

Back 10

Excessive time (5-10 minutes), sterile technique, special equipment, skill deterioration, high complication rate, chest x-ray should be obtained immediately, inability to perform while other patient care activities are occurring, not generally useful, lower flow rates

Front 11

State the causes of infiltration

Back 11

Dislodgement of catheter, puncture of distal vein wall, leakage of solution from vein, poorly secured IV, poor site selection, irritating solution, high rate or pressure

Front 12

State the signs and symptoms of infiltration

Back 12

Coolness of skin near site, swelling at site, sluggish or absent flow rate, infusion continues when pressure is applied to vein proximally, no backflow

Front 13

State the management of infiltration

Back 13

Lower fluid reservoir to check for back flow, discontinue infusion, remove needle, apply pressure dressing, choose alternative site, document

Front 14

State the signs and symptoms of air embolism

Back 14

Hypotension, cyanosis, weak and rapid pulse, loss of consciousness

Front 15

State the management of air embolism

Back 15

Close the tubing, turn patient on left side with head down, check tubing for leaks, high-flow o2, and notify medical direction

Front 16

Name the drugs to be given via endotracheal route

Back 16

Lidocaine, epinephrine, atropine, naloxone

Front 17

List the items to be written on an IV medication label

Back 17

Name of medication, amount of medication, resultant concentration in the reservoir, date, time, and name of preparer

Front 18

List the universal precautions

Back 18

Use appropriate barriers, wash hands and affected areas thoroughly post-contamination, avoid sharps sticks, do not use mouth-to-mouth, refrain from patient care if exudative lesions or weeping dermatitis is present, pregnant persons should use extreme caution to prevent infection

Front 19

List the steps taken to prepare medication from a vial

Back 19

Assemble the necessary equipment, compute the desired volume, clean the stopper with alcohol, inject air into vial equivalent to amount to be withdrawn, withdraw medication, and expel air

Front 20

List the steps taken to prepare medication from an ampule

Back 20

Assemble the necessary equipment, compute the desired volume, tap amp to settle fluid, clean the neck with alcohol, break neck, withdraw medication, change needles and expel air

Front 21

Describe the procedure for administering an intradermal injection

Back 21

Cleanse the site, hold skin taut with one hand, hold syringe at 15 degree angle with bevel up, puncture skin until bevel is completely within skin and inject medication, withdraw needle and appropriately discard. Inject no more than 0.5 ml

Front 22

Describe the procedure for administering an subcutaneous injection

Back 22

Cleanse the site, pinch skin with one hand, hold syringe at 45 degree angle with bevel up, puncture skin draw back to check for NO blood, and inject medication, and withdraw needle and appropriately discard. Inject no more than 0.5 ml

Front 23

Describe the procedure for administering an intramuscular injection

Back 23

Cleanse the site, hold skin taut with one hand, hold syringe at 90 degree angle with bevel up, and inject medication, withdraw needle and appropriately discard. Inject up to 5 ml

Front 24

Relate measures that should be taken to preserve asepsis during parenteral drug administration.

Back 24

Hygienic measures, cleaning agents, antiseptics, disinfectants, and barrier fields

Front 25

Explain techniques of drug administration by enteral routes.

Back 25

The way drugs are administered and absorbed through the GI tract. Methods include: oral, gastric, and rectal

Front 26

Explain techniques of drug administration by parenteral routes.

Back 26

The way drugs are administered and absorbed outside of the GI tract, generally referring to injections. Methods include: intradermal, subcutaneous, intramuscular, intravenous and intraosseous

Front 27

Describe the steps to safely initiate an intravenous infusion.

Back 27

Explain the procedure, assemble the necessary equipment, flush air from tubing, select catheter, prepare other equipment, apply gloves, select site, prepare site, stabilize vein, advance needle, advance catheter, withdraw needle while applying pressure, release tourniquet, attach tubing, cover site, document

Front 28

Describe the steps to safely initiate intraosseous infusion.

Back 28

Apply gloves, cleanse site, prepare needle, insert needle pointing away from epiphyseal plate, using a screwing motion advance needle until it “pops”, remove stylet, draw up bone marrow into saline-filled syringe, infuse saline, secure needle, attach IV tubing, document

Front 29

Explain techniques of drug administration by percutaneous routes.

Back 29

The way drugs are administered and absorbed through the mucous membranes or skin. Methods include: topical, sublingual, buccal, inhaled, endotracheal, and drugs for the eye or ear or nose

Front 30

Identify special considerations for administering pharmacological agents to pediatric patients.

Back 30

Establish positive relationship, be honest about pain, allow child to help, use only mild physical restraint and explain the necessity, enlist help of parents, injection site must be well stabilized despite promises by child to “hold still”, be aware that there is a smaller margin of error on a smaller child

Front 31

Explain the technique for obtaining a venous blood sample.

Back 31

Blood samples should be obtained at the time IV access is established and prior to the infusion of any fluids. Should blood samples need to be collected in the absence of an IV, a needle and syringe or vaccu-tainer should be used.

Front 32

Describe how to safely dispose of contaminated items and sharps.

Back 32

DO NOT CAP, BEND, OR BREAK. Discard with the syringe in a clearly marked, appropriate puncture- and leak-proof container

Front 33

Steps to be taken to avoid medication errors

Back 33

Avoid distractions, repeat orders, read label at least three times, verify route, ensure drug label is correct for what you want to give, never use unlabeled drugs, double-check difficult calculations with paper or coworker, label syringe if not used immediately, don’t use unlabeled drugs prepared by others, don’t use outdated drugs, double-check when there is question, monitor patient, document