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Safe Parenteral Medication Administration
Terms in this set (30)
What are the 6 rights of medication administration?
What do you need prior to giving a medication?
How many medication checks do you do?
1. When pulling the medication from drawer.
2. When comparing against MAR.
3. At patient's bedside and explaining meds to patient.
4. During documentation (save labels!)
What are the three methods of administering parenteral injections?
1.) Subcutaneous (fatty area)
2.) Intramuscular(muscle-deltoid, vastus lateralis, ventrogluteal)
3.) Intradermal (right below epidermis and slightly above dermis)
You should pick the syringe that best fits your...
ie: Use 1ml syringe for administering 0.5ml because it is more accurate
You need to keep what as sterile as possible?
What criteria are used to determine the type of equipment needed for an injection?
Route of administration
Viscosity of solution
Quantity to be administered
Type of medication
What is an ampule?
Need a filter needle because there might be glass shards inside
Draw out all medication out of ampule, then waste if you don't need all of it.
The smaller the number, the bigger the lumen
What is a vial?
can be plastic or glass
18 gauge needle
let air in 6ml or whatever is ordered
inject air into multi-dose vial
draw up 6ml into syringe
How long can you keep a multidose vial after you have removed a dose?
24 hours generally
How do you decrease microbial growth?
Agitate top of lid for 30 seconds
What are the two moderate duration insulins?
Regular and NPH
What helps lengthen time of insulin?
Dr orders 50 units NPH and 10 units Regular insulin. What are steps?
1. Put 60ml of air into syringe.
2. Put air into cloudy 1st NPH (50ml) without touching liquid
3. Put 10ml of air into regular, then draw 10u out of regular.
4.Roll NPH insulin to mix solution.
5. Take 50ml out of NPH solution
Where should you do an insulin sub-q injection?
Abdomen because absorbs better
wipe injection site out from center
If you pinch 2 inches you use _______ angle. If you pinch 1 inch, you use______angle.
Instructions for using Flexpen:
1. uncap pen
2. prime by twisting tube to 2 and prime needle---can do up to 6 times if fluid doesn't come out of top of needle
3. Always go at 90 degree angle and have to hold down into skin for 6 seconds if 6 units ( takes 1 sec per unit)
Sub q injection sizes:
Length: 3/8th to 1in
Amt of solution: up to 1 ml
Angle of injection: 45-90
What do you need to know before giving Lovenox, Heparin or insulin?
Know INR to know viscosity of blood
can go home with patient
low molecular weight heparin
works on blood clots
inject into love handles
works on blood clots
inject into lower part of abdomen (1 in around umbilicus)
inject into sub q
delivers medication into certain muscles for faster onset of action and may have a longer duration of effect
IM injection sites
Ventrogluteal-side of buttocks
Landmarks for VS muscle
Anterolateral aspect of thigh
Usually utilized in infants and children
divide thigh into thirds-want outer
Landmarks for Deltoid muscle
Find acromion process (top of shoulder)
3 fingers down( give injection right below fingers)
generally give 1/2 ml into deltoid
recommended site for vaccines for adults and children 1-18 years of age
Limit solution to be injected to 1 ml
Sizes for IM
Gauge 18-25 (usually 20-22)
Length: Dependent upon size of injection and patient age
Generally 5/8 to 1 1/2 inch
Deltoid- generally a 22-25 gauge needle used and length is based on size of patient
Amt of solution: generally 1-4ml
No more than 1 ml in deltoid
Angle of injection: 72-90 ( depends on site and size of patient)
Use 5/8 for elderly patient
Sizes for ID
Use a small syringe (1ml syringe) and needle length of 3/8- 1/2 inch)
25-27 gauge needle
Injected into dermis just below epidermis
Volume usually less than 0.5ml
Angle of administration is 10-15 degrees
Landmarks for VG muscle
Large muscle mass that includes the gluteus medius and minimus muscles
Relatively free from major nerves and blood vessels
Use left hand for right buttocks and right hand for left buttocks
sub q moved and sealed off fluid into muscle
prevents fluid from leaking out
Find appropriate site
Attach a new needles to syringe
Pull the skin down or to one side about 1in (hold this position with nondominant hand)
Insert needle, inject solution slowly
withdraw needle steadily and release the displaced tissue to allow it to return to its normal position
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