Which parenteral medication should only be given intramuscularly Quizlet
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Parenteral (Define and characteristics) Show Administration of medication by injection into body tissue *Invasive procedure (increase risk of infection) *Use asepsis *Wear gloves *Onset of medication is quicker than non-parenteral and requires close pt monitoring *Avoid areas of trauma, skin alterations, bony prominences 4 types of parenteral administration 1. Intramuscular (IM) 3 parts of a needle 1. Hub The size of the needle you use depends on what 4 things? 1. The location of injection 2. The type of injection (IM, ID, SC) 3. The size of the pt 4. The viscosity (thickness) of medication Sizes of needles are based on what 2 things? Gauge and length Gauges (Define) The diameter of needle *Smaller number equals bigger needle EX.) 31 G (smaller) -- 19 G (bigger) Syringes (2 types, sizes) 1. Types 2. 0.5ml - 60 ml *Will see many w/ safety devices to prevent needle sticks Carpujets Pre-filled syringes *Dont have a needle on end, have to put adapter on end and a needle Blunt tip needles are used for what? Mixing and drawing up medications Vials *Can be multi dose or single dose *Liquid or dry powder that needs to be reconstituted (Instructions on vial) *Rubber seal on top of vial *Air needs to be injected prior to withdrawing medication (1ml) Why does air need to be injected prior to withdrawing medication from vials? Prevents vacuum from developing in vial which causes you to not be able to draw anything out of the vial at some point *More important w/ multi-dose vials Ampules *Glass *Cap needles to be broken off at pre-scored mark *USE A FILTER NEEDLE to draw up medication just in case any glass particles fell into medication from breaking off *No air needs to be injected prior to withdrawing medication (has no vacuum or seal) 7 general tips for injections 1. Use sharp needles 2. Use smallest needle that is adequate for medication and site 3. Insert quickly and smoothly 4. Stabilize the skin and tissue that you are injecting 5. Hold syringe stable while injecting medication 6. Rotate sites if requiring multiple injections 7. DON'T massage injection sites Why shouldn't you massage injection sites? Can cause bruising, tissue damage, and affect absorption Intramuscular injections Deposit medication into muscle tissue *Faster absorption versus SQ injections and secondary to vascular muscle tissue *Z track method recommended to reduce tissue irritation IM needle insertion angle 90 degrees IM injection amount No more than 3 ml per injection site IM needle gauge and length *18-25 gauge needle *5/8 - 1 1/2 inches long IM needle length depends on what? Amount of SQ tissue 6 steps to IM injection 1. Cleanse the area in circular motion 2. Hold syringe like a dart 3. Inject needle using a quick, smooth motion 4. Administer medication slowly 5. Withdraw needle 6. Apply gentle pressure 3 sites for IM injections 1. Ventrogluteal site What is the preferred and safest site for IM injections? Ventrogluteal site Ventrogluteal site Use the gluteus medius muscle *Use for larger volumes (> 2ml) Ventrogluteal site injection steps 1. Position pt supine or lateral 2. Place palm of hand on head of greater trochanter and thumb pointing toward abdomen 3. Extend index finger up and other fingers back toward iliac crest 4. Inject b/w the "v" formed from your index finger and other fingers Vastus lateralis injection Use vastus lateralis muscle on anterior aspect of thigh *Should grasp muscle when injecting *Use for moderate volumes of medication (1-2ml) *Use middle third of muscle 1. measure one hand width below greater trochanter Deltoid site injection *Use deltoid muscle on lateral aspect of upper arm *Use for smaller volumes (1 ml or less) *Need to assess if muscle is to underdeveloped to use for injection *Use middle portion of muscle 1. Measure 2-3 finger widths below acromion process Z track method For all intramuscular injections; prevents tissue irritation caused when medication leaks into SQ tissues *Seals the medication in the muscle tissue z track method steps 1. Displace the skin and the SQ tissue at the site about 1 - 1 1/2 in w/ the side of your dominant hand 2. Mantain this displacement throughout the injection and release immediately after you withdraw the needle from the skin Subcutaneous injections Used when slower absorption is required *Most common SQ meds: heparin, lovenox, insulin SQ injection amount Small volumes *1 ml or less SQ needle insertion angle 45 to 90 degrees SQ needle gauge and length *25 to 30 gauge 2 preferred sites for a SQ injection 1. Outer posterior upper arm Other sites for SQ injections (3) 1. Anterior aspect of thighs SQ injection steps 1. cleanse area in circular motion (let alcohol dry) 2. hold syringe like a pencil 3. pinch site while injecting (determines angle) 4. use swift, smooth motion while inserting needle 5. inject medication slowly 6. w/draw needle 7. apply gentle pressure after removing needle Intradermal injections Typically used for skin testing, TB screening, and allergy testing *Medications are potent and injected into the dermis where blood supply is reduced and medication absorption occurs slowly *WATCH FOR ANAPHYLACTIC REACTIONS (because usually injecting things your wanting to see react like TB and allergy tests) ID needle insertion angle 5-15 degree angle *Because in dermal area of skin, not wanting to get to tissue ID needle gauge and length *27-31 gauge ID injection amount Very small volume injection ID injection sites Need to be lightly pigmented, free of lesions, and relatively hairless *Inner forearm and upper back are ideal locations! Steps to ID injections 1. cleanse site in circular motion 2. angle needle at 5-15 degrees 3. ensure that bevel is pointed up 4. use a smooth and steady motion when inserting needle 5. inject medication 6. need to create "bleb" when doing intradermal injection - if bleb does not form, or if the site bleeds after needle w/drawal, the medication may have entered SQ tissue 7. w/draw needle Mixing medications Some meds need to mixed from 2 vials or from a vial and an ampule *Mixing compatible drugs avoids the need to give a pt more than one injection *When mixing meds, fluid must be correctly aspirated from each container WITHOUT contaminating either vial's contents *Ensure final dose is accurate *Maintain aseptic technique Insulin (Define, administering) Hormone used to treat diabetes *When administering you need to know the onset, peak, and duration of insulin to know when to administer 4 classifications of insulin 1. Rapid Acting ( Ex. -Humalog) 2. Short Acting (Ex. - Regular) 3. Intermediate Acting (Ex. - NPH) 4. Long Acting (Ex. - Lantus) How is insulin ordered? in units *Usually 100 units in 1 ml Insulin is a high risk medication. True or False True Why is insulin a high risk medication? Because very small volumes and minimal errors in dosage can have a drastic effect for pt's How is insulin typically administered? In SQ tissues *Should always be given around the same area every time (arm, abdomen, thigh..) Insulin syringes characteristics *Hold 0.3 to 1 ml What kind of insulin can be given IV? Regular insulin *When very specific control of blood sugars is required When mixing insulin, you will always go from __________ to ___________. Clear, cloudy Why is insulin mixed sometimes? To give better control of blood sugars Which 2 types of insulin are typically mixed? Intermediate (NPH) and short acting (regular) Pre-mixed insulin *Called 70/30 *Already has NPH (70%) and regular (30%) insulin mixed Which type of insulin do you never mix? Lantus or levemir (Long acting insulin) Steps for mixing NPH and regular insulin 1. Roll the vial of NPH insulin 2. Cleanse the top of both vials 3. Inject the correct amount of air into the NPH insulin first 4. Inject the correct amount of air into the regular insulin next 5. W/draw the correct amt of regular insulin 6. W/draw the correct amt of NPH insulin Which of the following is a parenteral method of drug administration quizlet?Parenteral Administration: any non-oral means of administration, but is generally interpreted as relating to injecting directly into the body, bypassing the skin and mucous membranes. The common parenteral routes are intramuscular (IM), subcutaneous (SC) and intravenous (IV).
Does parenteral include IM?Administration by injection (parenteral administration) includes the following routes: Subcutaneous (under the skin) Intramuscular (in a muscle) Intravenous (in a vein)
When injecting insulin which parenteral route is most commonly used?The most common route of insulin administration is subcutaneous insulin injections.
Is Intramuscular parenteral or enteral?Parenteral drug administration can be taken literally to mean any non-oral means of drug administration, but it is generally interpreted as relating to injection directly into the body, by-passing the skin and mucous membranes. The common routes of parenteral administration are intramuscular (IM), subcutaneous and IV.
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