Parenteral med routes - answer inject/infuse
ID: just beneath skin
transdermal
subQ
IM
IV: faster bc vascular, cath/cannula in vein
Parenteral med containers - answervials (cap reseals, 1/multi) and ampules (snap to
access)
reconstitute from powder: not stable
2 meds in 1 syringe (must be compatible)
Parts of a syringe - answerplunger: push part
barrel: where med is, avoid touching
tip: where med comes out
measure dose at base of triangle
What to know before injection - answerV of med to admin
characteristics and viscosity of med
anatomy of injection site
IM route and characteristics - answerfaster absorption than subQ
tolerate more fluid, less irritating at low V, vascular
90 degree angle, longer needle
BMI and adipose tissue influence needle size
IM volume amounts by age - answeradult: 2-5 mL (4-5 unlikely to absorb well)
kids, elderly, thin: up to 2 mL
small kids and older infants: up to 1 mL
smaller infants: up to 0.5 mL
IM sites - answerventrogluteal: preferred and safest site on adults
- V > 2 mL, don't use butt bc sciatic nerve
vastus lateralis: mainly infants and toddlers
- lie flat/sit to relax muscle, grasp muscle if thin/small
deltoid: small V ( < 2 mL), vaccines or other sites bad
Z track method - answerIM injection
min skin irritation by sealing med in muscle
change needle after mixing so no fluid on outside
, less leaking into subQ
don't aspirate w immunizations
Subcutaneous injections characteristics - answerless vascular -> slow absorb
pain receptors -> discomfort
sensitive to irritants/large V (up to 2 mL)
can form abscess
Subcutaneous injection examples - answerheparin: 2 in from umbilicus
- keep air bubble, grasp skin, slow inject
insulin: rotate sites (@ least 1 in from previous site every month)
Intradermal route characteristics - answernot vascular, potent, absorb slow, bleb forms
can -> anaphylaxis if absorb fast
lots of bleeding -> went into subQ
don't massage
IV route and types - answerfast (few secs), give over few mins
IV push: not K please
IV piggyback: fluids, intermittent, antibiotics
medicated drips: continuous
Injection safety - answermost needle-stick injuries preventable!
safety syringes
never recap
avoid fatigue
if you get stuck, report it
Reasons for IV therapy - answermaintain/correct fluid and electrolyte balance
admin meds
replace blood
osmolarity > 900: admin via CL
Types of IV solution - answerisotonic
hypotonic
hypertonic
IV equipment - answerinfusion pole
primary set: primary solution
secondary set: addition that connects to primary (med)
Y tubing: blood (1 NS, 1 blood)
Z spikes for long tubing
Priming primary fluid bag - answer3 days: close roller clamps, remove spike cover (don't
touch spike bc sterile), spike bag, squeeze drip chamber 1/2 way, slowly open clamp to
allow fluid move, invert Y connector as fluid approach, roll clamp
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