Injections

Question 1

How are parenternal meds administered?

Answer 1

via injection

Question 2

What are the 4 parts of a syringe?

Answer 2

1. plunger
2. Barrel
3. Needle hub
4. Needle

Question 3

what is the sterility of the tip, shaft, and hub of the needle?

Answer 3

Sterile

Question 4

Why do we use blunt fill-filter needles to draw up meds from amps when possible?

Answer 4

1. because a larger gauge 18G, 1 1/2 length helps with thicker solutions
2. prevents unnecessary blunting of injection needles
3. filter glass out of medication

Question 5

What info do we need to review in the PDM before preparing and administering an injection?

Answer 5

1. drug class
2. alternate names
3. student nurse yes/no
4. sub cut route?
5. IM?
6. dosage
7. hazards
8. stability
9. compatibility
10. contraindications

Question 6

what does parenternal mean?

Answer 6

anything not enteral (not GI tract) ie: oral or GI

Question 7

What part of the Syringe do we not touch? (keep sterile)

Answer 7

1. needle hub/tip
2. needle

Question 8

what part of the syringe do we never touch anything with?

Answer 8

needle

Question 9

what gauge do we never use in a patient but is used to draw up medication?

Answer 9

blunt fill needles (red) 18G

Question 10

What needle sizes and gauges are appropriate for subcut?

Answer 10

25-29 G
1/2”-5/8” length

Question 11

after drawing up medication and putting on the correct needle, what must we do?

Answer 11

Label the syringe!

Question 12

what is the order of patient safety med checks?

Answer 12

1. check 1 before getting medication
2. prepare medication
3. make label
4. check 2
5. gather supplies and head to patients’ room
6. check 3 at bedside

Question 13

subcut injection sites

Answer 13

1. upper back
2. back love handles
3. abdomen * (heparin especially)
4. back of arms

Question 14

how far do you inject from the last site?

Answer 14

2-5 cm at least

Question 15

how to give an injection

Answer 15

1. clean skin with swab - center to outwards 15-30 sec
2. grasp 2-5”
3. go in at either 45 ° (2.5cm grasp) or 90° (5cm of tissue)
4. sign mar

Question 16

When mixing NPH insulin with a rapid/short acting insulin, which do you draw first?

Answer 16

1. Draw Air into NPH syringe
2. Draw Air into Rapid/short insulin
3. Draw short insulin first
4. With same syringe draw NPH

*rationalle - b/c there is clear insulin in NPH but not cloudy in clear so can’t put cloudy into clear vial

Question 17

when do we look up drug monograph, prior to preparing the drug or after preparing it?

Answer 17

Prior - so that you don’t draw up the wrong things and waste medication

Question 18

where do we give intradermal injections typically?

Answer 18

on the forearm area

Question 19

What is a secondary place you can give intradermal injections typically?

Answer 19

on the back - scapula

Question 20

Which way does the bevel go for intradermal injections?

Answer 20

The bevel (hole) should be pointing up

Question 21

what angle should we go with a intradermal injection?

Answer 21

5-15 degrees

Question 22

What muscles can we give IMs in?

Answer 22

Deltoid
Vastus lateralus
Ventro gluteal

Question 23

How do we landmark the Deltoid?

Answer 23

1. acromion process
2. 3-4 finger widths down
3. line up with axilla (armpit)

Question 24

How do we landmark the Vastus lateralus?

Answer 24

1. hand on the knee
2. hand on the hip
3. Just above IT area of the leg

Question 25

Where is the most common muscle for an infant IM?

Answer 25

Vastus lateralus

Question 26

What is the preferred site for an IM and why?

Answer 26

Ventro gluteal 1. holds meds the best 2. dense- and safe for all patients 3. most developed in people 4. least risk of hitting nerves 5. safe for people who are incontinent and nonambulatory too 6. Large volume 7. Viscous 8. irritating medications

Question 27

How do we landmark the ventro gluteal?

Answer 27

1. palm over the greater trochanter 2. with IX feel for top of illiac spine 3. third finger reach towards illiac crest 4. Injection site is between your IX and 3rd finger 5. place alcohol swab to keep landmark

Question 28

what site do we not give IMs in anymore and why?

Answer 28

Dorsal gluteal Because it's too close to the sciatic nerve

Question 29

What is Z tracking and why is it used?

Answer 29

When you displace tissue using the ulnar of your hand in the place you landmarked. -pull skin tight to one side - Give needle and then when you take it out, release the skin - It helps seal in the medication so it can't track up the needle path - can also pull down - point is to tighten the skin/tissue - less lesions - less discomfort for the patient

Question 30

What does it mean to aspirate when giving an IM?

Answer 30

If you get blood in the syringe then you've hit a vein. Wrong. start over

Question 31

Why do we not aspirate when giving subcut?

Answer 31

1. can damage tissue 2. very low chance of hitting a vein

Question 32

What angle do we give IMs?

Answer 32

90 °

Question 33

What is the speed to inject IM?

Answer 33

1ml/10sec (is a bit too long but the point is inject slowly)

Question 34

What are the 3 steps for performing reconstitution of IM meds? (mixing powder with sterile water)

Answer 34

1. inject air into sterile water 2. draw up sterile water 3. inject sterile water into ampacilan powder vial

Question 35

What site is used most often in Emergencies with IM?

Answer 35

Vastus lateralis

Question 36

When is the Deltoid used most often and why?

Answer 36

Usually only vaccines (small amounts <2mL) because it's not well developed in most patients

Question 37

What is the risk of injury with Deltoid use?

Answer 37

-brachial artery - radial/ulnar nerve

Question 38

If med is > or = 3mL what muscles do we give IM into?

Answer 38

1. Vatus lateralis 2. Ventrogluteal

Question 39

What is the most common IM injection?

Answer 39

vaccination

Question 40

What's the most important step to help prevent nerve and tissue damage (right route)?

Answer 40

proper injection site -use anatomical landmarks