Level 1
Injections that goes beneath the skin layers
Subcutaneous
2 parts:
Up to ___ ml can be safety injected in the ventrogluteal, vastsus lateralis, rectus femoris sites in most adults.
how about the geriatric and thin patients: ___ ml, and why?
3 ml
2 ml, because of less muscle mass
When preparing injection what information should be included on the LABEL of the syringe: (3)
pt's name, name of medication; dose
What could be the outcome/consequences if YOU AS the NURSING STUDENT and SOON to BE NURSE do not rotate injection sites?
tissue irritation/Fibrosis
bruising; bleeding; ecchymosis
The more _________ the tissue, the quicker the medication is absorbed.
VASCULAR
A Luer-Lok tip would be the choice for am _____ injection because of the locking mechanism prevents a sudden separation of the needle and syringe.
How about a non-Luer-lok tip, when would this be used:_______
IM
ID
T/F: Ampules can sometimes contain muti-dose medication
FALSE-only a single standard dose of medication
The basis of TST is that a person infected with __________ __________ develops sensitivity to certain products of this organism
MYCOBACTERIUM TUBERCULOSIS
List 3 types/classes of medication that YOU AS THE FUTURE NURSE will have another nurse INDEPENDENTLY double-check
INSULIN, HEPRAIN, INJECTABLE HEART MEDICATION, PARENTERAL CHEMO MEDICATIONS
List 3 subcutaneous injection sites according to the Williams chapter 35 reading? (DO NOT USE TEXT, PHONES)
1. Upper portion of the upper outer arm;
2.anterior surface of the thigh;
3. or the abdomen where there are no blood vessels.
The slanted part of the needle tip is called:
BEVEL
2 1/2 parts question:
1. Why do you NOT inject air into an ampules before withdrawing medication?
2. What kind of needle would YOU as the nursing student and future nurse to withdraw medication from an AMPULE? Why?
1. the med will bubble up and fall out of the ampule
2. FILTER NEEDLE
2 PARTS:
True/False-When I as future nurse begins to read TB test, I will look at the extend of erythema.
A recent immigrant from India has an 12 mm induration following the TST. What are the results?
1. F
2. POSITIVE
You as the nursing student administered morphine IM to a patient in pain, the pt asked how long does it take to start working. what is you answer/onset for IM medication
15 minutes (because IM is more vascular than SUBQ)
2 part question:
What size gauge are used for subQ injections?
At what angle is the needle inserted for a subQ injection?
27-gauge 3/8-1/2 inch and 25-gauge, 5/8-inch is used
45-or 90 degree angle
T/F: The smaller the number of the gauge, the larger the needle.
False: The LARGER the number of the gauge, the SMALLER the needle. pg. 676
What are the TWO typical dilutents
sterile water; normal saline
LIST THE 4 STEPS of mixing doses of insulin from a multi-dose vial
1. inject AIR into LONG-ACTING (CLOUDY)
2. Injection AIR into SHORT-ACTING (CLEAR)
3. Withdraw prescribed amount of short-acting (clear)
4. Withdraw prescribed amount of longer-acting insulin
The correct site for injection can be located by placing ____ fingers across the deltoid muscle, with the _____ finger on the _______ process; the site is the three finger widths below the _______ process.
four; little; acromion; acromion
2 part
1. List the most commonly used IM sites? (4 sites)
2. At what angle are IM injections given?
Deltoid, ventrogluteal, vastus lateralis, rectus femoris
90 degrees
2 parts:
1. An obese person requires a _______ needle than one who is normal weight; a very thin person requires a ______ needle.
2. Why is using a short needle inappropriate for example an obese pt?
longer; shorter
if the needle is TOO SHORT, the medication will be deposited into the fat or subQ tissue
What should be on the label of a multi-dose medication:
date, time, initials (use AGENCY PROTOCOL)
Heparin is given in the ________ ________ sites
abdominal subQ
According to EBP why is the dorsogluteal site NO LONGER RECOMMENDED?
2. WHY is the vastus lateralis the preferred site fir IM injections for adults, infants, and children?
1.HIGH RISK FOR INJURY TO THE SCIATIC NERVE AND BLOOD VESSELS
2. FREE FROM MAJOR NERVES AND BLOOD VESSELS