NFDN 1002

IM Med Admin

100

IM needle gauge range

23-25g

200

IM Needle Length Range

1-1.5"

300

IM injection sites

Deltoid, Ventrogluteal, Vastus Lateralis

400

Angle of IM injection

90 Degrees

500

Maximum fluid for deltoid muscle 

1 – 2 ml of fluid

Subcu Med admin (Anticoagulant)

100

Needle gauge for subcutaneous injections

25-27g

200

Needle length for subcutaneous injection

1/2" - 5/8"

300

Subcutaneous Injection Sites 

Abdomen, Back of upper arms, Anterior thigh

400

Angle of Subcutaneous Injection

45-90 Degrees angle

500

Patient Education regarding Anticogulant

• Easy bruising.
• Nosebleeds.
• Bleeding gums while brushing.
• Heavier than normal menstrual bleeding
• Prevent Bleeding: Use a soft toothbrush and electric razor, avoid contact sports, and be cautious with sharp objects.

General Med Admin

100

When do we get instructor check for med admin?

3rd check/verification (e.g. high alert, narcotic, etc...)

200

10 Medication Rights

Right Patient, Right Medication, Right Dose, Right Route, Right Time, Right Reason, Right Education, Right to Refuse, Right Documentation, Right Evaluation

300

Opioid effect on the body 

• Central Nervous System (CNS) Depression: Opioids slow down messages between the brain and body, leading to drowsiness, dizziness, and confusion.
• Respiratory Depression: This is the most dangerous effect, where breathing becomes slow and shallow, which can lead to hypoxia (too little oxygen reaching the brain), coma, or death.
• Gastrointestinal Distress: Opioids commonly cause nausea, vomiting, and, most frequently, constipation, due to slowed gut motility.
• Other Immediate Effects: These include tiny (pinpoint) pupils, itching, dry mouth, sweating, and difficulty urinating

400

Timing of 3 checks + 4th unofficial check

Pull, Pour, Put away and bedside 

500

When do we hold Digoxin?

Pulse less than 60

Oxygenation

100

Signs of respiratory distress

Accessory muscle use, Rapid shallow breathing (Tachypnea), Low SpO2 (desaturation), pursed lip breathing, cyanosis, Nasal flaring, Difficulty speaking, Body positioning (forward leaning), Chest pain.

200

Nasal cannula O2 rate limit

Up to 6L of O2

300

Respiratory assessment 

Vital signs (SpO2, Respiratory rate, BP, Pulse), Inspection, Palpation, Auscultation, Subjective information

400

Respiratory interventions (Medical + Non-medical)

Med admin (Inhalers), O2 administration, High fowler/Orthopenic positioning, Deep breathing, Incentive spirometry, airway management (Suctioning)

500

Side effects of Ventolin

Fine tremors (shakiness), Headache, Rapid or pounding heart rate (palpitations), Dizziness, Nervousness, and Throat irritation/Thrush

Insulin

100

Optimal blood glucose level range in healthy diabetic patient

4-8 mmol/L

200

Signs of Hyperglycemia

• Frequent or increased urination (polyuria): Excessive urination.
• Intense thirst (polydipsia): Constant, dry mouth.
• Difficulty concentrating/confusion
• Increased hunger (polyphagia): Feeling hungry even after eating.
• Fatigue: Feeling tired, sluggish, or weak.
• Blurred vision: Temporary difficulty focusing.
• Headaches

300

Signs of Hypoglycemia 

• Tremors/Tremulousness: Shaking or trembling.
• Diaphoresis: Intense sweating, often clammy.
• Palpitations: A rapid, racing, or pounding heart.
• Tachycardia: A fast heart rate.
• Anxiety/Nervousness: Feeling anxious, fearful, or irritable.
• Polyphagia: Extreme hunger.
• Pallor: Color draining from the skin, looking pale.
• Paresthesia: Tingling or numbness in the lips, tongue, or cheeks.
• Nausea: Feeling sick to the stomach
• Cognitive Dysfunction: Difficulty concentrating, confusion, or inability to complete tasks
• Dizziness/Lightheadedness: Feeling lightheaded or unsteady.
• Fatigue/Weakness: Lack of energy, extreme tiredness.
• Visual Disturbance: Blurry or tunnel vision.
• Dysarthria: Slurred or slow speech.
• Ataxia/Clumsiness: Lack of coordination.
• Altered Mental Status: Unusual behavior or confusion.
• Drowsiness/Somnolence: Feeling very sleepy.
  Severe  
• Convulsions/Fits: Seizures due to severely low brain energy.
• Loss of Consciousness: Fainting, passing out.
• Coma: Unresponsiveness

400

Signs of Diabetic Ketoacidosis (DKA)

• Ketonuria: High levels of ketones in the urine.
• Ketosis: Fruity-smelling breath (often described as pear drops).
• Kussmaul Breathing: Deep, rapid, or labored breathing.
• Nausea/Vomiting/Abdominal Pain: Gastrointestinal distress.
• Altered Mental Status: Confusion, lethargy, or disorientation

500

Onset/Peak of Rapid-acting insulin (Humulin R)

Begins to work within 5 to 20 minutes and keeps working for three to five hours (Peak in 1-2 hours)