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## Glossary of Mosby Ch 9: Venus Access and Medication Administration objectives

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Convert selected units of measurement between the household, apothecary, and metric systems.
1 kilogram (kg) =2.2 pounds (lbs), 1 milliliter (ml) =1 cubic centimeter (cc), 1 quart (qt) =960 milliliters (ml), 1 teaspoon (t) =5 milliliters (ml), 1 tablespoon (T) =3 teaspoons (t)
Describe how to convert from Fahrenheit to Celsius and back again
Fahrenheit to Celsius: subtract 32 then multiply by 5 and divide by 9. Celsius to Fahrenheit: multiply by 9 then divide by 5 and add 32.
Identify items to remember to perform drug dosage calculations.
Convert all units of measure to the same unit and system, Assess the computed dose to determine whether its reasonable, Use one method of dose calculation consistently
Compute the correct rate for an infusion of drugs or intravenous fluids.
Must first know: the volume to be infused, the period of time (in minutes) over which the fluid is to be infused, number of drops per ml the set delivers. Drops/min=volume*drop factor/total time of infusion (min)
List the five rights of the safe administration of medications.
Correct patient, correct medication, correct time, correct dosage, correct route, correct documentation
Describe actions the paramedic should take if a medication error occurs.
Accept professional responsibility, immediately advise medical direction and supervisor, carefully assess and monitor patient, Document, Modify personal practice to avoid future errors, Follow agency procedures
Describe how to compute infusion rate
P*F/E Where P = prescribed dose, F = drop factor, and E = effective concentration
Describe the risks associated withparental routes of medication administration
Lipodystrophy, cellulitis or abcess formation, necrosis, skin skoughing, nerve injury, prolonged pain, periostitis
State the advantages of central venous access
State the disadvantages of central venous access
Excessive time (5-10 minutes), sterile technique, special equipment, skill deterioration, high complication rate, chest x-ray should be obtained immediately, inability to perform while other patient care activities are occurring, not generally useful, lower flow rates
State the causes of infiltration
Dislodgement of catheter, puncture of distal vein wall, leakage of solution from vein, poorly secured IV, poor site selection, irritating solution, high rate or pressure
State the signs and symptoms of infiltration
Coolness of skin near site, swelling at site, sluggish or absent flow rate, infusion continues when pressure is applied to vein proximally, no backflow
State the management of infiltration
Lower fluid reservoir to check for back flow, discontinue infusion, remove needle, apply pressure dressing, choose alternative site, document
State the signs and symptoms of air embolism
Hypotension, cyanosis, weak and rapid pulse, loss of consciousness
State the management of air embolism
Close the tubing, turn patient on left side with head down, check tubing for leaks, high-flow o2, and notify medical direction
Name the drugs to be given via endotracheal route
Lidocaine, epinephrine, atropine, naloxone
List the items to be written on an IV medication label
Name of medication, amount of medication, resultant concentration in the reservoir, date, time, and name of preparer
List the universal precautions
Use appropriate barriers, wash hands and affected areas thoroughly post-contamination, avoid sharps sticks, do not use mouth-to-mouth, refrain from patient care if exudative lesions or weeping dermatitis is present, pregnant persons should use extreme caution to prevent infection
List the steps taken to prepare medication from a vial
Assemble the necessary equipment, compute the desired volume, clean the stopper with alcohol, inject air into vial equivalent to amount to be withdrawn, withdraw medication, and expel air
List the steps taken to prepare medication from an ampule
Assemble the necessary equipment, compute the desired volume, tap amp to settle fluid, clean the neck with alcohol, break neck, withdraw medication, change needles and expel air
Cleanse the site, hold skin taut with one hand, hold syringe at 15 degree angle with bevel up, puncture skin until bevel is completely within skin and inject medication, withdraw needle and appropriately discard. Inject no more than 0.5 ml
Describe the procedure for administering an subcutaneous injection
Cleanse the site, pinch skin with one hand, hold syringe at 45 degree angle with bevel up, puncture skin draw back to check for NO blood, and inject medication, and withdraw needle and appropriately discard. Inject no more than 0.5 ml
Describe the procedure for administering an intramuscular injection
Cleanse the site, hold skin taut with one hand, hold syringe at 90 degree angle with bevel up, and inject medication, withdraw needle and appropriately discard. Inject up to 5 ml
Relate measures that should be taken to preserve asepsis during parenteral drug administration.
Hygienic measures, cleaning agents, antiseptics, disinfectants, and barrier fields
Explain techniques of drug administration by enteral routes.
The way drugs are administered and absorbed through the GI tract. Methods include: oral, gastric, and rectal
Explain techniques of drug administration by parenteral routes.
The way drugs are administered and absorbed outside of the GI tract, generally referring to injections. Methods include: intradermal, subcutaneous, intramuscular, intravenous and intraosseous
Describe the steps to safely initiate an intravenous infusion.
Explain the procedure, assemble the necessary equipment, flush air from tubing, select catheter, prepare other equipment, apply gloves, select site, prepare site, stabilize vein, advance needle, advance catheter, withdraw needle while applying pressure, release tourniquet, attach tubing, cover site, document
Describe the steps to safely initiate intraosseous infusion.
Apply gloves, cleanse site, prepare needle, insert needle pointing away from epiphyseal plate, using a screwing motion advance needle until it pops, remove stylet, draw up bone marrow into saline-filled syringe, infuse saline, secure needle, attach IV tubing, document
Explain techniques of drug administration by percutaneous routes.
The way drugs are administered and absorbed through the mucous membranes or skin. Methods include: topical, sublingual, buccal, inhaled, endotracheal, and drugs for the eye or ear or nose
Identify special considerations for administering pharmacological agents to pediatric patients.
Establish positive relationship, be honest about pain, allow child to help, use only mild physical restraint and explain the necessity, enlist help of parents, injection site must be well stabilized despite promises by child to hold still, be aware that there is a smaller margin of error on a smaller child
Explain the technique for obtaining a venous blood sample.
Blood samples should be obtained at the time IV access is established and prior to the infusion of any fluids. Should blood samples need to be collected in the absence of an IV, a needle and syringe or vaccu-tainer should be used.
Describe how to safely dispose of contaminated items and sharps.
DO NOT CAP, BEND, OR BREAK. Discard with the syringe in a clearly marked, appropriate puncture- and leak-proof container
Steps to be taken to avoid medication errors
Avoid distractions, repeat orders, read label at least three times, verify route, ensure drug label is correct for what you want to give, never use unlabeled drugs, double-check difficult calculations with paper or coworker, label syringe if not used immediately, dont use unlabeled drugs prepared by others, dont use outdated drugs, double-check when there is question, monitor patient, document