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Glossary of parenteral medications

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Name three locations used to give a intradermal injection.
inner lower arm

upper chest

the back beneath the scapulae
What arm is commonly used to administer TB screening?
Left inner lower arm
A syringe calibrated into hundredth of a milliliter and a #25 to #27b gauge needle that is 1/2 to 5/8 inch longs would be used for what type of injection?
intradermal.
When medication is given intradermal, often it will produce a__________ under the skin.
Wheal
To avoid puncturing the subcutaneous tissue when giving a intradermal injection, at what angle should the nurse inject the medication?
5 to 15 degree angle.
A wheal under the skin verifies that ?
the medication entered the dermis
To produce a wheal beneath the skin, what speed should the nurse inject the medication ?
slowly
Does the nurse massage the area of injection after giving an intradermal injection?
NO NO NO. Massage can dispense the medication into the tissue or out through the insertion site.
Depending on the test, when would the nurse evaluate the intradermal injection site?
within 24 to 48 hours
After 24 to 48 hours the nurse would inspect the intradermal injection site for the presence of _____________ ?
redness and induration
Some medications used for testing purposes when giving an intradermal injection can cause an allergic reaction. What should the nurse have on hand in case the client has an allergic reaction ?
An antidote drug = epinephrine
What are common sites for subcutaneous injections?
outer aspect of the upper arm
anterior aspect of the thighs
abdomen
scapular area
upper ventrogluteal and dorsogluteal
What syringe is used if Heparin is being injected?
Tuberculin syringe
IF giving a subcutaneous injection at a 45 degree angle, to an adult of normal weight, what needle would be most appropriate?
#25-gauge, 5/8 inch needle
For subcutaneous injections at a 90 degree angle, what needle would be most helpful?
3/8 inch needle
If you can grasp an inch of skin on a client, you should plan to inject at what angle?
45 degree
If a nurse can grasp two inched of skin on a client, the nurse should plan on administering the injection at what angle ?
90 degree angle
Insulin is most rapidly absorbed when it is injected into what area?
abdomen
Insulin is absorbed slowly when it is injected into the ?
thigh and buttock
A 2ml syringe, #25-gauge needle, 3/8 to 5/8 long would indicated what type of injection?
Subcutaneous injection.
A site with redness, swelling, scarring, itching, burning, or localized inflammation are not appropriate areas for injections because?
They can hinder absorption

increase the likelihood of injury or discomfort at the injection site.
What speed should the nurse inject medications given subcutaneously?
SLOW...to help eliminate discomfort
IF bleeding occurs when giving a subcutaneous injection what type of gauze should the nurse apply?
DRY STERILE GAUZE
What injection is most rapidly absorbed?
muscular injection.
How many mL can an adult with well developed muscles safely tolerate?
up to 4 mL
In an adult with less developed muscles, an amount of __________mL can be safety tolerated?
1-2 mL
What volume of medication can be injected into a deltoid muscle?
0.5 to 1 mL
When selecting a site for a intramuscular injection, a major consideration is a site away from ??
a major blood vessel

nerves

bones
What is the preferred site for a intramuscular injection?
VENTROGLUTEAL
Why is the ventrogluteal area a preferred site for a intramuscular injection?
it is away from major blood vessel
no large nerves
provides greatest thickness
sealed off by bone
less fat than the buttock area
What position is most helpful to locate the ventrogluteal muscle?
side lying
Why is the deltoid muscle not commonly used for a intramuscular injection?
small muscle
near the radial artery and radial nerve
no more than 1mL of solution can be used
What vaccine is usually given in the deltoid muscle ?
Hepatitis B vaccine
The sciatic nerve can be injured if giving a intramuscular injection into the ______________ area?
dorsogluteal
What is the advantage of using the rectus femoris muscle when giving a intramuscular injection?
clients can use this site to administer their own medications
What is a disadvantage of the rectus femoris muscle when giving a intramuscular injection?
it causes a great deal of discomfort in some clients.
What muscle is the anterior aspect of the thigh?
Rectus femoris
True or False...

When using the z-tract technique the nurse would pull the skin 1 inch to the side before giving the injection??
TRUE 1 inch or 2.5cm.
What angle is used when using the z- tract method?
90 ° angle
How many seconds do you allow for the medications to disperse before removing the injection when using the z-tract technique?
10 seconds
What is the meaning of parenteral?
drug administration occurring outside the alimentary tract;injecting into the body through some route other than the alimentary canal.
What are five routes of parenteral administration?
intramuscular
subcutaneous
intradermal
intravenous
intra-arterial
What is the advantage of parenteral medications ?
rapidly absorbed

rapidity of action

takes a short time to administer
Disadvantages of parenteral medications?
invasive
irretrievable
discomfort
cost
Subcutaneous sites
upper arm
thigh
abdomen
back
Subcutaneous angle of injections and length of needle for that angle.
45 degree angle with 5/8 inch needle

90 degree angle with 3/8 inch needle
Gauge of needle for a subcutaneous injection.
# 25-gauge
Intramuscular injection sites?
Posterior (dorsal) gluteal
ventrogluteal
deltoid
vastus lateralis
What size syringe, gauge size and needle length for a intramuscular injection?
2-5 ml syringe
#21 or #22-gauge needle
1& 1/2 inch needle
A viscous solution would require what type of needle?
large gauge needle

example #20 gauge
Intramuscular injection given to an obese client would require what length needle?
longer than 1&1/2 inch.
obese client would need a 2 inch needle
When giving a intramuscular injection to an emaciated client what length needle would need to be used?
shorter needle.

a 1 inch needle would be best.
When can the z-track injection be used?
anytime an intramuscular injection is given.
When giving a z-tract injection do you release the skin or the needle first?
release the needle then release the skin.
When giving an intramuscular injection using the z-tract method what motion should the nurse use when injecting the needle to lessen the client discomfort?
a quick motion
What size and gauge needle should be used to administer a intradermal injection?
#25 to #27-gauge needle

1/4 to 5/8 inch needle
What type syringe is used when administering insulin?
U-100 insulin
What is the saying to avoid adding NPH insulin to regular insulin, when combining insulin for a single injection?
Clear before cloudy.
What are the landmarks for a vastus lateralis injection?
divide the area between the greater trochanter of the femur and the lateral femoral condyle into thirds and use the middle third as the site for the injection.
What landmarks are used to determine the site for a posterior (dorsal) gluteal injection?
posterior superior iliac spine then draw an imaginary line to the greater trochanter of the femur. the site is lateral and superior to the imaginary line.
What position should a client be in when getting a dorsogluteal injection?
side lying with the upper knee flexed and in front of the lower leg.

or

prone position with toes flexed inward
medications in vials require________
to be injected before drawing up the medication.
air equal to the amount of medication to be drawn up
Does air need to be injected into ampules before drawing up medications?
NO ( crazy question if you think about it)
mixing medications using one syringe (insulin)

step 2
inject air into regular insulin
mixing medications using one syringe
(insulin)
step 1
inject air into NPH insulin first
mixing medications using one syringe (insulin)

step 3
withdraw regular insulin
mixing medications using one syringe
(insulin)
step 4
withdraw NPH insulin
Do not aspirate
Do not massage

when giving what type of injection?
intradermal
subcutaneous
Long acting insulin
onset 2 hours
peak 16-20 hours
duration24+hours
Rapid acting insulin
onset 15 minutes
peak 60-90 minutes
duration 3-4 hours
intermediate acting insulin
onset 2 hours
peak 6-8 hours
duration 12-16 hours
Insulin injection are given using what method?
subcutaneously
define intravenous medications
medications given directly by way of a vein, appropriate when rapid effect is needed. this route is appropriate when the medication my irritate tissues if given by other routes.
tubex is a
mechanical device: a plunger for a glass syringe
intradermal injections should be given with what type of medications?
water soluable
What is the maximum amount of medication that can be given subcutaneously?
no more than 1 cc
If a client is thin patient, what would you do to the skin before giving an injection?
pinch skin
If a client is overweight, what would you do to the skin before giving an injection?
spread the skin
When do you aspirate?
when giving an I.M. injection
Most common site for a heparin injection?
abdomen, 2 inches from the umbilicus
What should the nurse write on a vial of reconstituted drug?
date and time it was prepared
the amount of drug contained in each ml.
nurses initials

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