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Chap - 9


any route other than GI tract parenteral routes
parenteral administration can be understood more easily if purpose of administration or effects desired are considered as systemic or local
effect affecting the body as a whole systemic
administering drugs for the purpose of distribution of medication through circulatory system to area requiring treatment goal of systemic effects
sublingual/buccal, transcutaneous/transdermal, inhalations, & injections parenteral routes with systemic effects
limited to one location of body, with very little (if any) effect on rest of the body local effects
topical medications, drugs applies to mucous membranes to treat that specific tissue, & medications instilled in the eyes or the ears. parenteral routes with local effects
medications absorbed this way are unaffected by stomach, intestines, or liver; absorption is rapid, & used frequently when quick response is required buccal/sublingual system
deliver medication to body by absorption through skin; absorption slower but action is more prolonged than with other administration methods transcutaneous/transdermal system
inhalation system is frequently administered for those patients with chronic pulmonary conditions
metered dose inhalers (MDI) are provided for __ of medications self-administration
intermittent positive pressure breathing (IPPB) therapy is administered by trained personnel
rapid action with local effects, potent drugs in small amounts minimizing side effects, & convenience & comfort of patient are advantages of inhalation therapy
inhalation therapy requires cooperation of the patient in __ __ __ for effectiveness proper breathing techniques
a disadvantage of inhalation therapy is that adverse systemic side effects may result rapidly because of extensive __ capacity of the lungs absorption
if improperly/too frequently administered, inhalations can lead to __ of trachea or bronchi, or __ irritation; bronchospasm
asthmatic & COPD patients sometimes become __ on small-volume nebulizers or MDI dependent
if not cleaned properly, the small-volume nebulizer can be a source of infection
portable, easy to use, proper administration essential for drug effectiveness, & full canister provides approx. 200 puffs of medication metered dose inhaler (MDI)
older patients may find MDIs difficult because of the coordination of depression of canister while inhaling at the same time
can be added to MDIs to act as a reservoir for the aerosol, allowing patient to first depress canister & then inhale spacer
many drugs for respiratory system may be delivered in __ form via small-volume nebulizer aerosol
powered by a gas source, usually small air compressor, in home care setting; proper breathing techniques must be used by patient small-volume nebulizer
when using small-volume nebulizers patients should be cautioned that dizziness may occur is they hyperventilate
small-volume nebulizers should be rinsed with mild soapy water, and then soaked for 20-30 minutes in solution of 2 parts water & one part vinegar
combines administration of aerosol with mechanical breather to assist patients who are unable to take a deep breath on their own intermittent positive pressure breathing (IPPB)
the goal of IPPB treatment is to aid in __ __ the loosened secretions coughing up
outer, hollow cylinder that holds medication; contains calibrations for measuring quantity of medication barrel of syringe
inner, solid rod that fits snugly into cylinder; pulling back draws solution into syringe; pushing forward ejects solution from syringe plunger of syringe
portion that holds the needle; most are plain; some contain metal attachment at tip called Luer-Lok, keeping needle in place tip of syringe
flared end that fits on tip of the syringe hub of needle
long, hollow tube embedded in the hub shaft of needle
1/2, 3/8 & 5/8" needles used for intradermal or subcutaneous
1-1/2 & 2" needles used for intramuscular
depends on type of injection & size of patient length of needle
size of lumen through the needle, or diameter of shaft; numbered in reverse order (larger # = tinner/smaller) gauge
determined by site of injection & viscosity of solution size of gauge
pointed end with beveled edge tip of needle
type of syringe is determined by __ & __ medication & dosage
used most frequently for subcutaneous/intramuscular, calibrated/marked cc or mL & minims standard syringe
standard syringe size of 3mL or 2-1/2mL is the __ __ most common
5-50mL are the __ of standard syringes larger
syringe used for intradermal injections of very small amounts of a substance tuberculin (TB) syringe
tuberculin (TB) syringe also used for subcutaneous injections when __ __ 1mL is ordered less than
tuberculin (TB) syringe calibrated in lengths of a __ & in __ milliliter; minims
tuberculin (TB) syringe holds __ of 1cc or 1mL total
insulin syringe used only for insulin injections & calibrated in __ units
100 units of insulin is __ __ 1mL equal to
U-100 is the __ commonly used today size
standard U-100 syringe has a __ scale dual
U-100 syringe has even numbers on one side and __ __ on the other side odd numbers
on a U-100 syringe count each calibration as two units
in the Lo-Dose syringe, smaller insulin syringe, each calibration counts as one unit
all insulin injection should be checked, prior to administration, by two caregivers
premeasured amount of drug contained in syringe prefilled syringes
after an injection the syringe should be discarded with needle attached and uncapped
premeasured amount of medication contained in disposable cartridge prefilled cartridges
in prefilled cartridges units are made ready for __ by placing the cartridge in the holder injections
prefilled cartridges can be used to access __ ___ __ or a needle can be attached to administer IM or subQ injections needleless IV system
when drawing up medications for injections it is necessary to draw air into syringe equal to __ __ __ being withdrawn from the vial amount of solution
the air drawn into syringe, when drawing up medication for injection, should be injected into vial
for IM injections a small amount of __ can be added to syringe air
only sterile needles are to be recapped
intradermal injections are usually administered into the skin on the inner surface of lower arm
upper chest & back areas may be used for allergy testing
for intradermal injections you should hold person's forearm in your non-dominant hand and stretch surface taut
should be less than 10-15degree angle transdermal injections
subQ injections are administered into fatty tissues
no more than 2mL of medication may be administered subQ
if patient is receiving frequent injections be sure to rotate injection sites
needle should be inserted at 45 degree angle for __ injections subcutaneous
90 degree angle may be used for subQ injections w/a 3/8" needle, if there is sufficient subcutaneous tissue
90 degree angle may be used for subQ injections of insulin & heparin
administered deep into large muscles IM injections
upper outer quadrant of buttock (preferred site for adults) dorsogluteal
above & to outside of buttock area, on hip ventrogluteal
upper outer arm above axilla deltoid
front of thigh toward outside of leg vastus lateralis
front of lower thigh toward midline of leg rectus femoris
up to 3mL, maximum of 1mL in children, can be administered via __ injection IM
in IM injections absorption is more rapid because the muscle tissue is more vascular
1" needle for IM injections can be used on children or thin adults
1-1/2" needle for IM injections is standard for most adults
2" needle for IM injections might be required for obese person
in addition to upper outer arms & abdomen, subcutaneous injections can be given on front of __ & __ __ thigh & upper back
following administration of eye drops, health care workers should apply gentle pressure on the patient's inner canthus
when drawing up medication from an ampule __ __should be drawn into syringe no air
assessment important for health care worker to conduct before administering transdermal medication to a patient condition of skin
when administering heparin the health care worker should modify the subcutaneous technique by avoiding aspiration of syringe
use sterile gloves to apply medications, cover with sterile dressing, & apply gently is the procedure to applying topical medications to patient with burns
if eyes drops & ointment are ordered for same time, health care worker should instill __ __ 1st, wait 5 minutes, & then apply __ eye drops; ointment
sublingual administration requires patient to hold medication under tongue, avoid swallowing & not to eat or drink until absorbed
when using the Z-track for IM injections the injection site should not be massaged
medications prescribed for a variety of skin conditions are classified as topical
when applying medication to patient;s mucous membranes the health care worker should always follow instructions that __ __, unless otherwise directed by physician accompany medication