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ch 35
Administering Medicine
| Question | Answer |
|---|---|
| This can be accomplished by addressing the pt. by his or her name. | The right patient |
| Always compare the physician's written order with the medication label when you: 1. take the medication from the storage area. 2. Dispense the medication from the container, and 3. Replace the container to storage or before discarding the used container | The Right drug |
| If the ordered dose doesn't match the dose according to the drug label, perform pharmacology math to determine the accurate dose. If in doubt, have your calculations checked. | The Right drug |
| Check the physician's order to determine the route of administration. (oral, via the mucous membrane, or parenteral) | The Right Route |
| Most medications are ordered stat in the ambulatory setting. Refer back to the notes to clarify instructions on home administration. | The Right Time |
| The M.A. must be familiar with all techniques of administering medication. | The Right Technique |
| Immediately document the medication (strength, dose0, route, time and date. Also record any reactions the patient has to the medication. | The Right Documentation |
| Never substitute a ___ or its ____. | Drug or Strength |
| Prepare medications in a quiet, ___ ___ area. | Well lit |
| Store medications according to the ____. | label |
| The person who administers the drugs is responsible for any ___ ____. | Drug errors. |
| Routinely check _______ dates and discard _____ as needed. | Expirations and medications |
| Discard medications with _____ labels to avoid errors by inaccurately reading labels. | damaged |
| Always ask the patient about ____ _____, as these can change over time | Drug allergies |
| What physician-prescribed medication are you taking? | Include names, doses/ strengths, and routes of administration |
| Do you take any OTC drugs on a regular basis? | Record the purpose, amount, and frequency, and time/date of last dose. |
| Where do you store your medication? | Review any special storage procedures. |
| Can you tell me why you are taking the prescribed medication? | This is to ensure the patients are well informed about their drug therapy. |
| Do you use the same pharmacy to fill all your prescriptions? | To avoid medications contraindication, suggest that the patient uses only one pharmacy. |
| Gels/Magmas | Consist of minerals suspended in water. Minerals settle so products must be shaken before use. |
| Pre-filled syringe may use? | cartridge injections, ex. Tubex/Carpuject |
| Gauges range from 14 (____) to 31 (____) | Largest to Smallest |
| Gauges 27/28 are used for _____? | (ID) Intradermal Injections |
| Gauges 25/26 are used for ______? | (SC) Subcutaneous Injections |
| Gauges 20-23 are used for ____? | (IM) Intramuscular Injections |
| Needles larger than 20-gauge are used for _____? | Venipuncture, blood donations, and blood transfusions |
| (1 mL) (3/8 in long needle) used for | (ID) |
| (2mL) used for | (SC) |
| (2-5mL0 used for | (IM) |
| Needle length ranges from _/_ inch to _ inches | 3/8 and 4 |
| ID injections use the _____ in size | 3/8 |
| SC injections use the ___ - ___ in | 1/2 to 5/8 |
| IM injections use _inch or longer | 1 |
| A typical syringe holds up to _ ml | 3 mL |
| Hypotension from systemic vasodilation Hives/urticarial Difficulty breathing (dyspnea) form bronchoconstriction Difficulty swallowing due to edema Vomiting/ diarrhea | Signs/symptoms of Anaphylactic shock |
| Injections should not be given near? | Bones, blood vessels, scarred skin, discolored skin, or near excess tissue growth (ex mole) |
| Intradermal Injections are given ? | Within the skin layers |
| Intradermal Injections are used for? | Allergy and tuberculin testing |
| swelling/induration appears after? | 48 hours |
| A ____ should be raised on the skin when ID injection is given correctly | Wheal |
| The angle of insertion is ? | 15 degrees |
| Upper back, chest frequently used for ? | allergy testing |
| Subcutaneous Injections are given between the ? | Epidermis and muscle (adipose tissue) |
| for Subcutaneous Injections no more than ___ given | 2mL |
| for subcutaneous injections the angel of insertion is? | 45 degrees |
| Heparin/insulin are exceptions, administered at a? | 90 degree angels when using a micro needle or with an obese patient |
| SC injection sites? | Posterior upper arm, abdomen, anterior thighs, upper back |
| Site must be rotated when? | Frequent injections are required |
| Intramuscular injections are used if? | the drug is irritating, rapid absorption is needed, or a large amount of medication is needed. |
| Intramuscular injections angle of insertion is a | 90 degree |
| Intramuscular site of injections are? | vastus lateralis, deltoid, ventrogluteal, gluteus medius muscles |
| Intramuscular site of injections for children is/ | the vastus lateralis |
| Deltoid region | can hold up to 2mL |
| Vastus lateralis/ gluteal sites can | hold up to 5 mL |
| Infants/children should receive no more than 2mL in the | Vastus lateralis. ventrogluteal sites |
| Avoid IM sites near? | large nerves, bones, blood vessels |
| Deltoid Site is the | Muscular cap of the shoulder |
| Deltoid is the | Triangular shaped muscle |
| Types of shot to go in the Deltoid muscles is ? | Hepatitis B, flu vaccine, and vitamin B12 |
| 23 gauge, 1 inch needles are usually used on | the Deltoid site |
| 25 gauge, 5/8 inch maybe be use for | smaller arms |
| Place the palm of your hand across the shoulder, and | grasp the muscle before injection |
| the injection degree for the deltoid site is? | 90 degree angel |
| Vastus Lateralis (thigh) site is one of the? | largest muscles |
| The Vastus Lateralis is the safest IM site for? | Infants |
| Located one hand with above the? | Patella (knee cap) |
| Dorsolateral site (Gluteus Medius) is used for? | Deep IM injections |
| Dorsolateral site are used for? | adults only |
| Ventrogluteal site (Gluteus Medius) is? | infrequently used |
| The Ventrogluteal site is free of? | major nerves and blood vessels |
| The Ventrogluteal site is safest for? | Adult and Children |
| Z track intramuscular injection displaces the? | upper tissue laterally before insertion |
| For z track IM injection the skin is? | pushed to one side and held during injection |
| The z track IM prevents? | A direct pathway for the medication to return to the surface |
| z-tracks injections sites should not be? | messaged after aministration |
| 3 basic types of fluid used for IV therapy is? | Isotonic Solutions, Hypertonic Solutions and Hypotonic Solutions |
| Isotonic Solution | EX.9%sodum chloride (NaCl, normal saline) Contains the same amount of salt as normal body fluids Used for patients who need replacement of lost body fluids Provide electrolytes including sodium, potassium, calcium and chloride |
| Hypertonic solution | Contains more NaCl than those in body fluid causes extracellular fluid to shift from cells into bloodstream May be used in patients with extensive peripheral edema to dilute the concentrated plasma May lead to increase blood pressure in the blood vesse |
| Hypotonic Solution | D10W 10% dextrose in water, 5% dextrose in .3% sodium chloride Contains less salt than body fluid Promotes cellular hydration by shifting fluid from body vessels in the interstitial spaces around cells |
| unclean conditions may result in? | infection/systemic infection |
| Inflammation may occur at the? | IV site |
| Contaminated bandage over the IV site may cause | Inflammation |
| Veins may become inflamed when the patient moves the? | IV site, the medication is irritating or the IV solution is irritating |
| Possible phlebitis is immediately reported to the physician because? | it may lead to thrombus formation or systemic infection |
| indications of phlebitis are? | inflammation, edema, warmth, tenderness at site, veins that feel hard/ropelike |
| Infiltration occurs when the IV/catheter becomes? | dislodged from the vein. Close the roller clamp on the IV tubing and notify the physician STAT |
| Fluid overload is caused by? | administering the fluid too quickly. Complications may occur in those with hypertension, heart disease, or congestive heart failure. |
| Medication errors can occur and can be fatal. It is very important to ensure the correct medication is being given because? | it will be circulated throughout the body in one minute |
| all IV infusion equipment is individually ____ and ____ | packed and disposable |
| IV equipment includes? | skin-cleaning solution, needle or catheter, tubing with spike to insert into IV bag, sterile dressing, IV fluids |
| Usually packaged together in a? | sterile IV infusion kit |
| Always check the _____ date and check for _____ in the package | expiration and tears |
| Additional supplies are? | Tourniquet, disposable gloves, biohazard container, and IV pole |
| For IV the Gauges are? | 25-17, .5-1 inch in length needles |
| The macro drip delivers 8-20 gtt/mL for | Adult fluid replacement |
| Micro drip dispenses 50-60 drips/mL is used for? | children/patients who require slow administration |
| Drop are regulated by? | compressing the roller clamp |
| Be alert for indication of? | phlebitis or infiltration |
| watch for too quick? | infusion |
Created by:
chass
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