Pharm Parenteral Routes CCC PN105
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| Three sites for injections | deltoid, vastus lateralis, and ventrogluteal muscles
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| Before giving injection, examine site to determine | adeuqate muscle tissue
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| Areas to avoid | lesions, trauma, inflammation, bony prominences
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| IM angle to insert needle | 90 degrees
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| IM - after puncture, do this | aspirate plunger to check for blood return
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| This confirms needle placement in muscle | lack of blood on aspiration
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| Angle to withdraw needle | angle of insertion
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| Do not _________________ site after IM injection | massage
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| If blood is withdrawn upon IM aspiration | withdraw needle and start over
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| Before injection, always check to see if patient is on | blood thinners
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| Landmarks for deltoid muscle injection | acromion process and axillary line
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| Where to insert needle in deltoid | 2-3 finger lengths below acromion process, above axillary line
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| Landmarks for vastus lateralis injection | head of greater trochanter and knee
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| Where to insert needle in vastus lateralis | middle third of muscle at least one hand width below greater trochanter and above knee
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| Landmarks for ventrogluteal injection | head of greater trochanter and anterior superior iliac spine
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| Reason to not use dorsogluteal site for injection | paralysis from sciatic nerve damage
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| What determines injection volume and needle size | age and size of patient and type of medication
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| If prescribed medication is greater than recommended dosage for particular site | Then break into smaller injections and give at different areas
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| Adult deltiod dose | 1ml
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| Contraindications for deltoid injection | infant or toddler age
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| Adult vastus lateralis dose | 3ml
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| Infant vastus lateralis dose | 1ml
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| Small infant vastus lateralis dose | 0.5ml
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| Preferred injection site for infants | vastus lateralis
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| Adult/ ventrogluteal dose | 3ml
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| Infant ventrogluteal dose | 1ml
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| Small infant ventrogluteal dose | 0.5ml
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| Toddler ventrogluteal dose | 2ml
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| Age 3 and older ventrogluteal dose | 2-3ml
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| Adolescent ventrogluteal dose | 3ml
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| Intradermal injections are used for | skin testing and administering local anesthetics
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| Sites for intradermal injections | inner forearm and upper back
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| What to avoid when giving intradermal injection | lesions and hair
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| Type of syringle for intradermal injection | tuberculin or small (1ml)
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| Angle of insertion for intradermal injection | 5-15 degrees, almost parallel to skin
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| When giving intradermal injection, make sure skin is | pulled taut
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| Bevel should be facing ____ for all injections | up
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| Intradermal injections should be given ___ | slowly
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| Watch for skin to ____________ when giving intrdermal injection | blanche and wheal
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| ___ indicates intradermal injection was given incorrectly | bleeding or absence of wheal
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| SubQ injections are used for | slow absorbing medication
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| IM injections are used for | rapid absorbing medication
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| Favored site for subQ injections | large areas that are easy for patient to reach for self-administration
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| Most commong sites for subQ injections | upper outer arm, abdomen (2in from unbilicus), anterior thigh, scapula, upper ventrodorsal gluteal
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| To prevent tissue damage from repeat injections | rotate injection sites
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| Amount to administer subQ | 1ml
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| To determine subQ needle length | equivalent to 1/2 width of skinfold from pinching tissue up from underlying muscle
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| Angle to insert subQ injection for average sized person | 45-90 degrees
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| angle to insert subQ injection for obese person | 90 degrees
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| Best subQ site for thin person | upper abdomen
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| You do not have to __________ before giving subQ injection | aspirate
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| Once subQ needle is inserted | release pinched skin and use hand to stabilize syringle
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| vastus lateralis needle size, oil-based or viscous solutions | 18-25 gauge, 1-1.5"
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| vastus lateralis needle size, aqueous solution | 22-27 gauge, 1-1.5"
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| vastus lateralis needle length for infant | 1"
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| deltoid needle size | 5/8-1"
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| ventrogluteal needle size, oil-based or viscous solutions | 18-25 gauge, 1-1.5"
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| ventrogluteal needle size, aqueous solutions | 22-27 gauge, 1-1.5"
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| infant, toddler, 3+ children ventrogluteal needle size | 21-25 gauge, 1/2-1"
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| intradermal needle size | 25-27 gauge, 3/8-5/8"
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| SubQ needle size | 25-30 gauge, 3/8-5/8"
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