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(Intradermal) Common sites to administer?
- inner surface of the forearm
- uppper back (under scapula)
- dorsal upper arm
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(Intradermal) What gauge/length needle is used?
26-27 gauge or 1/4"-1/2"
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(Intradermal) What dosage is usually given?
Less than 0.5mL
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(Intradermal) At what angle is it administered?
10-15 degrees
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(SQ) Sites of administration?
Outer aspect of upper arm, abdomen (from below the costal margin tot he iliac crests), anterior aspects of the thigh, upper back, dorsaogluteal area
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(SQ) What gauge/length needle is used?
25-30 gauge, 3/8"-1". (3/8" & 5/8" are most commonly used)
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(SQ) At what angle do you insert?
45-90 degrees
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(SQ) How many mL is usually administered via this route?
1mL or less.
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(SQ) Why would you aspirate air from the injection site prior to pushing the medication?
To see if the needle is in a vein. If the needle is in the vein you would remove the syringe, discard, and prepare a new syringe.
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(IM) What drugs are typically administered via this site?
vaccines, hormones, antibiotics.
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(IM) Sites of injection?
Vastus lateralus, deltoid, ventrogluteal
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(IM) What gauge/length needle is used?
18-25 gauge (where 18 may be used for oil-based solutions).
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(IM) How many mL of a solution are given in the deltoid?
1-2mL
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(IM) How many mL can be given (max) via this method?
4-5 (max)
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What is the Z-track technique?
- Recommended for IM injections. Reduces pain and discomfort for pt.'s recieving injections over an extended period.
- A clean needle is attatched to the syringe after the syringe is filled with the medication to prevent the injetion of any residual medication on the needle into superficial tissues. The skin is pulled down or to one side about 1" and held in this position with the nurse's nondominant hand. The needle is inserted and the nurse aspirates carefully to detect the presense of blood.
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List the 5 patient rights + 2 modern rights that are being incorporated into medication administration.
- Right patient
- Right route
- Right time
- Right dose
- Red medication
- Right documentation
- Right reason
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What are "The Three Checks"?
- 1. When the nurse reaches for the container or unit dose package
- 2. After retrieval from the drawer and compared with the MAR, or compared with the MAR immediately before pouring from a multidose container
- 3. When replacing the container to the drawer or shelf or before giving the unit dose medication to the pt.
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How do you find the site of needle insertion for a ventrogluteal injection (IM)?
Place the palm on greater trochanter and the index finger toward the anterosuperior iliac spine.
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How to find the site of needle insertion for an IM injection into the vastus lateralis?
This site is determined by dividing the thigh into thirds (horizontally, vertically... the last, third, portion, isthe insertion site).
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How do you determine the site of needle insertion for deltoid (IM) injections?
Palpate the edge of the acromion process, form a triange against this edge with first 2 fingers spread apart... the center of this triangle (area of thickest muscle) is the site for insertion.
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What is a piggyback delivery system?
Intermittent or additive solution is placed higher than primary solution being infused.
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When administering medication via eyedrops, where should the drops be administered?
Drops should fall into the lower conjunctival sac.
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What should you do to prevent the medication from flowing into the tear duct?
Apply gentle pressure to the inner canthus. Do not rub the affected eye.
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When administering eyedrops, how should the patient be positioned?
Head tilted back (if sitting up),or laying down with head on pillow. Head may be slightly turned to one side to prevent tears from flowing to opposite eye.
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What direction should the patient look while eyedrops are being administered?
The patient should be looking up.
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Prior to intilling ear drops, what should be done to the solution to minimize discomfort for the pt.?
Warm the solution.
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When instilling eardrops how should the pt. be positioned?
Lay on unaffected side, or sitting with head tilted to the side so that the affected ear is uppermost. This prevents eardrops from escaping the ear.
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How should eardrops be instilled?
Pinna up and back, hold container above auditory canal, allow drops to fall on the side of canal.
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What should the nurse do to help move the medication from the canal toward the tympanic membrane?
Apply gentle pressure to the tragus.
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