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Parental administration equipment
- Syringes: sizes, types
- Needles: length, gauge
- Ampules
- Vials
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Luer-lock
Twist & lock - cannot remove needle after locked
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Slip-lock
Slips onto tip - slips on & off, no twisting
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Parts of a syringe
Plunger, barrel, tip, hub, shaft, bevel
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Ampules
Clear glass, constricted neck with colored ring
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Opening ampules
- ETOH pad
- Break away from you
- Dispose properly
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Withdrawing med from ampule
- Insert needle, aspirate med upside down or flat on surface.
- Needle tip below surface of liquid.
- Expel excess air bubbles & fluid cover needle.
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Removing meds from vials
- Remove cap - metal or plastic
- Wipe rubber seal with ETOH swab
- Draw air in syringe = vol of med
- Insert tip of needle thru seal
- Inject air into vial -- needle not in fluid
- Invert vial
- Needle below fluid level
- Air pressure will fill syringe
- Remove air
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Mixing meds
- Determine compatibility of meds
- Do not contaminate one med with another
- Ensure the final dose is accurate
- Maintain aseptic technique
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Mixing meds from 2 vials
- 1 syringe - 2 needles
- Air into A ,air into B
- Withdraw B, withdraw A
- Change needle
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Insulin basics
- Hormone used to treat diabetes
- Always check sugar before giving
- Use correct syringe
- Classified by rate of action: rapid, intermediate, long acting
- Pt may require more than 1 type
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Regular (rapid acting) / short
- Clear solution - mix with others
- 5 minute time- regular
- 30 minute - short
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Lente - NPH - intermediate
- Cloudy - can be mixed with regular
- Administer at room temp
- Rotate between hands - no shaking
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Prepare insulin
- 1. Inject air into cloudy (do not touch solution)
- 2. Remove syringe
- 3. Inject air into clear- withdraw dose
- 4. Check with RN
- 5. Removesyringe - remove air
- 6. Return to cloudy & withdraw dose
- 7. Check with RN
- 8. Admin within 5 minutes
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Insulin sliding scale
- Based on BS - usually reg used
- Different for every pt
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Airlock
- Bolus of air follows med
- Traps solution in intramuscular tissue
- After med drawn up, expel excess air, draw up 0.2 cc of air
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Z track
- Primary reason: seal off med
- Decrease discomfort
- Pull skin & sq tissue approx 1 1/2" - 2" laterally to side
- Hold taut
- Inject needle deep, aspirate 10 sec after med injected, withdraw syringe
- Release skin, dont rub site
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If blood is aspirated
- Remove needle
- Discard med & syringe
- Repeat procedure
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SQ needle insertion
- If average build - 45 degree angle, obese - 90 degree angle, thin - 15-45 degree angle
- Small doses, 0.5-1 ml (if more is needed, give 2 shots)
- 1/2 - 5/8 - 1 inch needle
- 25g - 5/8" needle @45 degrees
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IM needle insertion
- 90 degree deep into muscle
- 3 ml max injected
- Children & elderly & thin <2ml
- Large muscle - gluteus medius
- 20g - 23g 1 1/2" - 3" (1" - 1 1/2")
- Deltoid
- 23g - 24g 5/8" - 1"
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Intradermal needle insertion
- Tuberculin syringe
- 10-15 degrees 26g needle
- Bleb or wheal
- Bevel up
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Heparin
- Never rub 25g
- Never aspirate 3/8"-5/8" needle
- Check with other RN
- Prevent bleeding & bruising
- Avoid 2" around umbilicus
- Tubex
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Tubex & carpuject
- Reusable plastic mechanisms
- Uses prefilled, disposable, sterile cartridge-needle units
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Subcutaneous injection sites
Arms, thigh, abdomen
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Intradermal injection sites
Forearm, back
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Intramuscular injection sites
Vastus lateralis, ventrogluteal, dorsogluteal, deltoid
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Vastus lateralis
- TOES IN
- Anterior-lateral aspect of thigh
- Handbreath above knee
- Handbreath below greater trochanter of femur
- Middle 3rd is best
- Width-midline of thigh's top to midlineof thigh's outer side
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Deltoid
- Flex elbow
- Lower edge of acromion process
- Axillary line
- Imaginary triangle
- 4 fingers along acromion process
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Ventrogluteal
- Gluteus medius & minimus
- Heel of opposite hand over greater trochanter
- Point thumb toward groin & fingers toward head
- Index finger back along iliac crest toward buttocks
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