The advantages of administrations of medications by injection include
- bypassing the gi tract
- rapid onset time
- ease of administration to uncooperative or unconscious pts
- better absorption of drugs that are poorly absorbed via the oral route
Disadvantages of parenteral administrations
- invasive and uncomfortable
- requires additional supplies and equipment
- requires qualified personnel to administer
- carries a risk of infection and nerve injury
Threaded grooves that screw onto the needle hub and lock it into place
Smooth, slightly tapered tip that inserts into the needle hub, requiring a slight twist of the syringe or need to securely snug the needle and syringe together
A Regular Syringe is available in what sizes?
Available in sizes 1, 3, 5, 10, 20 and 60 mL
smaller diameter syringe that holds a total volume of 1 mL and is calibrated in tenths and hundredths of a milliliter
Similar in size and shape to a TB syringe but it is calibrated in units of insulin and used only for injecting insuline
single-dose, ready-to-use, disposable syringe cartridges, some with an attached needle and some to which you must attach a needle, that contain specific dosages of specific medications
The choice of needle gauge depends on several factors
- viscosity of the medication
- route of administration
- size of pt and muscle mass
Multiple Dose Vials
Contain bacteriostatic preservatives that reduce risk of microorganism growth, while the single vials do not
What do you do when opening a multiple dose vial?
- Write date, time, initials on the vial
- discard after 24 hours
small, sealed glass drug container that must be broken to withdraw the medication
How do you open a vial
- tap the top of the ampule to distribute the medication to the bottom
- clean the neck of the vial with alochol
- use an ampule breaker, paper towel, etc to place between your fingers and ampule
- break the ampule away from you
What kind of needle is needed when drawing medications from an ampule?
A filter needle
First Pass Metabolism
process of metabolizing the drug decreases the amount of drug remaining in the blood after it leaves the liver to enter the systemic circulation, where it can perform its intended function
Which routes of medication escape first pass metabolism?
- parenteral routes
Intradermal injection is the injection of a small amount of fluid into the dermis, or true skin layer immediately below the epidermis
What size length and gauge is appropriate for an ID?
- 1/4 to 1/2 inch
- 25 to 30 g
What degree to you hold the needle when injecting an iD?
Deposits the medication into the subcutaneous layer below the skin and above the muscle layer
Produces a slower absorption time
What sites can you use for a subcutaneous injections?
- back of the upper arms
- abdomen, 2 inches away from belly button
- anterior thighs
- area of the back just below scapula
- upper buttocks
What size length and gauge of needle is appropriate for a subcu injections?
At what angle do you administer a subcu injection?
45 to 90 degree
What is the maximum volume for a subcu injection?
1 to 2 mL
What do you do after injecting medication for a subcu?
- apply gentle pressure
- massage the skin to distribute medication UNLESS you are administering insulin or heparin
Which type of insulins are never to be mixed?
long lasting (lantus) can not be mixed with any other type
What size length and gauge needle is appropriate for an IM injection?
- 1 to 1.5 inches
- between 20 and 22g
for thick fluids, 18g
method of IM injection that prevents irritating and dark-colored medications from leaking out of the injection site into sensitive tissues or subcu tissues that may stain. Helps reduce inflammation and discomfort
Which two medications do you use the z track method for?
haldol and vistaril
What is the maximum amount of fluid you should inject in the gluteus medius and glutesus minimus?
2 to 3 mL
What is the maximum amount of fluid you should inject in gluteus medius and meduis muscles?
1 to 2 mL
What is the maximum amount of fluid you should inject in small infants and small children?
0.5 to 1 mL
What is the maximum amount of fluid you should inject in deltoid muscle in small children and up through older adults
0.5 to 1 mL
A paraenteral route of medication administration is one that bypasses which two organs?
injection of a drug into the upper layers of the skin is known as the _____ route of medication administration
which site of subcu administration has the most rapid absorption of insulin?
Which steps should the nurse perform when combing two types of insulin and administering them?
- "clear before cloudy"
- insert needle at a 45 or 90 degree angle