Skills Test Ch. 37

  1. 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
  2. Disadvantages of parenteral administrations
    • invasive and uncomfortable
    • expensive
    • requires additional supplies and equipment
    • requires qualified personnel to administer
    • carries a risk of infection and nerve injury
  3. Luer-Lok Tip
    Threaded grooves that screw onto the needle hub and lock it into place
  4. Slip Tip
    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
  5. A Regular Syringe is available in what sizes?
    Available in sizes 1, 3, 5, 10, 20 and 60 mL
  6. Tuberculin Syringe
    smaller diameter syringe that holds a total volume of 1 mL and is calibrated in tenths and hundredths of a milliliter
  7. Insulin Syringe
    Similar in size and shape to a TB syringe but it is calibrated in units of insulin and used only for injecting insuline
  8. Prefilled Syringes
    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
  9. The choice of needle gauge depends on several factors
    • viscosity of the medication
    • route of administration
    • size of pt and muscle mass
  10. Multiple Dose Vials
    Contain bacteriostatic preservatives that reduce risk of microorganism growth, while the single vials do not
  11. What do you do when opening a multiple dose vial?
    • Write date, time, initials on the vial
    • discard after 24 hours
  12. Ampule
    small, sealed glass drug container that must be broken to withdraw the medication
  13. 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
  14. What kind of needle is needed when drawing medications from an ampule?
    A filter needle
  15. 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
  16. Which routes of medication escape first pass metabolism?
    • sublingual
    • buccal
    • parenteral routes
  17. ID
    Intradermal injection is the injection of a small amount of fluid into the dermis, or true skin layer immediately below the epidermis
  18. What size length and gauge is appropriate for an ID?
    • 1/4 to 1/2 inch
    • 25 to 30 g
  19. What degree to you hold the needle when injecting an iD?
    15 degrees
  20. Subcutaneous Injections
    Deposits the medication into the subcutaneous layer below the skin and above the muscle layer

    Produces a slower absorption time
  21. 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
  22. What size length and gauge of needle is appropriate for a subcu injections?
    • 3/8 to 7/8 inch
    • 24 to 29g
  23. At what angle do you administer a subcu injection?
    45 to 90 degree
  24. What is the maximum volume for a subcu injection?
    1 to 2 mL
  25. 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
  26. Which type of insulins are never to be mixed?
    long lasting (lantus) can not be mixed with any other type
  27. 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
  28. Z-Tracks
    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
  29. Which two medications do you use the z track method for?
    haldol and vistaril
  30. What is the maximum amount of fluid you should inject in the gluteus medius and glutesus minimus?
    2 to 3 mL
  31. What is the maximum amount of fluid you should inject in gluteus medius and meduis muscles?
    1 to 2 mL
  32. What is the maximum amount of fluid you should inject in small infants and small children?
    0.5 to 1 mL
  33. 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
  34. A paraenteral route of medication administration is one that bypasses which two organs?
    • stomach
    • liver
  35. injection of a drug into the upper layers of the skin is known as the _____ route of medication administration
  36. which site of subcu administration has the most rapid absorption of insulin?
  37. 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
Card Set
Skills Test Ch. 37
Med Admin