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administration by any route other than the Gastrointestinal route.
Parenteral Route
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When drugs are given parenterally rather than orally:
- the onset of drug action is more rapid but shorter duration
- the dose is often smaller because of drug potency
- the cost of drug therapy is often greater
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the nurse preparing and administering the medication must focus on:
- basic knowledge regarding the drugs being ordered, prepared, and administered
- symptoms for which the drug is ordered and a collection of baseline data to be used to monitor the effectiveness of the drug
- the nursing assessments needed to detect, prevent, and improve adverse events
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Injections require skill and special care because of:
- the trauma at the site of needle puncture
- possibility of infection
- chance of allergic reaction
- once a drug is injected, it is no longer retrievable
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Estimates show that there are to needlesticks and percutaneous injuries to health care workers annually
600,000 to 800,000
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One-third of all "sharps" injuries are related to the process
disposal
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What are the three parts of a syringe?
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outer portion of syringe where the calibrations for measurements are located
Barrel
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in inner Cylindrical portion of the syringe that fits snugly into the barrel; used to draw up and eject the solution from the syringe
Plunger
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the portion of the syringe that holds the needle
Tip
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Syringes are made of either or .
glass or hard plastic
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Syringes are calibrated in , , or .
mL, units, minims, cc's
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Most commonly used syringes are:
1mL, 3mL, and 5mL
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the 1mL syringe used to measure small volumes of medication accurately
Tuberculin syringe
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this syringe has a scale specifically calibrated for the measurement of insulin
the insulin syringe
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What are the parts of a needle?
- the hub
- the shaft
- the beveled
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the is the diameter of the hole through the needle
the needle gauge
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The size of syringe used is determined by:
- the volume of medication
- the degree of accuracy needed for measurement of the dose
- the medication to be administered
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glass containers that usually contain only a single dose of medication
ampules
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glass containers that contain one or more doses of a sterile medication
vials
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glass containers with two compartments (lower chamber contains drug; upper chamber contains a sterile solution); usually contains only a singe dose of medication
mix-o-vials
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the maximum volume for IM injection at one site for small children and older infants is
1mL
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Adults can usually tolerate a maximum volume of in one site for IM (except the deltoid which is 1mL max)
2mL
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Gauge size: Intradermal
26-29g
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Gauge size: Subcutaneous
25-27g
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Gauge size: Intramuscular
20-22g
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Gauge size: Intravenous
- 20-22g (for IV fluids)
- 15-20g (for blood administration)
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The process of adding a solution to a medication in powdered form to dissolve it and form a solution is referred to as
Reconstitution
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The solutions commonly used for reconstitution are:
- sterile water
- normal saline
- 5% dextrose and water
- bacterial static water
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a new fast-acting insulin; works within 5 to 15 minutes; can be administered 5 minutes before meals; clear in appearance
Lispro insulin
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fast-acting insulin; must be administered 30 to 60 minutes before meals; only insulin that may be given IV; clear in appearance
Regular Insulin
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a new long-acting insulin; administered at anytime during the day for 24- hour coverage without a peak; clear in appearance; cannot be mixed with any other insulin
Lantus Insulin
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have become popular for patients who must mix fast-acting and intermediate-acting insulin; purpose is to stimulate the varying levels of insulin within the bodies of diabetic persons
Fixed combination insulins
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Basic action times of insulins
- Rapid acting-ex Regular, Novolog, Lispro
- intermediate acting-ex NPH
- long acting- ex Lantus, Levemier
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To prepare two insulins in one syringe you must:
- check the compatibility of the two drugs to be mixed before starting to prepare the medications
- Check the labels of the medication against the medication order
- Check the following: type, concentration, expiration date, appearance, temperature
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