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What's the purpose behind reconstitution of powdered medications?
Some meds are unstable or lose their strength or potency faster when stored as liquid form.
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How are powdered meds packaged?
They come in powder form and they must be dissolved by a liquid, which we call solvent or diluent.
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Describe what qualifies as a solvent or diluent.
Usually sterile saline or sterile water preservative free. Info can be found on drug insert.
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This is the resulting mixture of a solute plus solvent.
Solution
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This liquid substance dissolves another substance to prepare a solution.
Solvent or Diluent
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This substance is to be dissolved or diluted. It can be in a solid form or liquid form.
Solute
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What is the most important thing when doing the reconstitution procedure?
#1 Read the directions!
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Medication allows for a choice of multiple strength solutions, who decides which solution to make?
Nursing judgment
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In order for concentration of solution to be correct...
add exact amount of diluent to vial.
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There are 2 ways to inject diluent into vial.
- 1. Injecting diluent with vial upright.
- 2. Injecting diluent with vial inverted and needle above solution.
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After diluent is added to vial, how do we make sure all medication is dissolved?
- 1. Swirl vial, avoid shaking, or rub vial between hands
- 2. NO clumps
- 3. NO particles floating
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Once med is mixed what do we do next?
- 1. Label syringe/IV bag completely.
- 2. Label vial including expiration date if will be used again
- 3. Store according to manufacturer's instructions, refrigerate or discard
- 4. Administer med according to MD orders
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What factor may dictate the amount of diluent?
Whether med will be given IM or IV
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Why do we combine meds from 2 vials?
Avoids need to give 2 IM injections
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Before we can mix meds from 2 vials, what must we do first?
Check compatibility of meds using drug reference, compatibility chart, or asking pharmacist
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What's the maximum amount of fluid we can give IM for a large muscle?
3mL
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What's the time frame for mixed meds?
Must be administered within 15min.
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Once we figure out how much med we need to draw from each vial what must we inject into the vial first?
Air (how much = how much we are drawing from vial)
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When we get an air bubble while mixing meds, what do we do next?
START OVER!
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After we mix meds, what do we do with the needle?
Change the needle before administration.
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If we are mixing controlled substances, what do we need?
Need a witness when doing waste. (in clinical = instructor RN + RN)
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What do we know about proper medication disposal?
No Drugs Down the Drain! Check hospital policy on how to discard.
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