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IV Therapy for LPN
Skills for Administering and Documenting Injections
| Question | Answer |
|---|---|
| Where does the medication go when you administer an intradermal injection? | between layers of the skin |
| What is the purpose of an intradermal injection? Give two examples of when an intradermal injection would be given. | to instill a substance and detect a reaction to that |
| What is the standard medical abbreviation for subcutaneous injection? | SQ, SC, Subq |
| Where is the medicine deposited when you give a subcutaneous injection? | in the fatty layer of tissue beneath the skin and above the muscle |
| What is the standard medical abbreviation for intramuscular injection? | IM |
| Where is the medicine deposited when you give an intramuscular injection? | into the layers of the muscle |
| List three classifications of medications that might be given via intramuscular injections | analgesics; antiemetics; antibiotics; antipsychotics; nonsteroidal anti-inflammatory (Toradol);anticholinergics |
| What standard medical abbreviations are used medications administered intravenously | IV |
| List two types of medication given via subcutaneous injections | insulin; heparin; calcitonin |
| Where does the medication go when intravenous medications are administered? | directly into the bloodstream |
| List injection routes in order from the most rapidly absorbed to the least rapidly absorbed. | IV, IM, SC, ID |
| List three factors that influence the selection of needle length and gauge. Explain the significance of each. | type of medication to be injected—how deeply it needs to be injected; type of injection to be given—intradermal, subcutaneous, or intramuscular; size of the patient—amount of adipose tissue to inject into or for needle to penetrate past; consistency of me |
| What range of needle lengths and gauges would you use for a subcutaneous injection? | 1/2 to Scinch needles; 25, 26, 27 gauges |
| What range of needle lengths and gauges would you use for an intramuscular injection? | 1, 1 1/2, or 2-inch needles; 20, 21, 22 gauges |
| What are the two most common sizes of syringes used for | 1 cc and 3 cc |
| What is the difference between an insulin syringe and a tuberculin syringe? | An insulin syringe is marked in units, usually 100 units per 1 cc. A tuberculin syringe is calibrated in tenths of a cc and equals 1 cc. |
| What is a cartridge syringe (Tubex, Carpuject)? | A cartridge syringe is a pre-filled glass syringe barrel with needle attached. It loads into a reusable plastic or metal holder. |
| What is the difference between a vial and an ampule? | An ampule is a glass container with a narrow neck, containing a single dose of medication. The top must be broken at the neck to open the ampule. A vial is a small glass bottle that may contain one or more doses of a medication. It is sealed with a remova |
| How is a pre-fillea cartridge loaded into a cartridge syringe? | The pre-filled cartridge drops into the metal or plastic cartridge syringe and screws into place. The plastic or metal plunger screws into the top of the cartridge. |
| What type of needle should be used when drawing medication , ^TA. from an ampule into a syringe? | a filter needle to filter out any tiny shards of glass left from breaking the top of the ampule |
| Under what circumstances would yow change the needle after drawing up a medication for injection? | the gauge is large enough to cause a core of rubber to be cut out of the stopper on; a vial the needle has touched a different medication, such as when two medicines are; mixed in same syringe if needle penetrates a rubber stopper on vial more than once |
| How do you know if a medication for injection is too old to USe? | check the expiration date on the ampule or vial |
| What is the purpose of injecting air into the medication vial before drawing up the medication? | to displace the amount of medication needed with air, preventing a vacuum |
| What is the Z-track method for giving intramuscular injections? | a method designed to keep irritating medicines from being dragged through the subcutaneous tissue as the needle enters or exits the muscle |
| Under what circumstances would you use the Z-track method? | when the medication is irritating to the subcutaneous tissue |
| What is the purpose of creating an airlock when drawing up medication for Z-track injection? | the airlock pushes the medicine completely through the needle and into the muscle |
| List four-ractors to assess when choosing a site for injection | amount and type of medication to be injected; size of patient; location of bruises, scars, dressings; site of previous injection |
| When you give an intramuscular injection, at what area should you insert the needle? | 90° angle |
| What is the purpose of using this angle? | to be sure the bevel of the needle is completely within the muscle |
| What angle is used for giving a subcutaneous injection? | 45° angle when using a 5/8-inch needle; 90° angle when using a 1/2-inch needle |
| What is the maximum amounr of medication that can be given in one intramuscular site? | 3cc |
| What should you do if the dose ordered is larger than the maximum amount? | divide the dose and give in two different sites |
| If a medication reference book states that a medication should be given deep IM, what site(s) might you choose to inject? | dorsal gluteal, vastus lateralis |
| What is the purpose of rotating subcutaneous injection sites for insulin? | to prevent over-injection in one area and to promote absorption |
| Where is the preferred site for heparin injection? | abdomen |
| What type of syringe and size of needle are used to administer heparin? | tuberculin syringe and 1/2-inch 23 or 25 gauge needle |
| How does the angle of injection for heparin differ from the usual subcutaneous injection? | it is given at a 90° angle |
| List two sites used for intradermal injection | inner surface of the forearm; upper back |
| At what angle is the needle inserted for an intradermal injection? | 15° angle |
| How is the result of an intradermal injection read? | by the amount of induration around the injection site |
| Explain how you would select a syringe and needle to give an injection to a child | age and body size of child; type and amount of medication to be injected; shorter needle than used for adult; may need a tuberculin syringe to measure very small amounts of medication accurately |
| Which intramuscular injection site would you choose when the patient is an infant or young child? | vastus lateralis, because it is the largest muscle at that age; Invite a pediatric nurse to discuss administering injections to children |
| How would you evaluate the effectiveness of heparin | PTT & mouth and vaginal bleeding, SQ bleeding, blood in urine |
| How can the effectiveness of an insulm injection be evaluated? | FSBS and listen to the ot. |
| How can you tell if an antibiotic injection is effective against infecting microorganisms? | Cultures- signs and symptoms or infection |
Created by:
LPNin11
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