Administration of Medications
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| Needle gauges 18-30 - What happens as needle gauge goes up? | The size of the needle decreases as the gauge increases. Gauge 18 has a larger diameter than a 30 gauge needle
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| Drawing up medications from multiple vials. | 1. Make sure the meds are compatible with each other.
2. Inject air into both vials as necessary.
3. Draw up medication from multidose vial first, then the single dose vial.
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| Mixing insulin in one syringe. | 1. Never shake insulin; roll it in the palms
2. Draw up the short acting first, then the long acting to prevent accidentally mixing long acting into the short acting insulin.
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| Needle gauges 18-30 - What happens as needle gauge goes up? | The size of the needle decreases as the gauge increases. Gauge 18 has a larger diameter than a 30 gauge needle
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| SubQ injection - Site | 1. outer aspect of upper arm
2. the abdomen (below costal margin to iliac crest.
3. anterior aspect of thigh
4. dorsogluteal area
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| SubQ injection - Absorption rate | Fastest: abdomen
Next: outer aspect of upper arm
Next: thighs
Slowest: upper ventral or dorsogluteal areas
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| SubQ injection - Equipment |
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| Drawing up medications from multiple vials. | 1. Make sure the meds are compatible with each other.
2. Inject air into both vials as necessary.
3. Draw up medication from multidose vial first, then the single dose vial.
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| Mixing insulin in one syringe. | 1. Never shake insulin; roll it in the palms
2. Draw up the short acting first, then the long acting to prevent accidentally mixing long acting into the short acting insulin.
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| SubQ injection - Site | 1. outer aspect of upper arm
2. the abdomen (below costal margin to iliac crest.
3. anterior aspect of thigh
4. dorsogluteal area
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| SubQ injection - Absorption rate | Fastest: abdomen
Next: outer aspect of upper arm
Next: thighs
Slowest: upper ventral or dorsogluteal areas
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| SubQ injection - Equipment | Gauge: 25-30
Length: 3/8"-5/8" (but officially can be 1")
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| SubQ injection - Procedure | Angle: 45-90 degrees
Pinching: for skinny people and longer needle --> release pinched skin once the needle is in
** apply gentle pressure only (no rubbing) after injection
** rotate sites if frequent injections are necessary
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| IM injection - General | - faster absorption than SubQ
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| IM injection - Sites | 1. ventrogluteal site (trochanter + anterior superior iliac spine + V shape between index and middle finger)
2. Vastus Lateralis (especially for children and infants) - rule of thirds horizontal and vertical
3. Deltoid - acromion + 2" below
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| IM injection - Equipment | Gauge: a) biological agents and aquaeous solution 20-25 b)oil based solutions 18-25 gauge
Lgth: 5/8"-1 and 1/2"
Vastus: 5/8"-1"
Deltoid: 5/8"-1 and 1/4" (kids) 1 and 1/2" adults
Ventrogluteal: 1 and 1/2"
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| IM injection - Procedure | Amt: 1-4 mL, but 1-2 mL in deltoid
- 72-90 degrees
- Z track - new needle after med has been drawn up
- aspirate
- inject slowly and withdraw needle
- release skin --> maybe light pressure, but no massaging
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| Eyedrops - Equipment | 1. tissues to wipe afterwards
2. gauze with saline or cotton ball to clean the eye
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| Eyedrops - Procedure | 1. Hand hygiene + gloves
2. patient looks at sg. at ceiling
3. lower the lower eyelid
4. apply the amt. of drops
5. pt. closes eyes (do not rub it)
6. apply gentle pressure on the inner canthus to prevent med from going into tear duct
7. remove glov
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| Eardrops - Equipment | - gloves // tissue for pt. // cotton balls + NS to clean ears //
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| Eardrops - Procedure | // prepare meds
// pull ear up and back for adult, back for school age child, and down and back for infant
// turn to unaffected site
// administer drops but not on tympanic membrane
//apply pressure on tragus to prevent med from tymp. membrane
//5 m
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