Injection Theory.txt

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Author:
Danette
ID:
154509
Filename:
Injection Theory.txt
Updated:
2012-05-17 23:06:09
Tags:
Exam one
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Description:
Injections
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    • author "me"
    • tags "Exam 1"
    • description "
    • "
    • fileName "Injection Theory"
    • freezingBlueDBID -1.0
    • Parental administration equipment
    • Syringes: sizes, types
    • Needles: length, gauge
    • Ampules
    • Vials
  1. Luer-lock
    Twist & lock - cannot remove needle after locked
  2. Slip-lock
    Slips onto tip - slips on & off, no twisting
  3. Parts of a syringe
    Plunger, barrel, tip, hub, shaft, bevel
  4. Ampules
    Clear glass, constricted neck with colored ring
  5. Opening ampules
    • ETOH pad
    • Break away from you
    • Dispose properly
  6. Withdrawing med from ampule
    • Insert needle, aspirate med upside down or flat on surface.
    • Needle tip below surface of liquid.
    • Expel excess air bubbles & fluid cover needle.
  7. Removing meds from vials
    • Remove cap - metal or plastic
    • Wipe rubber seal with ETOH swab
    • Draw air in syringe = vol of med
    • Insert tip of needle thru seal
    • Inject air into vial -- needle not in fluid
    • Invert vial
    • Needle below fluid level
    • Air pressure will fill syringe
    • Remove air
  8. Mixing meds
    • Determine compatibility of meds
    • Do not contaminate one med with another
    • Ensure the final dose is accurate
    • Maintain aseptic technique
  9. Mixing meds from 2 vials
    • 1 syringe - 2 needles
    • Air into A ,air into B
    • Withdraw B, withdraw A
    • Change needle
  10. Insulin basics
    • Hormone used to treat diabetes
    • Always check sugar before giving
    • Use correct syringe
    • Classified by rate of action: rapid, intermediate, long acting
    • Pt may require more than 1 type
  11. Regular (rapid acting) / short
    • Clear solution - mix with others
    • 5 minute time- regular
    • 30 minute - short
  12. Lente - NPH - intermediate
    • Cloudy - can be mixed with regular
    • Administer at room temp
    • Rotate between hands - no shaking
  13. Prepare insulin
    • 1. Inject air into cloudy (do not touch solution)
    • 2. Remove syringe
    • 3. Inject air into clear- withdraw dose
    • 4. Check with RN
    • 5. Removesyringe - remove air
    • 6. Return to cloudy & withdraw dose
    • 7. Check with RN
    • 8. Admin within 5 minutes
  14. Insulin sliding scale
    • Based on BS - usually reg used
    • Different for every pt
  15. Airlock
    • Bolus of air follows med
    • Traps solution in intramuscular tissue
    • After med drawn up, expel excess air, draw up 0.2 cc of air
  16. Z track
    • Primary reason: seal off med
    • Decrease discomfort
    • Pull skin & sq tissue approx 1 1/2" - 2" laterally to side
    • Hold taut
    • Inject needle deep, aspirate 10 sec after med injected, withdraw syringe
    • Release skin, dont rub site
  17. If blood is aspirated
    • Remove needle
    • Discard med & syringe
    • Repeat procedure
  18. SQ needle insertion
    • If average build - 45 degree angle, obese - 90 degree angle, thin - 15-45 degree angle
    • Small doses, 0.5-1 ml (if more is needed, give 2 shots)
    • 1/2 - 5/8 - 1 inch needle
    • 25g - 5/8" needle @45 degrees
  19. IM needle insertion
    • 90 degree deep into muscle
    • 3 ml max injected
    • Children & elderly & thin <2ml

    • Large muscle - gluteus medius
    • 20g - 23g 1 1/2" - 3" (1" - 1 1/2")

    • Deltoid
    • 23g - 24g 5/8" - 1"
  20. Intradermal needle insertion
    • Tuberculin syringe
    • 10-15 degrees 26g needle
    • Bleb or wheal
    • Bevel up
  21. Heparin
    • Never rub 25g
    • Never aspirate 3/8"-5/8" needle
    • Check with other RN
    • Prevent bleeding & bruising
    • Avoid 2" around umbilicus
    • Tubex
  22. Tubex & carpuject
    • Reusable plastic mechanisms
    • Uses prefilled, disposable, sterile cartridge-needle units
  23. Subcutaneous injection sites
    Arms, thigh, abdomen
  24. Intradermal injection sites
    Forearm, back
  25. Intramuscular injection sites
    Vastus lateralis, ventrogluteal, dorsogluteal, deltoid
  26. Vastus lateralis
    • TOES IN
    • Anterior-lateral aspect of thigh
    • Handbreath above knee
    • Handbreath below greater trochanter of femur
    • Middle 3rd is best
    • Width-midline of thigh's top to midlineof thigh's outer side
  27. Deltoid
    • Flex elbow
    • Lower edge of acromion process
    • Axillary line
    • Imaginary triangle
    • 4 fingers along acromion process
  28. Ventrogluteal
    • Gluteus medius & minimus
    • Heel of opposite hand over greater trochanter
    • Point thumb toward groin & fingers toward head
    • Index finger back along iliac crest toward buttocks

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