Chapter 29

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Chapter 29
2011-04-19 01:39:28
Med administeration

Taylors Ch 29
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  1. IM
    • 72-90 degrees, 5/8-1 1/2'' in needles..
    • Ventrogluteal, vastus lateralis, and deltoid sites.
    • Deltoid limit to 1 mL. 1-1.5 in needle
    • Aqueous solutions- 20 to 25 g
    • oil-based- 18-25 g
    • 1-4 mL
    • children, elderly- 1-2 mL IM injections
  2. ID
    • 26-27 g, usually less than 0.5 mL dose
    • 1/4-1/2 in needle
    • 5-15 degree angle
    • longest absorption time
    • forearm, upper back, under scapula
    • TB, allergies.. bleb forms
  3. Sub Q
    • into adipose tissue
    • Insulin and Heparin (do not aspirate)
    • 25-30 g
    • 3/8 (90)- 5/8 (45) or 1inch needle
    • 45-90 degree angle
    • Deltoid, abdomen, anterior thighs, upper back, dorsogluteal area.
    • usually, no more than 1 mL given
  4. Z track
    recommended for all IM injections, to make sure that meds do not leak back through needle track into subq tissues.
  5. Enteral route
    Admin though enteral tube
  6. Intradermal route
    Corium (under epidermis)
  7. injunction route
    rubbing drug into skin
  8. instillation route
    placing drug in direct contact with mucus membranes
  9. pharmacology
    study that deal with chemicals that affect the bodys functioning.
  10. Generic and Trade name
    EX; acetaminophen is Generic name and Trade name is Tylenol
  11. Pharmacokinetics
    • the effect of the body in the drug;
    • movement of drug molecules in the body in relation to the drugs absorption, distribution, metabolism and excretion.
  12. Commom Drug preperations
    Capsule, elixir (med in liquid), enteric coated (prevent stomach irritation), extended release, liniment (rubbed into skin), lotion, lozenge (candy?) ointment, pill, powder, solution, suppository, suspension, syrup, tab, transdermal patch
  13. Where does metabolism Primarily occur?
  14. Why would the elderly have hard time metabolising (breaking down drugs)? (Biotransformation)
    due to the aging process the liver has impaired functioning
  15. Where does excretion of drugs primarily occur?
    KIDNEYS, or lungs if drugs were inhaled
  16. Distribution of drug in body
    depends on the blood flow to the tissues, drugs ability to leave the bloodstream, and drugs ability to enter the cells
  17. Pharmacodynamics
    process were drugs alter cells physiology and affect the body
  18. Anaphylactic reaction (Anaphylaxis)
    life threatning and results in respiratory distress, sudden severe bronchospasms and cardiovascular collapse.
  19. Idiosyncratic Effect
    Unusual response to med
  20. IM injection sites
    • Deltoid (toddlers, adults) 5/8-1.5
    • Vastus lateralis (infants, toddlers) 5/8-1in
    • Ventrogluteal (adults) 1.5
    • faster onset than SubQ
  21. ID injection sites
    • Forearm
    • upper back
    • under scapula
  22. Teratogenic Drugs
    potential to cause developmental defects in fetus
  23. Expected responses to meds based on ...
    18-65 year old adults, 150 lbs
  24. Peak level
    highest plasma concentration, should be measured when absorption of drug is complete.
  25. Trough Level
    drug at lowest concentration, specimen usually drawn within 30 mins interval before next dose.
  26. Half-Life
    amount of time it takes for 50% of blood conc of a drug to be eliminated from the body
  27. Standing Order
    carried out as specified until it is cancelled out by another order
  28. 6 Patient RIGHTS
    • 1. Right Pt
    • 2. Right Med
    • 3. Right Dose
    • 4. Right Route
    • 5. Right Time
    • 6. Right Documentation
  29. Preferred system for Measurement of Drug Admin?
  30. What should be done when admin of meds though NG tube?
    • Powders or crushed tabs must be mixed with 15-30 mLs
    • Check placement of tube
    • Flush with 15-30 mLs of water
    • if connected to suction, disconnect for 20-30 after adim of meds.
  31. How long can an eye disk be used in the eye?
    up to 1 week
  32. Metric units of measurements?
    • Meter (length)
    • Liter (volume)
    • Gram (weight)
  33. 3 Times the label should be checked during med prep and admin?
    • 1. when reaching for container
    • 2. when comparing with CMAR
    • 3. when putting container back and before giving to pt
  34. When are 2 witnesses needed in drug admin?
    when disposing of controlled substance
  35. Parenteral Route
    outside the intestines or alimentary canal
  36. when do most needle stick injuries occur?
    when recapping
  37. how long is a multidose vial good for?
    24 hrs
  38. Example of med that comes prefilled and should not have air expelled from syringe...
    • Lovenox (enoxaparin)
    • also provided in prefilled cartidges
  39. First thing to do when going to mix 2 meds in one syringe?
    Make sure the 2 drugs are compatible! do not mix more than 2 drugs in one syringe
  40. Draw the med in the (BLANK) vial into the syringe FIRST.
    • this prevents contents of the multidose vial from being contamined with meds inthe single dose vial.
  41. If preparing meds in vial and ampule, which do you draw up first?
    Draw meds inthe vial FIRST, then the ampule
  42. 2 Insulin meds prep
    First draw air and inject air into cloudy (NPH), then inject air into clear (reg), then draw up reg dose, then draw up cloudy dose.
  43. which insulins cant be mixed with other insulins?
    Lantus and Levemir
  44. how many units in 1 mL of insulin?
    100 U insulin for 1mL of solution
  45. Reconstitution
    adding dilutent to a powdered drug
  46. Intradermal injections injected were?
    • into dermis
    • longest absorption time
    • TB, allergies test and local anethisia
    • tuberculin syringe
    • usually less than 0.5 mL dose
  47. Do NOT aspirate with this med
    • can result in hematoma formation
    • abdomen most common site of injection
  48. Insulin Syringes
    • 28-30 G
    • 5/16- 1/2 in needles
  49. Levonox (enoxaparin)
    • Site of injection at lateral aspects of abdomen
    • admin with air bubble at 90 degree angle
  50. Morphine
    • can be given SubQ through continuous infusion.
    • advantage is longer rate of absorption and convinience.
  51. Most dangerous route of perenteral drug admin?
    • IV
    • immidiate absorption
    • cannot be recalled or slowed
  52. Piggyback delivery system
    additive solution to be placed higher than the primary solution container
  53. Volume-control admin set
    med is diluted with SMALL amount of solution ot be admin through IV
  54. CVAD
    Central Venous Access Device
  55. Common Med errors
    • incorrect dose, quantity, route
    • extra, omitted or wrong dose
    • wrong pt
    • incorrect rate
    • incorrect time