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Identify the gauge, length, and angle for subcutaneous injections
- 25-27 gauge
- 3/8- 5/8 inches long
- administer at 45-90 degree angle
What are the three checks for medication administration?
- 1. When you reach for the container
- 2. Before you pour the medication
- 3. Before giving it to the patient
What are the six rights for medication administration?
- 1. Right medication
- 2. Right dose
- 3. Right patient/client
- 4. Right route
- 5. Right time
- 6. Right documentation
Describe documenting medications
1. Document on the Medication Administration Record
2. Document immediately following administration- never chart a med before administration
3. Include name of med, dose, route and exact time, record injection site
4. In nursing note explain if client refused med or was testing/procedure and missed the dose
5. Always document client response to med and any side effects
What are the oral routes for medication administration
- 1. mouth
- 2. enteral route (directly into stomach/intestines)
- 3. sublingual
- 4. buccal
What the aspiration precautions for oral medication administration
- 1. check presence of gag reflex
- 2. assess ability to swallow and cough
- 3. If unilateral weakness, place med in stronger side of the mouth
- 4. Prepare in easiest form to swallow
- 5. administer one pill at a time
- 6. avoid straws
- 7. thicken regular liquids
- 8. If aspiration severe, administer the med via an alternative route
What are the disadvantages for oral medication administration?
- 1. Avoid when client has alterations in GI function, reduced motility, surgical resection
- 2. clients who are unable to swallow
- 3. oral meds can irritate GI tract and discolor teeth and hae an unpleasant taste
- 4. Unconsious/ confused client who is unable/unwilling to swallow or hold medication under the tongue
- 5. cant administer when clients have gastric suction.
What are the parenteral routes of med administration?
- 1. Subcutaneous
- 2. Intramuscular
- 3. Intravenous
- 4. Intradermal
Identify the gauge, length, and angle for intramuscular injections:
- 19-23 gauge
- 1-1/2 inch length for adult
- 1 inch for child
- needle enters skin at 90 degree angle
- Sites should be rotated if repeated dosage...record pattern
3 ml considered maximum
What are the intramuscular injection sites?
- Ventrogluteal: considered safest for adults
- Vastus Lateralis: leg, thick muscle
- Deltoid muscle: upper arm, not capable of absorbing large amount.. 1 ml only
Dorsogluteal: not recommended due to sciatic nerve
What is Z-Track method and who is recommended for?
The Z-track IM is meant to decrease trauma on persons with decreased muscle mass. Indicated for elderly.
Use on all sites except the deltoid
- Skin is pulled to one side, med injected slowly, tissue is replaced once needle is withdrawn
- No massage needed
What are subcutaneous injection sites?
Identify the gauge, dosages, length, and angle for intradermal injections:
- 26-27 gauge
- 3/8 - 5/8 needle length
- dosage less than .1 to .3 ml
- administer at 15 degree angle
Longest absorption time...for TB testing and allergy testing
Describe IV infiltration
IV fluids enter the subcutaneous tissue around the venipuncture site
There is swelling, pallor, and coolness
Extraversion: caustic substance leaks out of vessel into the tissue
Inflammation of the vein
There is pain, tenderness, warmth, and redness associated with it
What are some key safety points for med admin?
- Avoid using needs when there are effective needless systems
- Plan safe handling and disposal before the procedure
- Never recap a used needle
- Safely discard in sharps container immediately after use
Where are topical medication administered?
- skin application
- transdermal patch
- nasal and ear instillation
What is basic formula for dose calculations?
dose ordered divided by dose on hand multiplied by the amount on hand = amound to administer
What is the formula for calculating IV drops per minute?
Volume divided by time (minutes) multiplied by the drop factor = drops per minute