IV/Drug Admin (mine)

PDART

acronym for 5 rights of drug administration

5 rights of drug administration

right patients

right drug

right amount

right route

right time

What things do you need to check to ensure “right drug”?

order and the label (3x): storage, before drawing, and after drawing

how long do you observe the pt. following drug admin?

1 hour for any drug

What is crucial when it comes to drug admin? (or anything really)

documentation

1cc (cubic centimeter) = ? mL

1mL

1 kg = ? lb

2.2 lb

how is micrograms written for charting purposes?

mcg

Can an RN take a telephone/verbal order for drug admin?

yes

What must be charted for a telephone/verbal order?

whoever M.D. by whoever RN (TO/VO)

stat =

given now

PRN =

pro re nata/give as needed

single order =

give only once (radiographic contrast usually given only once)

What are the parts of the syringe?

tip, barrel, plunger

tip

accepts hub of needle

barrel

body

plunger

fits into inner barrel

syringes are

disposable and single-use

syringes are disposed of in

biohazard or sharps container

what are the 2 types of syringe tips?

leur-lok or slip-tip

what are the parts of the needle?

hub, cannula, lumen, bevel

hub

attaches to syringe

cannula

elongated part of the needle

lumen

hollow tube running length of shaft

bevel

sharp angulated tip of needle

gauge

thickness or diameter of the needle

what is the general gauge range for needles?

14-28

a smaller number gauge =

larger needle size/diameter

an 18g needle is ____ than a 22g needle

larger

the angiocatheter associated with the needles follows

the same gauge scale

what is the typical needle/catheter gauge used for power injections (CT)

18-22g

French catheters used for bladder catheterization are _____ of needles/angiocatheters

opposite

and 8Fr catheter is ____ than a 14Fr catheter

smaller

length of the needles

measurement in inches of shaft

what is the general range of needle lengths?

0.25-5”

shorter needles are used for

subcutaneous injections

longer needles are used for

intramuscular injections

what are the longest needles used for?

spinal needles used to inject/be inserted into spinal canal/intrathecal

syringes are ______ to show measurements

graduated

syringes are usually graduated in ____ or ___

mL ; cc

vials are usually

glass or plastic with a rubber stopper held by a metal band

If multidose, you must use _____ for each access and _______ for stopper

new sterile needle ; alcohol swab

what are the steps for loading the syringe from a vial?

check label for drug name, correct strength, expiration date

break seal, expose rubber stopper, wipe with alcohol swab

pull back plunger to desired dose reading: attach needle to syringe (everything but needle hub is considered sterile)

invert vial, insert needle into rubber stopper, inject air from syringe into space in vial

pull back on plunger until correct amount of drug drawn into syringe

remove needle, hold syringe with needle up while tapping syringe with finger to move any air bubbles up toward hub (can be expelled by gently pushing on plunger)

after use, dispose entire syringe and needle into sharps biohazard container

what are the steps for withdrawing from a glass ampule?

flick top of neck until all liquid is in the bottom of the container

snap top off with gauze pad (or little plastic thingy)

withdraw contents, careful not to let shaft of needle touch broken edge of ampule

^use filter needle

drawing meds from ampules can be accomplished ______ or _______

one person (sterile drawing from sterile ampule) ; two person (sterile drawing from unsterile ampule)

Why are filter needles used?

to filter glass particles/contaminates

lates =

milky fluid that comes from a tropical rubber tree

T/F? repeated exposure to a protein in natural latex can make you more likely to develop a latex allergy

true

what are some common products that may contain latex?

gloves, tourniquets, tape, condoms, BP cuffs, urinary catheters, CPR equipments, and pacifiers

T/F? healthcare workers are at an elevated risk (high exposure level to latex products)

true

who are some other people who are at a high risk for latex allergies?

patients with spina bifida, food allergies (banana, avocado, kiwi, melon, tomato, celery), rubber industry workers, and pt’s with multiple, long surgical procedures

latex is known to cause ___ of the ___ types of hypersensitivity

2 ; 4/5

type 1 latex allergy

the most serious and rare form

immediate and potentially life-threatening

can be broken up into mild, moderate, and severe

mild type 1 latex allergy

sudden appearance of redness/hives where latex touched the skin

moderate type 1 latex allergy

hives all over the body

severe type 1 latex allergy

asthma, wheezing, life-threatening anaphylaxis

T/F? a severe type 1 latex allergy can be caused by breathing powder from latex gloves by a very sensitive person?

true

Type IV latex allergy AKA

allergic contact dermatitis

type IV latex allergy

less serious, not life-threatening

involves a delayed skin rash that is similar to poison ivy with blistering and oozing of the skin

caused by chemicals used to process the rubber

A type IV latex allergy develops

after latex touches the skin

symptoms develop gradually, appear 6-48 hours after contact

skin problems, scaling, dryness, redness, swelling, blisters, cracks, itching

irritant dermatitis

not an allergic reaction

what is the most common type of reaction to latex?

irritant dermatitis

irritant dermatitis affects those who

frequently wear gloves

irritant dermatitis symptoms

dry, itchy, irritated areas on the skin - most often the hands

irritant dermatitis can be caused by latex, but it can also be due to

frequent hand washing, incomplete drying, hand sanitizers, etc.

enteral administration

by mouth/GI tract

if tablet is not scored

don’t break it

enteric coating =

do not chew

enteral drug admin steps

2 pt. identifiers, tell pt. drug, dosage, why its given, and what to expect

oral tablets or liquids are presented to the pt. in

medicine cup (do not touch the medicine with your hands)

sublingual and buccal meds are

small/uncoated to dissolve quickly

sublingual

pt. holds the tablet under the tongue

buccal

pt. holds tablet inside lower cheek beside gum toward back of mouth

do not give ____ when giving sublingual/buccal meds

water

documentation needed for enteral admin

drug give, dosage, route, and time

observe for reactions- at least ____ for any drug given

1 hour

parenteral administration includes

intra-arterial, intrathecal, intravenous, intradermal, subcutaneous, and intramuscular

all equipment must be ___ for parenteral admin

sterile

If skin is to be broken, it should be

prepped according to surgical asepsis

even though we aim for surgical asepsis,

medical asepsis is what is normally achieved

parenteral drugs AKA

legend drugs

parenteral/legend drugs require

a doctor’s order

intradermal

just under the skin

usually less than ____ is given with intradermal injections

0.5mL

examples of intradermal injections

TB skin test (PPD - puridied protein derivative)

Tuberculin syringe (intradermal)

1/2” in length, 25-27 gauge

intradermal injection angle

low , 10-15 degrees

small raised area seen after injection

wheal

subcutaneous

below the skin

no more than ____ of fluid is given with subcutaneous injections

1cc

subcutaneous injection needles

23-25g; 1/2-5/8”

meds should be ____ for subcutaneous admin

water-soluble

it is not necessary to _____ for subcutaneous injections

aspirate

subcutaneous injection sites

outer aspect of upper arms, abdomen, scapula, interior thigh

what sites should not be used for subcutaneous injections?

edematous/scar tissue

subcutaneous injection angle

45 degrees

intramuscular

prompt absorption, rich blood supply to muscle

what amount of drugs can be administered via intramuscular injection?

1-5cc

What syringe is used for intramuscular injections?

3-5mL

intramuscular needle

18-22g , 1.5” (22g, 1” for a thin pt.)