week 10

What are the 4 types of injections?

• Intradermal (ID)

• Subcutaneous (SC)

• Intramuscular (IM)

• Intravenous (IV)

What should be remembered about ampules? (2)

• Single dose only

• Withdraw using filtered needle

What are the sites for IM injection? (3)

• Ventrogluteal

• Vastus lateralis

• Deltoid

What is the preferred IM site?

Ventrogluteal

What IM site is used when giving immunizations to children?

Vastus lateralis

How do you handle an adverse reaction to an IV medication? (4)

1. Stop the infusion.

2. Assess and monitor vital signs.

3. Perform interventions.

4. Document + report event.

What is the formula for IV drip rate?

Total volume (mls) / Rate per min (gtt/min) X Drop factor (gtts) = IV flow time (hours)

What pharmacokinetic changes occur during pregnancy? (4)

• Increase in blood supply to abdominal organs.

• Decreased gastric emptying and gastric acidity.

• Increased pulmonary blood flow

• Increased respiratory tidal volume.

How do drugs transfer across the placenta?

Diffusion

When is the fetus at greatest risk for developmental anomilies?

During the first trimester (conception - 3 months)

What is 1 lb in kg?

1 lb = 2.2 kg

What is required for homeostasis?

Fluid intake = fluid output

What imbalances indicate the need for IV therapy? (3)

• Body fluids

• Electrolytes

• Acid-base

What is osmolality?

measures the body's electrolyte–water balance

Hypertonic intravenous fluid

water moves from interstitial space to plasma

Hypotonic intravenous fluid

water moves from plasma to interstital space

Isotonic intravenous fluid

no fluid shift

What regulates fluid output? (3)

The kidneys

• Renin-angiotensin-aldosterone system

• Aldosterone

• Antidiuretic hormone (ADH)

How are deficient fluid balance disorders treated?

Oral or IV fluids

How are excess fluid balance disorders treated?

Diuretics

Crystalloids

An IV solution with electrolytes

When would we want to use an isotonic solution?

To increase the extracellular fluid volume or to lower BP

When would we want to use an hypotonic solution?

to bring fluid from the bloodstream into the cells and tissues, commonly used to help patients avoid dehydration

When would we want to use an hypertonic solution?

to increase intravascular fluid volume and to elevate blood pressure

Is normal saline 0.9% NaCl iso, hypo, or hypertonic?

isotonic

Is lactated ringers iso, hypo, or hypertonic?

isotonic

what is the difference between colloids and crystalloids?

colloids have larger molecules, crystalloids have smaller molecules

What potassium values indicate hyperkalemia?

greater than 5

What potassium values indicate hypokalemia?

less than 3.5

What is the normal range for potassium?

3.5 - 5

What sodium values indicate hypernatremia?

greater than 145

What sodium values indicate hyponatremia?

less than 135

What is the normal range for sodium?

135 - 145

What causes hypernatremia?

kidney disease

What can acute hypernatremia be treated with? (2)

• Hypotonic IV fluids

• Diuretics

What can hyponatremia be treated with? (4)

• Loop diuretics

• Normal saline

• Lactated ringers

• Oral sodium chloride

What are symptoms of hypernatremia? (5)

• Thirst

• Fatigue

• Weakness

• Muscle twitching

• Altered mental status

What are symptoms of hyponatremia? (4)

• nausea

• vomiting

• abdominal cramping

• altered neurologic function

What is the most serious consequence of postassium imbalance?

cardiac dysrhythmias

What is important to remember about administering potassium chloride? (2)

• always give oral medication while the patient is upright to prevent esophagitis.

• Never administer IV push.