injectable medication administration

syringe parts

syringe parts

• barrel

• tip

• plunger

leur-lock

twist on lock that fasten needle to syringe

secure needle by twisting onto threaded tip

when NON luer tip. - push needle on and twist slightly while applying pressure

syringe measurement

• always use insuline syringe to measure insulin

• accurate admin includes measure dose at correct part of plunger

• insulin no more than 1mL

prefilled syringe

• load syringe into holder, needle end first

• turn blue lock half turn

• rotate plunger rod until fully screwed into plunger of syringe

• uncap needle and eject air and any excess medication while holding needle end lower to prevent hand and needle contact

• after admin dispose in sharps

  • position holder so it’s cradling syringe

  • unscrew plunger rod from plunger of syringe

  • rotate blue lock half turn invert holder over opening letting syringe and needle drop into container

needles

sterile needles packages individually in sealed sleeves or together with a syringe

when choosing a needle keep in mind client’s age, size, and injection site

filter needles

specific needle required when drawing up certain medications but never used to administer medications

length of needle depends on intended use

needle package always say gauge and length

needle parts

bevel

the shaft

the hub (part that attaches to syringe)

must keep parts sterile as u prepare and administer injection

packed w caps to prevent contamination and injury

recapping needle

• one handed scoop technique

  • place cap on firm flat surface w opening facing out to same side as your dominant hand

  • without contaminating, insert tip into cap and scoop cap up so it covers the needle

  • secure cap by pressing tip against a solid surface

  • dont use safety mechanism to recap, will make it unusable intra

intradermal needle selection

diameter: 25-27 gauge

needle length : ½ to 5/8 inch

needle angle: 5-15 degrees

subcutaneous needle selection

25-27 gauge

3/8 to 5/8 inch length

45-90 degrees angle

intramuscular

18-35 gauge diameter

5/8 to 1.5 inch length

90 degree needle angle

handling contaminated needles

• needlstick injuries r primary exposure to bloodborne diseases

• before injection make sure sharps container is at arm’s length and eye level

• make sure conrainer is functionla and no overfilled before admin

• dont carry contaminated needles in hand or pocket

• NEVER RECAP CONTAMINATED NEEDLE

• NEVER DISPOSE ON WASTEBASKET OR CLIENTS MEAL TRAY

vials

plastic or glass container in which liquid or powdered medication is packages in airtight or sterile environment

sealed w rubber stopper

access medication by pushing sterile needle through center of stopper

can be multidose if perservative added to solution

• follow policy for determining if vial in good condiition to use subsequently

• most make throw away after 1 month

withdrawing solution from a vial

• check exp. date and check label with MAR 2x while preparing

• pressurize vial by drwing air into syringe, should be same amnt ur withdrawing later

• cleanse stopper w alcohol and let dry

• insert needle into center of rubber stopper and inject all of air into air space inside vial

• invert vial and draw solution keep needle under liquid

• tap or flick syringe as needed to remove air bubbles to top of syringe so that u can eject them from syringe

• vial urpright withdraw needle from vial and recap using one handed scoop technique

mixing meds

• draw correct amnt of air for med A and inject into vial w med A

• withddraw needle and draw air for med B

• inject air into med B, invert vial and withdraw amount of med B

• upright and remove needle

• insert needle into med A invert vial and withdraw med A

• if one vial is single dose it should be second one that is withdrawn from (A)

reconstituting medication

• remove protective cap over rubber stoppers of medication and diluent vial

• cleanse both stoppers w alcohol swab

• pressureize diluent vial

• withdraw amount of diluent u need and inject into powder med vial

• allow to dissolve

• roll vial in hands to dissolve

• withdraw medication

• carefully read label to calculate dosage

ampule

glass, single use containers for liquid injectable meds

check exp date on ampule and check label w MAR 2x before admin

snap off top of scored neck (at colored ring)

need ampule breaker, gauze pad, cotton ball or unopened alcohol pad to protect fingers when opening ampule

dispose top in sharps container

withdrawing med from ampule

• MUST USE FILTER NEEDLE TO KEEP GLASS PARTICLES FROM ENTERING

• can withdraw upright or upside down

• insert into center of opening dont touch needle to ampule to avoid contamination

• pull back plunger keeping tip of needle submerged in fluid

• if u aspirate air, remove needle and hold upright

  • tap syringe if necessary to move air to top of syringe

  • pull plunger nack slightly to remove any med from needle

  • eject air and reinsert needle through ampule opening and resume

wasting excess medication

• once all air removedm discard excess medication into sink or waste bin

• hold needle lower than syringe to avoid contaminating needle and spilling med onto hand

• before= administering injection remove filter needle and replace w appropiate needle for injection

intramuscular injections

• deposit med deep into vascular muscle tissue = rapid absorption

• deltoid, vastus lateralis, ventrogluteal muscles used

• examine site to determine wheather there is adequate muscle tissue

• avoid area w lesions, trauma , inflammation , and bony provinces

• rotate IM injection sites when injections are regularly scheduled

Z track technique

• use on all intramuscular injections. '

• displace skin and subC tissue 1-1.5 inches to side w nondom hand

• insert needle at 90 degrees

  • use quick darting motion

• inject medication slowly and smoothly then hold needle in place for 10 sec to allow med to disperse

• withdraw needle quickly at same angle u inserted and let nondom hand go at same time

• cover sit w dry gauze and immediately apply gently pressure

• do not massage site

• if total volume to be administered exceeds max volume recommended for a particular site, split into separate injections at diff sites

deltoid injection

2-3 finger / 1-2 inches under acromion process

above axillary line in middle of triangle shaped deltiod muscle

potential injury due to proximity to brachial artery and redial nerve

give up to 2mL of meds w 1.5 inch needle

DONT use younger than 3 years

preschoolers - .5-2.5 inch

vastus lateralis

head of greater trochanter and the knee

insert needle into middle third of the muscle at least one hand width below greater trochanter and one hand width above knee

up to 3 ml w/ 18-25 gauge

5/8 in-1in for oil based sol.

22-27g 5/8-1inch for aqueous sol.

infants = 1mL w 1in needle

small infants 0.5mL w 5/8 in needle

ventrogluteal

head of greater trochanter and anterior superior iliac spine

heel of hand on head of greater trochanter w thumb pointing at abdomen

extend index finger up to superior iliac spine and spread other finger on iliac spine

insert needle in between index and third fingers

up to 3mL of meds

25-28G 1.5 needle for oil based

22-27G 1.5 in needle for aqueous sol.

infants = 1mL; .5-1in

intradermal injections

• used for skin testing to administer locaal anesthetics

• inner forearm and uper back

• examine site is free of lesions and hair

  • might interfere w accuracy

• use tuberculin or 1ml or smaller syringe

• .5- 5/8 inch

• 25-27 gauge needle

• cleaning w alcohol depends policy

1. pull skin taut

2. insert 5-15 angle w bevel up

3. insert ab 1/8 inch - will be able to see underneath

4. withdraw and apply gauze

5. DONT massage

6. bleeding or no wheal (bubble) formation at site indicates given wrong

subcuataneous injections

• for meds intended to be absorbed slowly

• subC tissue is less vascular

• avoid lesions, trauma, inflammation, bony

• favored sites r large areas client can reach for self admin

• upper outer aspect of arm, abdomen at least 2 inch from umbilicus and anterior thighs

• scapular area and upper ventrodorsal gluteal area can also be used

• rotate injection sites both within each location as well as among sites to prevent damage

• 25-31G , 5/8in nedle

• 45 degree ang;e or ½ inch needle at 90 degrees

• based on weight

• pinch area of clients loose fatty tissue w finger of nondom hand and quickly inseert needle at 45-90 degree angle

• dont have to aspirate

• once inserted release pinch and use that hand to admin medication slowly w dominant hand

• remove quickly at same angle inserted

• cover site w dry gauze and apply pressure, dont massage