medications pt 2

ventrogluteal injections

use on adults free from major blood vessels/nerves. inject using 1.5' needle and use max a 3mL syringe

vastus lateralis injection

safe for all (preferred on infants and toddlers), don't inject near large blood vessels/nerves. divide anterior thigh into 3 equal parts horizontally and vertically and inject in outer middle third. use 5/8-1' needle

deltoid

recommended for adults and children 3+. rapidly absorbed. use max 3mL syringe with 5/8-1.5' needle

IM injections

given into muscular layer (more vascular). use a 3mL syringe 8-25 g that 5/8-3'. inject at 70–90-degree angle.

to choose an injection spot intramuscularlly

use best judgement

heparin administration

SC injection that uses small gauge and 5/8-7/8' needle. administer in abdomen

how is heparin measured

in units

heparin admin technique

make sure the needle is free from heparin drips, pinch tissue, insert at 90 degrees and hold throughout injection

when mixing insulin

draw up regular insulin first.

how to mix insulin

inject air into NPH (opaque) vial then do the same for regular (clear) vial without letting needle touch the insulin. then draw regular (clear) insulin first then NPH (opaque insulin)

how are insulin injections measured

in units and only use insulin syringes

when can you shake suspensions

never. you can only agitate opaque suspensions

when should you administer insulin injection

abdomen

site rotation for insulin injection?

yes don't use same spot but can use same area

subcutaneous injection

uses 0.5-1mL syringe with a 25-30 gauge and 3/8-5/8' needle at 45–90-degree angle

which absorbs faster IM or SQ

IM

tissue grasp rule

used for SQ injections: if you can grasp 1in, choose longer needle and insert at 45 degrees. if you can grasp 2in+ choose shorter needle and insert at 90 degrees

pinching technique (SQ injections)

pinch and release when needle have been inserted: used for longer needles/ thinner patients

common SQ sites

abdomen (fast), upper arms, anterior thighs, gluteal (slow)

what should you know about abdominal injections

avoid 2' around umbilicus

for intradermal injection, what syringe do you use

tuberculin syringe

purpose of intradermal injection

PDD or allergy testing

places to administer intradermal injection

inner forearm, upper back, under scapula

intradermal technique

bevel of needle up, insert at 5-15 degree angle

EpiPen treats...?

severe allergic reactions and anaphyliais

where can you inject an epipen

outer though at 90 degrees (blue to the sky, orange to thigh)

can you massage EpiPen injection

YES!!

injection pens administration

patients attach needle and dials up 2 units to perform "air shot", then hold pen upright to make sure you can see a drop of insulin. Then dial up to needed dose and stick to skin like a dart, holding button down for 10 sec before releasing.

insulin injection is measured in

units; U30 holds 0.3 mL// U50 hold 0.5mL// U100 is most common (1mL)

are insulin syringe needles detachable

no! they have 28-30 gauge at 1/2 or 5/8' needle

3mL syringes are calibrated by

0.1

5mL syringes are calibrated by

0.2

tuberculin syringes are calibrated

1/100

how big can tuberculin syringes get

1mL with 25-27 gauge at 1/4 or 1/2' needle

a gauge needle is based on

the viscosity of the med

when drawing med from a single and multi-dose which one are you drawing first

the multi dose first

you're combining from vial and ample, which one are you drawing first

viral first