Med. Procedures Lec. - Exam 2

Admin of meds, injections

What is an example of administering medication?

A medical assistant gives an IM injection to a patient.

The term parenteral refers to:

Sites located outside the gastrointestinal tract.

Which of the following is assigned by the pharmaceutical company that first develops a drug?

Generic Name

What is the name of a drug preparation that is applied externally to produce a feeling of heat or warmth?

Liniment

1 ml = ? cc

1 cc

Which system is used most often to prescribe and administer medication?

Metric

What is the term for the slanted edge at the top of a needle?

Bevel

Lumen sizes

The smaller the gauge number the larger the lumen. For example, an 18 G lumen is larger than a 27 G lumen.

Which of the following is a function of the flange of a syringe?

Helps in injecting the medication

Which of the following techniques should not be preformed when an ampule is used to administer medication?

Inject air into the ampule before removing the medication.

Which of the following is used to administer an intradermal injection?

Tuberculin syringe

The purpose of aspirating when administering an injection is to

Ensure that the needle is not in a blood vessel.

Which of the following needle lengths is used to administer an intramuscular injection into the dorsogluteal site on an average size adult?

1 1/2 inches

The vastus lateralis site is used most often to administer medication to

Infants and young children

What angle of needle insertion should be used to administer an IM injection?

90 degrees

The Z-track method is used to administer medications that are

irritating to the subcutaneous tissue

Which of the following is used to administer an intradermal injection? (what size?)

27 G, 1/2 inch

Erythema without induration occurring from a Mantoux test indicates a(n) ______ reaction

negative

What is done if a patient has a positive reaction to a Mantoux test?

Further diagnostic procedures are performed

Administered

given to a patient at the office

Prescribed

Physician provides patient with a handwritten or computer-generated Rx to be filled at a pharmacy

Dispensed

Medication given at the office for a patient to take home

Precise description of chemical composition. Example: n-acetyl-para-aminophenol

Chemical Name

Assigned by manufacturer who developed the drug. Example: Acetaminophen, paracetamol,

Generic Name

Name under which the drug is listed on official publications. Generic name is also used for this. Example: US Pharmacopeia (USP)

Official Name

Name under which pharmaceutical manufacturer markets the drug. Example: Advil, Tylenol

Brand Name

Sublingual tablet

dissolves under the tongue

Enteric-coated tablet

Coated with substance - prevents tablet from dissolving until it reaches the intestines

Sustained-release capsules

provides gradual and continuous release of medication

Basic Units

Gram (Weight), Liter (Volume), Meter (Linear)

Schedule I

Not available for prescribing; not used for treatment; high risk for abuse - examples: LSD, Heroin, MDMA

Schedule II

No refills allowed; currently accepted for tx; high risk for abuse - examples: Percocet, Adderall, Oxycontin

Schedule III

Moderate to low risk for abuse; can be refilled 5 times within 6 months - examples: Vicodin, Tylenol w codeine

Schedule IV

Low potential for abuse; limited psyche and physical dependence - examples: Xanax, Ambien, Valium

Schedule V

Low potential for abuse - Examples: Cough syrup

In order to administer, prescribe or dispense a controlled drug you must have a ________.

DEA Number

Superscription

Rx symbol; latin for recipe and take

Inscription

Name and dosage of drug - Example: Amoxil 250 mg

Subscription

Directions to pharmacist; designates number of doses to be dispensed

Signatura (sig)

Latin for write or label; directions for patient - Example: tab i po prn for pain (take one tab by mouth as needed for pain)

Which demographic of people are most affected by drugs?

The elderly and children

Factors affecting drug action

Age, route, size, time of administration and tolerance Ad

Adverse reactions

May be harmful; example: allergic reaction

May be harmless; referred to as side effects

Anaphylactic reaction symptoms

hives, vasodilation, angioedma (internal hives)

anaphylactic reaction - prevention

stay with patient after administration of meds

Idiosyncratic reaction

abnormal response to a drug that is unexplained and unpredictable (most often occurs in the elderly)

Seven rights

drug, dose, time, patient, route, technique, documentation

true or false: some vials require mixing

true

True or false: If a vial requires mixing shake it vigorously

False - shaking causes bubbles that may enter syringe; roll between hands

Ampule

small, sealed glass container holding a single dose

Diluent

Liquid used to reconstitute powder medication to liquid form

Hub - needle part

fits onto top of syringe

Shaft - needle part

inserted into body tissue

Lumen - needle part

opening in shaft of needle

Gauge ranges

18 to 27

Needle length ranges

3/8 to 3 inches - depends on type of injection

Barrel - syringe part

holds medication

Flange - syringe part

rim at the end of the barrel

Plunger - syringe part

movable cylinder that slides back and forth in the barrel

Hypodermic needle

Small capacity; ranges from 2, 2.5, 3 and 5 ml

Insulin syringe

calibrated in units; most common U-100

Tuberculine syringe

administers a small dose of medication; capacity of 1 ml

SQ sites commonly used

upper lateral part of arms, anterior thigh, upper back, abdomen

Angle of insertion for a SQ injection

45 degrees

True or False: a SQ injection has a slower absorption rate than IM

True

Do not give SQ injection into tissue that is

hardened, inflamed SQ nee

SQ needle length range

1/2 to 5/8 inch - 45 degree angle for 5/8 in needle - 90 degree angle for 1/2 in needle

Medications administered via SQ

epinephrine, insulin, allergy injections

SQ injections shoulder no exceed ___ml

1 ml

Intramuscular injections

located below skin and SQ layer

Amount that can be injected into gluteal and vastus lateralis sites

Adults: 3ml

Very thing or older adults: 2 ml

Amount that can be injected into deltoid site

no more than 1 ml

IM needle length range

1 to 3 inches

average adult: 1 1/2 in

Child or thin adult: 1 in

Obese: 2 to 3 in

IM needle gauge range

18 to 23 - depends on viscosity of medication

IM injection sites

Dorsogluteal - square on the ass cheek

Deltoid - upper arm

Vastus Lateralis - mid thigh

Ventrogluteal - closer to hip

What is the iliac?

tip of hip bone

To locate injection site for a deltoid injection you must palpate the____

Acromion process

Vastus lateralis site - recommended for

infants and children younger than 3

What angle of insertion do you administer intradermal injections?

almost parallel to skin

Amount allowed to be injected for intradermal

0\.01 to 0.2 ml

Intradermal needle length range

3/8 to 5/8 inch

Needle gauge for intradermal

25 to 27

Types of tuberculosis

Active (w symptoms) and Latent (no active symptoms)

When should you read a tuberculin test?

48 to 72 hours

Tuberculosis is caused by what bacteria?

Mycobacterium tuberculosis

Latent TB affects what percent of people infected?

90%

What does tuberculin consist of?

Purified protein derivative (PPD)M

Mantoux test

Most common - administer PPD into skin - the good old skin test bb

Tine test

four prong thingy

What is the dose of PPD?

0\.1 ml

PPD solution expires how long after opening?

30 days

What does it mean if the second skin test is positive?

likely caused by boosted reaction

True or False: the Quantiferon TB Gold blood test cannot determine if active or latent

true

What is a disadvantage of the Quantiferon test?

Must deliver blood specimen within 12 hour to lab

Allergen

a substance that is capable of causing an allergic reaction

Which immunoglobulin is present during an allergic reaction?

IgE

Skin punctures capture what type of blood?

capillary blood

Another name for skin puncture

capillary puncture

Examples of skin puncture tests

hemoglobin, hematocrit, blood glucose, mononucleosis

Skin puncture site

Adult: third or fourth finger

Infant: plantar surface of heel (can perform up until child is walking) De