FUNDS LAB #3 CHECK-OFF

Seven Rights of Medication Administration

1. Right Client

2. Right Drug

3. Right Dose

4. 4. Right Route

5. Right Time to give

6. Right Documentation

7. Right Reason

Three Medication Checks

1) When taking medication from the client's drawer/cart

2) Before opening/preparing the medication

3) When discarding the package or returning the medication before going to the bedside

Two Client ID Checks

1. Compare the MAR to the client’s ID bracelet, checking name.

2. Compare the MAR to the clients ID bracelet, checking medical record number.

G TUBES

Why do patients use G-tubes?

When a patient cannot safely or efficiently eat, drink, or take meds by mouth

A pH less than ______ is a good indicator that the tip of the tube is correctly placed in the stomach.

5.0 (acidic)

How many mL do you flush with when administering meds through a G-tube (in between giving meds)?

15-30mL

How many mL do you flush with when administering meds through a G-tube (after giving all meds)?

30-60mL

Why do we check for residual in G tubes?

To assess how well a patients stomach is emptying and to check for feeding intolerance/ensure it is going into the stomach

What do the levels of residual means?

Less residual means stomach is emptying normally, while more means substance is staying in the stomach longer than it should

If the residual exceeds ____ we cannot give the medication through the G-tube

500mL

How long do we wait if the residual level exceeds 500?

Wait 2 hours and recheck. If not better, contact healthcare provider

How do we check for residual?

Pull back 10-30mL of air into syringe and flush tube with air and pull back slowly to aspirate for gastric contents.

What should the pH of the residual be for a G tube?

5.5 or low (LOW): very acidic because our stomachs are very acidic

IM INJECTIONS

What are the needle lengths, gauges, and angle for an IM injection?

1. 1-3 inches (depending on patient size)

2. 19g-25g (depending on viscosity)

3. Administer at a 90-degree angle

IM needle angle and hand placement

90 degree angle for normal to overweight patients with the bevel UP

Why do we aspirate for blood when doing IM injections? And what do we do if we see blood?

We always want to make sure we did not hit a blood vessel. If we do see blood, we will immediately withdraw the needle and discard the needle and syringe safely

What are the four IM injection sites?

1. Deltoid (acromion process)

2. Ventrogluteal (greater trochanter, iliac crest, anterior superior iliac spine)

3. Vastus Lateralis (greater trochanter, knee/lateral femoral condyle)

4. Dorsal Gluteal (ALWAYS AVOID DUE TO SCIATIC NERVE)

How is the ventroogluteal injection site located?

By placing the palm on the greater troachanter and the index finger toward the anterior superior iliac spine

Per 1mL, how many seconds do we take to administer the medication?

10 seconds per 1mL

How long do you wait once you inject the IM medication?

10 seconds

SUBQ INJECTIONS

How long do you roll NPH insulin for and what do you do after?

10 seconds, then wipe vials

Three SQ Sites

1. Posterior aspect of the outer arms

2. Abdomen (below costal margins to iliac crest)

3. Anterior aspects of the thighs

4. Alternative sites may be used, but always assess the area

What are the needle lengths, gauges, and angle for an SQ injection?

1. 1/8-5/8 inch (depending on patient size)

2. 25-27g (depending on viscosity)

3. Administer at a 45-90 degree angle (depending on patient size)

How do you hold the skin when giving a SQ injection?

Pinch an inch (ish) of the skin when putting the needle in, then release pinch and inject the medication.

When handling injections, what method do we ALWAYS use to ensure needle safety?

The scoop method.