Parenteral Medications Flashcards

These flashcards cover the key concepts regarding parenteral medication administration, including routes, equipment, techniques, and medications.

Subcutaneous (SQ)

A route of parenteral medication administration where the injection is given into the dermis, the fatty tissue layer beneath the skin.

Intramuscular (IM)

A route of parenteral medication administration where the injection is delivered into the muscle tissue.

Intravenous (IV)

A method of delivering medication directly into the bloodstream through a vein.

Absorption speed

The rate at which a medication is absorbed into the bloodstream, with IV being the fastest, followed by IM, then SQ.

Syringe types

Common syringes for parenteral medications include 10 mL, 5 mL, 3 mL, tuberculin syringes, insulin, and low-dose insulin syringes.

Insulin syringe

A syringe specifically used for insulin administration, calibrated in units (U-100), with a non-detachable needle.

Tuberculin syringe

A syringe designed for administering very small, precise volumes, particularly for tuberculin testing.

Needle gauge

Refers to the diameter of the needle, ranging from 14 (widest) to 29 (narrowest).

Needle lengths

Needles for parenteral medications typically range from 0.4 to 3 inches in length, based on the route and patient size.

Prefilled syringes

Syringes filled with medication typically used for opiate analgesics and heparin, with a non-changeable needle.

Vial

A reusable container with a rubber stopper used to store medication.

Ampule

A single-dose glass container that must be broken to access the medication.

Sterility of vials

Contents of a vial are sterile, but the rubber stopper is not sterile and must be cleaned with alcohol.

Drawing medication from a vial

Process that involves cleaning the stopper, injecting air, and withdrawing the medication.

Powder-form vial

Vial used for medications that are not stable in liquid form, requiring reconstitution with sterile water.

Reconstitution process

Involves cleaning vial stoppers, injecting fluid into a powder vial, shaking, and withdrawing the reconstituted medication.

Safe ampule opening

Involves using gauze to break the neck and drawing medication with a filter needle.

Filter needle purpose

Prevents glass particles from entering the syringe when drawing from an ampule.

Cleaning rubber stopper

Should be cleaned with alcohol for 15 to 30 seconds before accessing the vial.

Air injection prior to withdrawal

Creates positive pressure to facilitate medication withdrawal.

Syringe labeling

Syringe labels must include the patient's name and the medication name for safety.

Syringe recapping

Should be performed using the single-hand technique to avoid needle-stick injuries.

Mixing medications

Medications can only be mixed in one syringe if they are compatible to reduce injection frequency.

Procedure for mixing medications

Involves cleaning vial stoppers, injecting air, drawing medications in sequence.

Overdrawing medication

If too much of the second medication is drawn, the syringe is discarded, and the process is restarted.

SQ injection site

Is injected into the dermis, which is the layer of fat beneath the skin.

SQ volume limit

Typically limited to small amounts ranging from 0.5 to 1 mL.

SQ needle size

Needle length ranges from 3/8 to 5/8 inch, and gauge is typically 25-30.

SQ injection angles

Injection can be done at 45 degrees or 90 degrees, depending on body habitus.

SQ technique

Involves pinching the skin, inserting the needle, and injecting without aspirating.

Preferred SQ sites

The abdomen, upper outer arm, and anterior thigh, avoiding scars and incisions.

Rapid absorption site

The abdomen is the preferred site for rapid absorption.

Common SQ medications

Medications like Insulin, Heparin, and sometimes opioids.

Aspirating SQ injections

Should not be done for subcutaneous injections.

Heparin use

Used primarily to prevent DVT and treat pulmonary embolism.

SQ heparin precautions

Do not aspirate or massage the site to prevent bruising.

Heparin alert status

Considered a high-alert drug due to bleeding risk; always double-check dosages.

Insulin syringe specification

Must be an insulin syringe calibrated in units with a non-detachable needle.

Insulin pen

A device for self-administration of insulin, ideal for patients with vision or dexterity issues.

Insulin injection sites

Include the upper arm, thigh, buttocks, and abdomen, avoiding direct vicinity to the umbilicus.

Rotation of insulin sites

Rotating sites prevents lipodystrophy and ensures consistent absorption.

Stability of open insulin vial

Stable at room temperature for up to 1 month; protect from heat and light.

IM absorption speed

Absorption is faster than SQ due to richer blood supply in muscle tissue.

IM volume capability

Can administer larger volumes than SQ, generally up to 5 mL.

IM needle size

Needle lengths typically range from 1 to 3 inches and gauges from 19 to 25.

IM injection sites

Common sites include Deltoid, Vastus Lateralis, and Ventrogluteal.

Factors for IM site selection

Include patient's age, medication volume, and patient's condition.

Preferred IM site

For adults and children, the Ventrogluteal site is preferred.

IM site for infants

Vastus Lateralis is preferred for immunizations in infants.

IM injection technique

Involves flattening the skin, inserting needle at 90 degrees, and optional massage post-injection.

Aspirating for IM

Current guidelines recommend against aspirating for IM injections.

Z-track technique purpose

Used for medications that irritate tissue, preventing leakage into subcutaneous tissue.

Z-track technique steps

Includes skin displacement and waiting before needle withdrawal after injection.

IV administration

Administered directly into the bloodstream, effective for system-wide effects.

Macro IV drip rate

Standard IV tubing typically administers at a rate of 10-20 drops per minute.

Mini-drip IV rate

Micro IV tubing administers at a rate of 60 drops per minute.

Manual IV drip rate formula

Calculated as: Drops per minute = (Volume ÷ Time in minutes) × Drop factor.

Factors for IV flow rate

Include height of solution container, extremity position, and tubing conditions.

Flushing IV line

Confirms IV patency before starting medication infusion.

VTBI meaning

Volume To Be Infused, used in IV pump programming.

LIB definition

Left In the Bag, referencing remaining volume in IV containers.

EID programming formula

Volume is divided by hours for setting mL/hr in an electronic infusion device.

Sites to avoid for injections

Any sites that are inflamed, swollen, or bear lesions such as scars.

Minimizing tissue damage during injection

Achieved by injecting medication slowly.

Skin handling during needle removal

Skin should be stabilized to reduce pain for the patient.

Documentation after injections

Should include the site of injection and observation of drug effectiveness.

Heparin calculation example

7,500 units ordered with a concentration of 10,000 units/mL results in 0.75 mL to administer.

SQ insulin injection sites

Suitable locations include abdomen, upper outer arm, and thigh.

Skin handling for SQ injection

Should be pinched prior to needle insertion.

Insulin syringe calibration

Calibrated in units, specifically U-100.

Post-SQ injection procedure

Involves withdrawing the needle and releasing the pinch without massaging the site.

Insulin teaching evaluation

Nurse confirms patient proficiency through return demonstration of injection technique.