Module 12

Injection Sites

  • Vastus Lateralis: outside of thigh, best for infants and young children, can hold 3 mL in a child

  • Rectus Femoris: Epi and Narcan, Anterior Thigh

  • Dorsogluteal: Gluteus Maximus, Can hold 4 mL, Sciatic nerve runs through this area

  • Deltoid: Upper outer arm, holds 1 mL, HepB

  • Ventrogluteal: Hip, Holds 3 mL

Best for children 7 months of age and younger: Vastus Lateralis

Most Used for vaccines: Deltoid

Isn’t used often because of the sciatic nerve: Dorsogluteal

Z-Track Method

Pull the skin taut and give the injection

Must use for Vaccines and Epi

IM injections, 90 degree angle, DO NOT RUB the skin

Transdermal Injection

Body size matters because it determines how fast/slow the medications will be absorbed and the size of the needle

Affects Absorption: Hair, Breast Tissue, Lesions, Temperature, Obesity

Rectal Suppository

Apply lubricant to suppository and gloved index finger, Insert 4 inches for an adult

Left lateral position

Tablets

-Sublingual: under the tongue

-Buccal: in cheek

Inhalers

Spacer: medication stays in the spacer until fully inhaled. Allows the patient to take several breaths without wasting any of the medication

-Care for Inhaler-

Clean after each use with mild soap and water, allow to air dry

Disinfect 1 time a week. Soak for 20 minutes in 1 pint of water with 2 oz of vinegar added

Meds that require STERILE technique

-Otic Irrigation

-Ophthalmic Medications

—Otic Meds: Lay patient on unaffected side with the affected ear up. Clean the ear and apply the drops. Instruct patient to remain laying in that position to allow the drops to fully settle. Adults: Pull pinna UP and back, Children: pull pinna DOWN and back

—Ophthalmic Meds: Pull bottom of the eye down and instill the meds in the corner

Requires over 3 mL IM

Dorsogluteal or vastus lateralis

2 separate syringes

Give 1.5 on each side of the body, same site

1 tsp= 5 mL

Insulin

-Mixing-

Clear to cloudy. Inject amount of air into long acting (cloudy) then into rapid acting (clear). Pull up rapid acting amount then the long acting amount and give the injection. DO NOT shake

-Storing-

Keep refrigerated, room temperature before administration

After using, can leave at room temperature for 28 days

-Cloudy-

NPH, long acting

Seizure Precautions

Turn patient to the side, use cushioning, have a suction setup incase aspiration occurs, O2 ready

Orders

  • prn: as needed

  • stat: one time immediately

  • standing order: once at a specific time , no specific end date

  • single order: one time, non emergent

FIRE safety

RACE

Rescue

Alarm

Confine

Extinguish

PASS

Pull

Aim

Squeeze

Sweep

Check MAR 3 TIMES!

10 Rights of Medication Administration

Right Medication, Right Dose, Right Route, Right Time, Right Patient, Right Education, Right Documentation, Right to Refuse, Right Assessment, Right Evaluation

“High Alert” Meds

Have another nurse verify the medication

Nurse Role in Abuse

Nurses are mandated reporters of known or suspected neglect/abuse for elders, children, and vulnerable adults.

Chapters 32 and 35 Fundamentals

https://quizlet.com/539635558/fundamentals-study-set-ch-32-flash-cards/

https://quizlet.com/392299661/kozier-ans-erbs-chapter-35-study-questions-flash-cards/