IM, SQ, and ID Injections – Flashcards
Unlock all answers in this set
Unlock answersquestion
What are the parts on a syringe?
answer
Plunger, Barrel, Needle hub or hilt, Needle length, Bevel, Gauge
question
What is the gauge size on and Intradermal needle?
answer
26-27 gauge
question
What is the gauge size and needle length on a SubQ needle?
answer
25-27 gauge, 3/8 to 5/8 inch length
question
What is the gauge size and needle length on an IM adult needle?
answer
18-23 gauge, 1-1.5 inch length
question
What is the gauge size and needle length on an IM Child needle?
answer
25-27 gauge, 1/2 to 1 inch length
question
Choosing the Correct Syringe/Needle
answer
Route of administration Viscosity of the solution Quantity to be administered Pt factors: obesity, muscle mass Type of medication
question
How to properly use an ampule?
answer
Breaking: flip or snap the ampule to remove liquid from the top. Wipe alcohol swab, Break away from your body Withdrawing medication:filtered needle, flat surface or invert, Do Not inject air. Dispose in sharps container
question
Prefilled cartridges or prefilled syringes
answer
require use of carpuject (holder) disposable carpuject NOT disposable If dose is more than ordered-med is wasted per hospital policy if carpujet is not available-needle removed and med drawn up as single dose vial
question
Single dose vials
answer
self sealing stoppers, opening, withdrawing medications, disposal
question
Multi dose vials
answer
opening and dating vials (per facility policy) not dated-do not use-discard withdrawing medications disposal or storage of opened vials
question
Reconstitution of medications
answer
amount of diluent, read label or PDR amount of injectate, calculate correct amount to be withdrawn based on final concentration found on label, technique
question
Intradermal injections
answer
TB testing or allergy testing, sites of administration-formearms or back, TB syringe (1mL syringe), skin prep with alcohol swab, administration, no aspiration, slowly withdraw needle, apply small gauze to site, Do Not massage, post injection car-mark site, note wheal, possible complications
question
Subcutaneous Injections
answer
site of administration-lower abdomen-2 inch from umbilicus, outer aspects of upper arms, anterior thighs, upper and lower back. technique for administration-needle size, angle of insertion, aspiration, massage
question
To aspirate or not to aspirate
answer
aspiration is done on all subq injections except for anticoagulants and insulin (per book) need to follow facility policy technically optional for insulin injections get in the habit with all subq's (except the anticoagulants/insulins) you are less likely to forget with and IM injection
question
Subq medication administraion possible complications
answer
lipodistrophy, lipoatrophy, infection, bruising rotate sites-document where injection given
question
IM injections sites of administration ventrogluteal
answer
palm greater trochanter of the femur, extend fingers posterior to the iliac crest anteriorly to the anteriosuperior iliac spine, tunbe is directed toward patient's groin
question
IM injections sites of administration vastus lateralis
answer
place one hand above the knee, other hand below the greater trochanter
question
IM injections sites of administration deltoid
answer
palpate lower edge of acromion process, becomes base of triangle, mid axillary line tip of triangle, administer in center of triangle or place pointer finger on acromion process. administer three finger widths below pointer finger
question
IM injections
answer
sterile technique, appropriate equipment, administration-dart needle, 90 degree angle, Aspiration? Massage? post injection care
question
IM injections possible complications
answer
localized pain and irritation, abscess formation, nerve damage, inadvertent administration into the vascular system, tissue damage from repeated injections, ecchymosis and hematoma formation
question
Z track
answer
locks medication into the muscle, produces less irritation, any IM injection can be given this way
question
IM injections reducing Pain/Complications
answer
use smallest gauge possible, keep medication off needle, use Z track for administration, inject into a relaxed muscle, rotate sites, use dart like motion and remove needle at same angle of insertion, don't rotate syringe while in the body, don't give more than recommended amount in any given site, inject at a rate of 1ml/10seconds, apply pressure after injection, encourage patient to express fears and concerns, EMLA cream
question
Injections special consideratins
answer
wear gloves with all injections, wash hands before and after, dispose of all sharps in appropriate containers, no tow handed recapping for dirty needles, document appropriately including site on MAR, Air lock: especially irritating solution: 0.2cc air in addition to medication
question
Vitamin K 10mg SQ for 210 lb, 5'6" male
answer
25 gauge, 5/8 inch needle
question
Which needle size and gauge would you use for a Demerol 25mg IM for 5'3" 125 lb female
answer
23 gauge, 1 inch needle
question
Which needle size and gauge would you use for a Morphine 10mg IM for 6'0", 185 lb male
answer
23 gauge, 1.5 inch needle
question
Which needle size and gauge would you use for a PPD skin test 0.1ml ID today
answer
27 gauge, 1/2 inch needle
question
Which needle size and gauge would you use for a 54 units Novulin NPH 215 lb female
answer
27 gauge, 5/8 inch needle, insulin syringe
