Injections – Flashcards
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When preparing an injection from an ampule, what will the nurse do if liquid is trapped in the neck of the ampule? Check the medication cabinet for an extra ampule of the medication. Notify the pharmacy that an additional ampule of medication will be needed. Use quick, light finger taps on the top of the ampule to move the liquid. Shake the medication out of the neck of the ampule.
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Use quick, light finger taps on the top of the ampule to move the liquid. CORRECT. Tapping the ampule will move the trapped fluid out of the neck of the ampule.
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What is the greatest safety concern when withdrawing medication from an ampule? Not wearing gloves when preparing medication Selecting an inappropriate needle size Withdrawing glass particles into the syringe Withdrawing bubbles into the syringe
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Withdrawing glass particles into the syringe CORRECT. Measures must be taken to prevent glass particles from being drawn into the syringe when aspirating medication from an ampule.
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How does the nurse minimize the risk of patient infection when preparing medication from an ampule? Using a filter needle to draw up the medication Preparing the medication in the patient's room Applying clean gloves while preparing the medication Preserving the sterility of the needle while preparing the medication
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Preserving the sterility of the needle while preparing the medication CORRECT. Maintaining the sterility of the needle is the primary method of minimizing the patient's risk for infection while preparing medication from an ampule.
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Which action minimizes the risk of introducing glass particles into the syringe when drawing medication from an ampule? Using minimal force to snap the neck of the ampule Using gauze to cover the top of the ampule when snapping it Using a filter needle or straw to draw the medication from the ampule Allowing the medication to settle after the ampule has been snapped open
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Using a filter needle or straw to draw the medication from the ampule CORRECT. Filter needles are designed to prevent glass particles in the ampule from entering the syringe.
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Which action might the nurse take when drawing up medication from an ampule? Hold the ampule upside down while inserting the filter needle. Inject air into the ampule before withdrawing the medication. Hold the ampule horizontally while inserting the filter needle. Expel air bubbles from the syringe while the filter needle is still inside the ampule.
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Hold the ampule upside down while inserting the filter needle. CORRECT. The ampule is either held upside down or placed on a flat surface to withdraw medication.
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A nurse is preparing to withdraw medication from an open multidose vial. After confirming that the vial contains the appropriate medication and checking the expiration date, what would the nurse do next? Apply clean gloves. Vigorously shake the vial. Wipe the rubber seal of the vial with an alcohol swab. Introduce air equal to the amount of medication needed.
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Wipe the rubber seal of the vial with an alcohol swab. Introduce air equal to the amount of medication needed. CORRECT. The rubber seal of a multidose vial must be cleansed with alcohol before use.
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What would the nurse do to remove air trapped in a syringe before withdrawing the syringe from the vial? Position the tip of the needle in the vial's airspace, and tap the barrel of the syringe. Position the tip of the needle below the fluid line, and tap the vial. Position the vial on a flat surface, and tap the syringe. Position the syringe above the vial, and tap the vial.
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Position the tip of the needle in the vial's airspace, and tap the barrel of the syringe. CORRECT. Positioning the tip of the needle in the vial's airspace and then tapping the barrel of the syringe will encourage any trapped air to move to the top of the syringe, where it can be expelled into the vial airspace
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How can the nurse prevent negative pressure from building up in the vial when preparing an injection? Inject an amount of air into the vial equivalent to the volume of medication to be withdrawn. Insert the needle through the center of the rubber seal. Keep the tip of the needle below the level of fluid in the vial. Tap the barrel of the syringe to dislodge air bubbles.
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Inject an amount of air into the vial equivalent to the volume of medication to be withdrawn. CORRECT. Inserting air into the vial to replace the medication to be drawn out will prevent the buildup of negative pressure in the vial.
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How can the nurse ensure that medication from a single-dose vial is used appropriately? Check to see when the medication vial was opened initially. Write the date and his or her initials on the label when opening the vial. Draw the entire amount of medication from the vial into the syringe. Discard the vial and any remaining medication in the vial directly after use.
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Discard the vial and any remaining medication in the vial directly after use. CORRECT. A single-dose vial is not reused after it is opened, regardless of the amount of medication remaining. The nurse would discard the vial and its contents.
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What will the nurse do after opening a multidose vial and withdrawing a dose of medication from it? Discard the unused portion of the medication. Wipe the entire vial with an antiseptic swab. Send the unused portion back to the pharmacy. Label the vial with the date it was opened and your initials.
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Label the vial with the date it was opened and your initials. CORRECT. The medication in an open multidose vial is perishable. Labeling the vial with the date on which it is opened will prevent administration of medication that has expired or lost its efficacy.
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How can the nurse best ensure the patient's safety when preparing insulin for administration? Obtain the patient's current blood glucose level. Clean the injection site with an antibacterial swab. Apply clean gloves. Wipe the rubber seal of the vial with alcohol.
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Obtain the patient's current blood glucose level. CORRECT. Obtaining the patient's current blood glucose level before administering insulin will best ensure the patient's safety.
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How would the nurse prepare insulin to ensure its efficacy? Do not allow refrigerated insulin to warm up before administering it. Follow aseptic technique during the entire process. Roll the vial of insulin suspension between the palms prior to drawing up the medication. Monitor the patient's blood glucose level before administering the injection.
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Roll the vial of insulin suspension between the palms prior to drawing up the medication. CORRECT. Rolling the vial of insulin suspension before drawing up the medication ensures that particles of suspension are adequately distributed into the solution, ensuring efficacy.
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When will a patient's blood glucose levels be most affected by a short-acting insulin injection, such as Humulin-R? In 2 to 3 hours For the next 12 hours During unplanned exercise When the patient eats carbohydrates
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In 2 to 3 hours For the next 12 hours CORRECT. Short-duration insulin peaks in 2 to 3 hours.
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Which of the following statements is accurate regarding insulin administration? Vials of insulin may be stored in the freezer to extend their shelf life. If the rapid-acting insulin ordered is unavailable, it is safe to substitute an alternative rapid-acting insulin. Vials of insulin must be inspected before each use for changes in appearance. All insulin must be shaken before use to redistribute particles within the suspension.
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Vials of insulin must be inspected before each use for changes in appearance. CORRECT. Insulin must be inspected before each use. A change in its appearance may indicate lack of potency, and the vial should not be used.
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To prevent hypoglycemia and enhance efficacy, it is appropriate to give rapid-acting insulin how many minutes before the next meal? 5 to 15 minutes 30 to 40 minutes 60 to 90 minutes The timing of insulin around meals is not necessary.
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5 to 15 minutes CORRECT. Onset of rapid-acting insulin occurs in 5 to 15 minutes.
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The nurse is preparing to mix short- and intermediate-acting insulins to administer to a patient. Which action best preserves the insulin's effectiveness? Determining the patient's blood glucose level Refraining from injecting the intermediate-acting insulin into the short-acting vial Applying clean gloves when administering the medication Having another registered nurse verify the dose of both types of insulins
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Refraining from injecting the intermediate-acting insulin into the short-acting vial CORRECT. Refraining from injecting the intermediate-acting insulin into the short-acting vial will prevent the short-acting insulin vial from being contaminated with intermediate-acting insulin
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The patient is to receive both Lantus® (insulin glargine) and regular insulin. To ensure the proper action of the insulins, what would the nurse do when preparing these two types of insulin for administration? Mix the insulins in one syringe for a single injection. Prepare the insulins in two syringes for separate injections. Roll each vial between the palms to disperse the medication within the suspension. Have another registered nurse verify the dose of the insulins.
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Prepare the insulins in two syringes for separate injections. CORRECT. Lantus is not to be mixed with other insulins. Separate injections are required.
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When preparing an injection that contains both short- and intermediate-acting insulins, what is the first step the nurse would take to ensure the effectiveness of the injection? Insert air into the intermediate-acting insulin. Warm the vials to room temperature. Shake the vials to disperse the medication within the suspension. Withdraw the prescribed amount of short-acting insulin after the intermediate-acting insulin.
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Insert air into the intermediate-acting insulin. CORRECT. Air is injected into the intermediate-acting insulin before it is injected into the short-acting insulin.
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When preparing an injection of mixed insulin that includes 12 units of NPH and 5 units of regular insulin, how does the nurse initially confirm the proper dosage in the syringe? By noting when 5 units of clear insulin is visible in the syringe By noting when 12 units of cloudy insulin is visible in the syringe By having another registered nurse verify the presence of 17 units of insulin By verifying that the prescription confirms the medication administration record (MAR)
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By noting when 5 units of clear insulin is visible in the syringe CORRECT. Because it is clear, regular insulin will be drawn into the syringe first, so it is the first thing the nurse will verify as she draws the proper dosage.
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Which action would the nurse take when mixing intermediate- and long-acting insulins together in one syringe? Draw the intermediate-acting insulin into the syringe first. Draw the long-acting insulin into the syringe first. Prepare two injections. Draw either the intermediate- or the long-acting insulin into the syringe first.
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Prepare two injections. Draw either the intermediate- or the long-acting insulin into the syringe first. CORRECT. You would need to prepare two injections because you never mix long-acting insulin with any other insulins.
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When administering an intradermal injection, which outcome would require the nurse to withdraw the needle and begin again? Aspiration of blood prior to injecting the medication Inability to feel resistance when injecting the medication Formation of a 6-mm bleb at the injection site Appearance of a lesion resembling a mosquito bite at the injection site
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Inability to feel resistance when injecting the medication CORRECT. Lack of resistance as the intradermal medication is injected indicates that the needle is not in the dermal layer and must be repeated
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Which statement might the nurse make to nursing assistive personnel (NAP) when caring for a patient who is prescribed an intradermal injection? "Be sure to wear clean gloves during the injection." "Tell him it's OK; the site should look like a mosquito bite." "Immediately report any patient complaints of itching or dyspnea." "Remind the patient to come back in 48 to 72 hours so we can evaluate the site."
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"Immediately report any patient complaints of itching or dyspnea." CORRECT. Reporting patient complaints is an acceptable role for NAP
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Which finding tells the nurse that a patient may have had a positive reaction to a tuberculin test? A raised wheal the size of a mosquito bite A bruised area 10 mm or greater in diameter A hard, raised area 15 mm or greater in diameter A flat, reddened area 5 mm or greater in diameter
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A hard, raised area 15 mm or greater in diameter CORRECT. An indurated area 15 mm in diameter or larger is considered a positive response in anyone with no known risk factors for tuberculosis, such as immunosuppression or exposure to tuberculosis
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In which site would it be inappropriate to administer an intradermal injection? Lower abdomen of an obese patient Upper back of a patient who is on bed rest Right deltoid of a high school softball pitcher Left forearm of a patient with right-sided weakness
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Right deltoid of a high school softball pitcher CORRECT. The deltoid area is not an acceptable intradermal injection site for any patient
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How can the nurse determine that the needle tip for an intradermal injection is in the dermis? A bleb the size of a mosquito bite will appear. The needle will enter at a 5- to 15-degree angle. The bulge of the needle tip will be visible through the skin. The needle will penetrate through the epidermis to a depth of about ⅛ inch.
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The bulge of the needle tip will be visible through CORRECT. Seeing the bump of the needle under the skin best ensures its proper placement in the dermis.
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Which action would the nurse take to diminish tissue irritation when administering a subcutaneous injection to a patient of average size? Massage the site after administration. Make sure the volume of the medication is less than 2 mL. Administer the injection at a 45- to 90-degree angle. Wear clean gloves while administering the injection.
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Make sure the volume of the medication is less than 2 mL. CORRECT. Delivering a volume of less than 2 mL by subcutaneous injection will reduce the likelihood of tissue irritation.
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Which needle would be most appropriate for the nurse to use when giving a subcutaneous injection to a patient of average height and weight? 20-gauge, ½-inch 22-gauge, 1-inch 25-gauge, ⅜-inch 27-gauge, 1-inch CORRECT. This needle is the correct gauge and length for a subcutaneous injection.
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25-gauge, ⅜-inch CORRECT. This needle is the correct gauge and length for a subcutaneous injection.
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What can the nurse do to minimize the discomfort of a subcutaneous injection? Inject the medication rapidly. Massage the injection site. Cover the injection site with gauze pad after withdrawing the needle. Inject the medication without pinching the skin.
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Cover the injection site with gauze pad after withdrawing the needle. CORRECT. Covering the nonintact skin of a subcutaneous injection site with a gauze pad, rather than with an alcohol swab, will reduce discomfort.
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When preparing to administer heparin or insulin subcutaneously, which site is preferred? Abdomen Scapula Deltoid muscle Back of the upper arm
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Abdomen CORRECT. The abdomen is the preferred site for subcutaneous heparin or insulin injection.
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What can the nurse do to ensure proper site selection for subcutaneous insulin injection? Insert the needle at a 30-degree angle. Select a different anatomical region for each injection. Ask the patient to relax before inserting the needle. Systematically rotate sites within the same anatomical location or area.
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Systematically rotate sites within the same anatomical location or area. CORRECT. Systematic rotation within one anatomical location will allow consistent insulin absorption.
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Which action by the nurse ensures patient safety when administering an intramuscular injection? Putting on clean gloves before administration Rotating injection sites Aspirating for blood return when administering a vaccine Injecting the medication quickly
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Rotating injection sites CORRECT. Rotating injection sites is important in order to prevent hypertrophy of tissue.
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When preparing an intramuscular injection, what can the nurse do to reduce the patient's risk for infection? Wear clean gloves. Use a 3-mL syringe. Clean the injection site with an alcohol swab. Massage the injection site.
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Clean the injection site with an alcohol swab. CORRECT. Cleaning the injection site with an alcohol swab before administering an intramuscular injection will reduce the patient's risk for infection.
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What can the nurse do to minimize the patient's risk for injury when delivering an intramuscular injection? Instruct the patient to relax. Insert the needle at a 45-degree angle. Pull back on the plunger after inserting the needle. Pull the skin taut at the injection site when inserting the needle.
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Pull back on the plunger after inserting the needle. CORRECT. Pulling back on the plunger will allow the nurse to determine if the needle is in a blood vessel, rather than in muscle tissue.
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Which site is most commonly used for intramuscular injections? Ventrogluteal Abdominal Deltoid Dorsogluteal
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Ventrogluteal CORRECT. The ventrogluteal site is the preferred IM injection site for adults and children, not for infants and toddlers.
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Which action by the nurse helps to ensure that the medication is delivered into the muscle when administering an intramuscular injection? Using a 1-inch needle Inserting the needle at a 45- to 60-degree angle Withdrawing the needle immediately after delivering the medication Aspirating for blood return before injection medication
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Aspirating for blood return before injection medication CORRECT. Aspirating for blood return ensures that the medication will be delivered into muscle tissue, and not into a blood vessel.
