IM, SQ, and ID Injections – Flashcards

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question
What are the parts on a syringe?
answer
Plunger, Barrel, Needle hub or hilt, Needle length, Bevel, Gauge
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What is the gauge size on and Intradermal needle?
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26-27 gauge
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What is the gauge size and needle length on a SubQ needle?
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25-27 gauge, 3/8 to 5/8 inch length
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What is the gauge size and needle length on an IM adult needle?
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18-23 gauge, 1-1.5 inch length
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What is the gauge size and needle length on an IM Child needle?
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25-27 gauge, 1/2 to 1 inch length
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Choosing the Correct Syringe/Needle
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Route of administration Viscosity of the solution Quantity to be administered Pt factors: obesity, muscle mass Type of medication
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How to properly use an ampule?
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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
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Prefilled cartridges or prefilled syringes
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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
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Single dose vials
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self sealing stoppers, opening, withdrawing medications, disposal
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Multi dose vials
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opening and dating vials (per facility policy) not dated-do not use-discard withdrawing medications disposal or storage of opened vials
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Reconstitution of medications
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amount of diluent, read label or PDR amount of injectate, calculate correct amount to be withdrawn based on final concentration found on label, technique
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Intradermal injections
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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
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Subcutaneous Injections
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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
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To aspirate or not to aspirate
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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
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Subq medication administraion possible complications
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lipodistrophy, lipoatrophy, infection, bruising rotate sites-document where injection given
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IM injections sites of administration ventrogluteal
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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
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IM injections sites of administration vastus lateralis
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place one hand above the knee, other hand below the greater trochanter
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IM injections sites of administration deltoid
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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
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IM injections
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sterile technique, appropriate equipment, administration-dart needle, 90 degree angle, Aspiration? Massage? post injection care
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IM injections possible complications
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localized pain and irritation, abscess formation, nerve damage, inadvertent administration into the vascular system, tissue damage from repeated injections, ecchymosis and hematoma formation
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Z track
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locks medication into the muscle, produces less irritation, any IM injection can be given this way
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IM injections reducing Pain/Complications
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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
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Injections special consideratins
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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
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Vitamin K 10mg SQ for 210 lb, 5'6" male
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25 gauge, 5/8 inch needle
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Which needle size and gauge would you use for a Demerol 25mg IM for 5'3" 125 lb female
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23 gauge, 1 inch needle
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Which needle size and gauge would you use for a Morphine 10mg IM for 6'0", 185 lb male
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23 gauge, 1.5 inch needle
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Which needle size and gauge would you use for a PPD skin test 0.1ml ID today
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27 gauge, 1/2 inch needle
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Which needle size and gauge would you use for a 54 units Novulin NPH 215 lb female
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27 gauge, 5/8 inch needle, insulin syringe
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