CSA Patient 1 - Rights and Procedures
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Questions and Answers

Which checks should be performed prior to medication administration?

  • Check patient ID and allergies
  • Verify the patient's prescription with the medication
  • Confirm the medication's expiration date
  • All of the above (correct)

It's acceptable to administer medications without checking the patient's allergies first.

False (B)

What does the 'R' in the PQRST(U) pain assessment stand for?

Radiation or where the pain is located

The correct dose of Digoxin to administer orally is __________ micrograms.

<p>250</p> Signup and view all the answers

Match the following medications with their dosage forms:

<p>Digoxin = 250 microg. dose PO Metoclopramide = 10 mg dose IM Heparin = Check independent dosage Pain management = Nonpharmacological interventions</p> Signup and view all the answers

What is the minimum heart rate requirement before administering Digoxin?

<p>60 bpm (C)</p> Signup and view all the answers

Nonpharmacological pain interventions should not be considered before administering medication.

<p>False (B)</p> Signup and view all the answers

What should the nurse check for when assessing a patient for pain management?

<p>Type and severity of pain, patient comfort needs, and potential allergies.</p> Signup and view all the answers

What is the correct dosage for heparin administered subcutaneously?

<p>5000 units (D)</p> Signup and view all the answers

Abdomen is a commonly used site for subcutaneous injections.

<p>True (A)</p> Signup and view all the answers

Name one site for intramuscular injections.

<p>Deltoid</p> Signup and view all the answers

For subcutaneous injections, the needlestick should not be pushed or rubbed at the _______.

<p>site</p> Signup and view all the answers

Match the following sites with their description:

<p>Vastus lateralis = Middle third of the thigh Deltoid = Three finger widths down from the acromion process Ventrogluteal = Palm over greater trochanter Dorsogluteal = Imaginary line between greater trochanter and posterior superior iliac spine</p> Signup and view all the answers

What gauge needle is recommended for subcutaneous injections?

<p>21 gauge (C)</p> Signup and view all the answers

It is recommended to rotate injection sites for regular injections.

<p>True (A)</p> Signup and view all the answers

What should you check the subcutaneous injection site for?

<p>Marks or signs of infection.</p> Signup and view all the answers

Why is the site recommended for IM injection not optimal?

<p>It risks contact with vital nerves and arteries (C)</p> Signup and view all the answers

The deltoid injection site is located on the anterolateral thigh.

<p>False (B)</p> Signup and view all the answers

What is the preferred amount of medication the gluteus medius muscle can absorb?

<p>1 to 5 mL</p> Signup and view all the answers

To locate the ventrogluteal injection site, one should place their palm over the greater trochanter with the thumb pointing towards the ______.

<p>umbilicus</p> Signup and view all the answers

Match the following injection sites with their correct anatomical markers:

<p>Deltoid = 3 fingers widths down from the acromion Vastus Lateralis = Halfway between the greater trochanter and the lateral femoral condyle Ventrogluteal = Anterior superior iliac spine and greater trochanter Gluteus Medius = Can absorb 1 to 5 mL of medication</p> Signup and view all the answers

What should be the angle of injection for intramuscular sites?

<p>90 degrees (C)</p> Signup and view all the answers

The vastus lateralis injection site is located on the outer side of the thigh.

<p>True (A)</p> Signup and view all the answers

In the ventrogluteal site identification process, which finger should be pointed towards the anterior superior iliac spine?

<p>Index finger</p> Signup and view all the answers

Flashcards

Patient Rights (Medication)

Patients have the right to receive the correct medication, given at the correct time and dose, using the correct route, having the correct expiration date, along with the correct form. Also the right to document and refuse medications.

Pain Assessment (PQRST)

A method for systematically assessing pain. It includes factors like location, quality, severity, and timing of the pain.

Drug Calculation (Example)

Calculate the appropriate medication dose using the strength (e.g., 250 mcg) of the medication and given amount (e.g., 250 mcg).

Medication Administration Checks

Multiple checks to verify the right patient, time, medication, dosage, route, and other factors before administering medication.

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Patient Allergy Checks

Important to check for any allergies and the types and severity and severity of reactions the patient may have had to medication. It must be verified against the patient's chart and arm band.

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Pain Interventions (Nonpharmacological)

Strategies for managing pain without using medication, including repositioning, distraction, and asking the patient about what might make it better.

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Digoxin Dosage

Digoxin oral dose, 250 micrograms to maintain a heart rate above 60 beats per minute (BPM).

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Metoclopramide IM Dosage

Metoclopramide IM dose, for medication calculation: medication calculation is required.

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Heparin Subcutaneous Dose Calculation

Calculate the volume of Heparin needed to administer 5000 units using the formula (SR/SS x volume).

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Heparin Subcutaneous Injection Site Rotation

Regularly rotate injection sites for subcutaneous heparin to avoid tissue damage and promote even distribution of medication.

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Subcutaneous Injection Sites

Areas on the body suitable for administering subcutaneous injections. These areas should show minimal tissue damage.

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Appropriate Subcutaneous Injection Needle Gauge

Use a 21 or 23 gauge needle for subcutaneous injections of heparin-based on the amount of volume and length of administered medication.

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Proper IM Injection Site for Vastus Lateralis

Inject into the middle third of the thigh, between the greater trochanter and the lateral femoral condyle

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IM Injection Site for Deltoid

Inject into the area between the index and middle finger, positioned three finger widths down from the acromion process. Focus on the midaxillary line.

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IM Injection Site for Ventrogluteal

Locate the injection site by placing the palm over the greater trochanter, index finger on anterior superior iliac spine, and middle finger on iliac crest. The injection site lies between the fingers.

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IM Injection Site for Dorsogluteal (Caution)

Use caution; an imaginary line is drawn between the greater trochanter and the posterior superior iliac spine for a suggested injection point.

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Deltoid Injection Site

The deltoid muscle is located on the outer upper arm. The injection site is 3 finger widths below the acromion process, in the middle of the deltoid, above the deltoid tuberosity.

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Vastus Lateralis Injection Site

The vastus lateralis muscle is located on the outer thigh. The injection site is halfway between the greater trochanter and the lateral femoral condyle.

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Ventrogluteal Injection Site

The ventrogluteal site is in the hip area, and is considered a safe and reliable site for intramuscular injections.

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What is the best method for determining the appropriate injection site?

The best method involves using anatomical landmarks to accurately identify the specific muscle and avoid critical structures like nerves and arteries.

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What is the recommended volume for a deltoid injection?

The deltoid muscle can safely absorb 1 to 5 mL of medication.

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Which injection site is not recommended?

The gluteus medius muscle is not recommended because of the risk of contacting the sciatic nerve or superior gluteal artery, and unpredictable absorption.

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What is the preferred injection angle?

A 90-degree angle is preferred for intramuscular injections to ensure the medication reaches the muscle layer.

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What is the importance of skin preparation before intramuscular injections?

The skin should be cleansed with an antiseptic wipe to reduce the risk of infection.

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Study Notes

CSA Patient 1 - Rights and Procedures

  • Patient Rights (11):

    • Right patient
    • Right time
    • Right prescription
    • Right medication
    • Right form
    • Right expiration date
    • Right to refuse
    • Right documentation
    • Right response
    • Right dose
    • Right route

  • Medication Checks (3):

    • Collection: Independent check for heparin and injections.
    • Dispensing: Independent check for heparin and injections.
    • Administration: Prior to administration.

  • Bedside Checks (4):

    • Name
    • Date of Birth (DOB)
    • Unique Record Number (URN)
    • Allergies

  • Pain Assessment (PQRSTU):

    • P (Provoking/Palliative): What makes the pain better/worse (movement, breathing)?
    • Q (Quality): Describe the pain (aching, sharp, stabbing, throbbing, crushing)?
    • R (Region/Radiation): Location of pain and if it spreads.
    • S (Severity): Pain scale from 0-10 (0 = no pain, 10 = worst possible).
    • T (Timing): When did the pain start, what were you doing, is it constant or intermittent?
    • U (Understanding): Have you experienced similar pain before? Why do you think you might have this pain now?

  • Non-Pharmacological Pain Interventions:

    • Asking the patient what might make the pain better.
    • Repositioning (e.g., semi-Fowler's).
    • Distraction (e.g., TV).
    • Checking pain level 30 minutes post-intervention.

  • Digoxin (Oral): Check heart rate (HR) must be above 60 bpm before dose. 250 microg PO. Calculation: SR/SS = 1 tablet.

  • Metoclopramide (IM):

    • Administration method: Intramuscular (IM)
    • Emesis bag required
    • Dose 10mg, and calculation: SR/SS x vol. = 2mL of solution

  • Heparin (Subcutaneous):

    • Administration method: Subcutaneous (SC)
    • 5000 units dose SC, and calculation: SR/SS x vol. = 1mL of solution.

IM Injection Sites (2)

  • IM Sites (25 gauge, 25mm 30g for insulin):

    • Vastus lateralis: Lateral middle-third of thigh.
    • Deltoid: 3 finger widths down from the acromion process.
    • Ventrogluteal: Center of the area between iliac crest, anterior superior iliac spine, and greater trochanter.
    • Dorsogluteal: (Not recommended, high risk of complications.) Between greater trochanter and posterior superior iliac spine, approximately 1 inch above the center of the line.

  • Important considerations for injection sites:

    • Cleanliness and condition of the injection site.
    • Avoiding previous injection sites.
    • Positioning and relaxation of the patient.

Subcutaneous Injection Sites

  • Subcutaneous (SC) (21 and 23 gauge, 16mm) sites:
    • Abdomen: 3-5 cm inferior and 10 cm lateral.
    • Lateral aspect of the upper arm.
    • Anterior thigh.
    • Scapula (fatty tissue underneath).

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CSA Patient 1 PREP May 2024 PDF

Description

Test your knowledge on patient rights, medication checks, and pain assessment procedures. This quiz covers important guidelines that healthcare professionals must follow to ensure patient safety and care quality. Explore the critical components that contribute to effective medication administration and patient evaluation.

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