Podcast
Questions and Answers
Which of the following routes of administration is preferred for medications that are irritating and require a quicker onset of action?
Which of the following routes of administration is preferred for medications that are irritating and require a quicker onset of action?
What should be the angle of needle insertion for an IM injection?
What should be the angle of needle insertion for an IM injection?
What is the maximum volume allowed for intradermal injections?
What is the maximum volume allowed for intradermal injections?
Which site is preferred for administering an IM injection in infants?
Which site is preferred for administering an IM injection in infants?
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Which of the following actions should NOT be performed after administering an IM injection?
Which of the following actions should NOT be performed after administering an IM injection?
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For subcutaneous injections, what is the typical angle of needle insertion for adults?
For subcutaneous injections, what is the typical angle of needle insertion for adults?
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What gauge needle is recommended for IM injections in adults?
What gauge needle is recommended for IM injections in adults?
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What is a typical site for a subcutaneous injection?
What is a typical site for a subcutaneous injection?
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In preparing for an IV administration of unfractionated heparin, which of the following is a standard dosage?
In preparing for an IV administration of unfractionated heparin, which of the following is a standard dosage?
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Which of the following is NOT a characteristic of the Z-track method for IM injections?
Which of the following is NOT a characteristic of the Z-track method for IM injections?
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What is the main role of pharmacokinetics in drug action principles?
What is the main role of pharmacokinetics in drug action principles?
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Which of the following factors can influence urination output?
Which of the following factors can influence urination output?
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What is the purpose of patient-controlled analgesia (PCA)?
What is the purpose of patient-controlled analgesia (PCA)?
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Which condition describes an inability to void as needed?
Which condition describes an inability to void as needed?
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In the context of altered urinary function, what is hematuria?
In the context of altered urinary function, what is hematuria?
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What is the correct procedure when documenting a patient's medication response?
What is the correct procedure when documenting a patient's medication response?
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Which type of incontinence is characterized by an inability to reach the bathroom due to physical limitations?
Which type of incontinence is characterized by an inability to reach the bathroom due to physical limitations?
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What is the minimum urine production that indicates normal kidney function for an adult?
What is the minimum urine production that indicates normal kidney function for an adult?
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Which method is recommended for diluting medication for children?
Which method is recommended for diluting medication for children?
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What is the process of adding a solvent to powdered medication commonly referred to as?
What is the process of adding a solvent to powdered medication commonly referred to as?
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What is the recommended order for drawing up insulin when mixing regular and NPH insulin?
What is the recommended order for drawing up insulin when mixing regular and NPH insulin?
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Which insulin type has an onset of less than 15 minutes?
Which insulin type has an onset of less than 15 minutes?
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What nursing action is important after administering a subcutaneous injection of heparin?
What nursing action is important after administering a subcutaneous injection of heparin?
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Which statement about regular insulin is correct?
Which statement about regular insulin is correct?
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When using a novolog pen, what is the first step before injecting?
When using a novolog pen, what is the first step before injecting?
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What is the correct way to administer medications via the otic route?
What is the correct way to administer medications via the otic route?
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What is a key safety consideration when administering insulin?
What is a key safety consideration when administering insulin?
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What is the purpose of the airlock when administering heparin?
What is the purpose of the airlock when administering heparin?
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Which of the following methods is used to ensure the right dose is given to a patient?
Which of the following methods is used to ensure the right dose is given to a patient?
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What is one of the primary nursing considerations before administering any medication?
What is one of the primary nursing considerations before administering any medication?
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Which type of delivery method requires a device such as a patch?
Which type of delivery method requires a device such as a patch?
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How long should a patient hold the needle in after administering an injection?
How long should a patient hold the needle in after administering an injection?
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Which medication is commonly given sublingually?
Which medication is commonly given sublingually?
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What does a low specific gravity in urine indicate?
What does a low specific gravity in urine indicate?
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Which specimen collection method is recommended for urine collection in young children?
Which specimen collection method is recommended for urine collection in young children?
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What is a normal specific gravity range in adults?
What is a normal specific gravity range in adults?
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What is the primary purpose of a urine culture and sensitivity test?
What is the primary purpose of a urine culture and sensitivity test?
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Which type of urinary catheter is used for accurate measurement of urine and typically has a balloon?
Which type of urinary catheter is used for accurate measurement of urine and typically has a balloon?
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What is a primary concern when using a urinary catheter?
What is a primary concern when using a urinary catheter?
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Which type of dialysis involves a catheter placed through the abdomen to filter waste from blood?
Which type of dialysis involves a catheter placed through the abdomen to filter waste from blood?
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Which of the following is NOT a method of hemodialysis?
Which of the following is NOT a method of hemodialysis?
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What is one of the primary bowel elimination factors that can worsen constipation?
What is one of the primary bowel elimination factors that can worsen constipation?
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What preparation is necessary before conducting a colonoscopy?
What preparation is necessary before conducting a colonoscopy?
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Which type of colostomy does not typically require irrigation and often has unformed stool?
Which type of colostomy does not typically require irrigation and often has unformed stool?
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Which of the following best describes the normalization of deviance?
Which of the following best describes the normalization of deviance?
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What is the purpose of a flexi-seal in fecal management?
What is the purpose of a flexi-seal in fecal management?
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What is an important consideration in patient safety regarding manual lifting?
What is an important consideration in patient safety regarding manual lifting?
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Study Notes
Medication Administration Routes
-
Oral (PO): Medications swallowed.
- Split or crush unit dose pills, except enteric-coated or sustained-release tablets.
- Administer liquid medications at eye level.
- Employ oral syringes for precise small doses.
- Use pudding, jello, or applesauce for patients with swallowing difficulties.
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Intramuscular (IM): Injection into muscle tissue.
- Needle length/gauge depends on patient age (adults = longer needle).
- Ventrogluteal site is preferred for adults, vastus lateralis for infants/children.
- Inject at a 90-degree angle.
- Use a syringe ½ cc larger than the dose.
- Avoid the deltoid, abdomen, and dorsogluteal in infants.
- Employ the Z-track method (retract tissue before injecting, allow tissue to return to original position).
- Do NOT massage the injection site.
-
Intravenous (IV): Injection directly into a vein.
- Unfractionated heparin commonly given IV for DVT-related pulmonary emboli.
- Usual dose: 50,000 units/liter of IV fluid.
- Administered as a drip infusion.
-
Intradermal (ID): Injection just beneath the skin surface.
- Max volume: 0.5 - 1.0 cc.
- Needle bevel should face upward, just below the skin.
- Used for skin tests (e.g., PPD, allergy).
- Evaluate for induration (hardened area) response.
-
Subcutaneous (SC): Injection into the fatty tissue beneath the skin.
- Slow, sustained release of medication.
- Short needle, small gauge.
- Typical dose: 0.5 - 1.0 ml.
- 90-degree angle for adults, 45-degree angle for children/emaciated adults.
- Common medications include insulin, heparin, vaccines, and pre-operative meds.
- Sites: lateral upper arms, abdomen, front mid-thigh, and buttocks (fatty areas).
- Insulin dosing: units and cc are NOT interchangeable.
- Example: 30 units = 0.3 cc; 100 units = 1 cc.
- Draw up regular insulin before NPH insulin when mixing.
- Ensure no air bubbles before administering NPH.
- Rotate injection sites to prevent tissue damage.
- Hypoglycemia assessment and protocol: if patient uses insulin.
- Signs: sweaty, rapid heart beat, dizziness, trembling.
-
Sublingual (SL): Placing the medication under the tongue.
- Dissolved, absorbed through mucous membrane.
- Example: Nitroglycerin.
-
Buccal: Placing medication inside the cheek.
- Absorbed through mucous membrane.
- Example: Nystatin.
-
Topical: Local effect applied to the skin or mucous membranes.
- Examples: creams, Preparation H, cortisone.
-
Transdermal: Adhesive patch delivering medication through the skin.
- Examples: hormones, blood pressure medications.
-
Inhaled: Aerosol medication delivered to the respiratory system.
- Example: Albuterol inhaler.
-
Otic: Liquid medication administered into the ear.
- Pull the ear down and back to straighten the ear canal.
- Example: ear drops for an infection.
Medication Safety and Administration
- Six Rights: Right patient, right medication, right dose, right time, right route, right documentation.
- Medication Verification: 3 times (pyxis, preparation, administration).
- High-Risk Medications: Narcotics, insulin, heparin, potassium.
- Error Prevention Measures: Barcode scanning, redesigned delivery systems, safety culture, communication.
- Medication Orders: Contain medication name, dosage, route, and purpose signed by provider.
- Medication Assessment: Before administration, assess patient's ability to swallow, GI motility, IV access, and vital signs.
Elimination Notes
- Normal Urine Output: 250-400 ml/ void (adult); 30 ml/hour minimum; 1200-1500 cc/24 hours (adult).
- Factors Affecting Urination: Fluid intake, nutrition, irritants (caffeine, carbonation), diuretics, salt, body position, cognition, disease, medications.
- Altered Urination: Dysuria, polyuria, oliguria, anuria, nocturia, hematuria, pyuria, urgency, frequency, urinary retention.
- Urinary Health Promotion: Adequate fluid intake, good hygiene, muscle tone (Kegels).
- Types of Incontinence: Stress, functional, total.
Diagnostics and Catheters
- Urine Specimens: Random, clean catch, 24-hour, catheter.
- Urinalysis Tests: Specific gravity, reagent strips, pH, glucose, proteins, bacteria, ketones, RBCs, WBCs.
- Urine Culture and Sensitivity: Identifies and tests for bacteria.
- Urinary Catheters: Straight, indwelling (Foley), triple lumen, indications, risks, types (use based on patient need).
Bowel Elimination
- Factors Affecting Bowel Elimination: Nutrition, fiber, fluid intake, medications, disease.
- Altered Bowel Function: Constipation, fecal impaction, diarrhea, incontinence, distention.
- Specimen Collection: Stool sample/culture, O&P, occult blood.
- Diagnostic Tests: Upper GI (barium swallow), lower GI (barium enema), ERCP, EGD, colonoscopy, enema (various types).
- Fecal Diversion: Ileostomy, colostomy, continent diversions.
Patient Safety and Communication
- Normalization of Deviance: Deviance from a standard becomes accepted.
- Swiss Cheese Model: System failures arise from multiple points of vulnerability.
- Communication Principles: Closed-loop communication, active listening, timeliness.
- Teamwork Tools: Staff safety assessment, TeamSTEPPS, timeouts, briefings, shadowing.
- Comprehensive Unit-Based Safety Program (CUSP): Learning from mistakes to improve safety culture.
- Safe Patient Handling: Manual lifting restrictions, use of assistive devices (e.g. hoists).
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Description
This quiz covers the different routes of medication administration, including oral, intramuscular, and intravenous methods. Each section details best practices, techniques, and important considerations for each route. Perfect for healthcare students or professionals looking to test their knowledge on medication delivery techniques.
