Medication Preparation and Insulin Administration

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Questions and Answers

What is the purpose of injecting air into both a single-dose vial and a multidose vial before drawing medication?

To create a vacuum for easier drawing of medication

To ensure accurate dosing from the multidose vial

To prevent contamination of the multidose vial (correct)

To prevent contamination of the single-dose vial

When preparing medications in one syringe, what must be ensured about the two drugs?

They are in vials of the same type

They are both single-dose vials

They are compatible (correct)

They have the same dosage

What happens to incompatible drugs when mixed in the same syringe?

They may become cloudy or form a precipitate (correct)

They remain clear and homogeneous

They multiply their onset time

They enhance each other's effectiveness

Why is mixing more than two drugs in one syringe generally not recommended?

It raises the risk of drug incompatibility Signup and view all the answers

Which of the following insulins cannot be mixed with others?

Lantus Signup and view all the answers

What is the most commonly used scale for calculating insulin dosages?

U100 Signup and view all the answers

What should you be aware of before administering insulin?

The onset time, peak, and duration of effects Signup and view all the answers

What is a vital resource that should be available to nurses preparing medications?

A drug-compatibility table Signup and view all the answers

Which personnel are allowed to prepare medication from two vials under specific conditions?

Licensed Practical/Vocational Nurses (LPN/LVN) Signup and view all the answers

When preparing insulin from two vials, which of the following assessments is critical?

Determining the compatibility of the two insulins Signup and view all the answers

What is an important visual assessment for insulin preparations that are typically unmodified?

They should be clear without particles Signup and view all the answers

What is the priority nursing diagnosis for a patient preparing for insulin administration?

Deficient Knowledge Signup and view all the answers

Which step should be performed first when preparing to administer medication from two vials?

Ensure the equipment is sterile Signup and view all the answers

What must be assessed before administering insulin to a patient?

Patient’s blood glucose level Signup and view all the answers

Which of the following options could affect the appropriateness of drug administration?

Assessment of laboratory data Signup and view all the answers

What type of insulin preparations typically do not appear as clear substances?

Modified preparations Signup and view all the answers

What should be done to ensure the correct mixing of a suspension medication like NPH insulin?

It should be rolled and agitated. Signup and view all the answers

Why is it important to allow the alcohol used to cleanse the rubber tops to dry?

To ensure that the alcohol does not enter the vial. Signup and view all the answers

What is the correct procedure when removing a cap from a needle?

Pull it off in a straight manner. Signup and view all the answers

Why is it necessary to draw back an equal amount of air into the syringe before withdrawing medication?

To avoid the formation of a partial vacuum in the vial. Signup and view all the answers

How should the needle be inserted into a modified insulin vial?

By piercing the center of the rubber stopper. Signup and view all the answers

What is a potential consequence of not mixing a suspension medication well before administration?

It could lead to inconsistent dosing. Signup and view all the answers

What should not be done when injecting air into a modified insulin vial?

Inject air into the solution. Signup and view all the answers

What is the main goal of using an antimicrobial swab on the rubber tops of vials?

To remove potential bacteria contamination. Signup and view all the answers

What is the purpose of checking a medication order against the original order in the medical record?

To identify errors that may have occurred during transcription Signup and view all the answers

Why is it necessary to know the safe dose ranges and adverse effects of medications?

To evaluate the therapeutic effect in relation to the patient's disorder Signup and view all the answers

What is the rationale for performing hand hygiene before medication administration?

It prevents the spread of microorganisms Signup and view all the answers

Why should medications be prepared for one patient at a time?

To prevent errors in medication administration Signup and view all the answers

What does the CMAR/MAR represent in the medication administration process?

Correct Medication Administration Record/Medication Administration Record Signup and view all the answers

Why is unlocking the medication cart important during medication administration?

It allows only authorized personnel access to medications Signup and view all the answers

What is the first step in verifying medications from stock before administration?

Comparing labels with the CMAR/MAR Signup and view all the answers

What is a key reason for performing dosage calculations with a second nurse if necessary?

To validate accuracy and ensure safety Signup and view all the answers

Why is it important to check the first medication in the syringe before adding a second drug?

To ensure accuracy and avoid errors Signup and view all the answers

What is the purpose of inverting the modified vial during the medication withdrawal process?

To create positive pressure for easier withdrawal Signup and view all the answers

What should be done after drawing up the prescribed amount of medication?

Check the amount of medication in the syringe Signup and view all the answers

What safety measure should be implemented to avoid needlesticks?

Use the one-handed recap method carefully Signup and view all the answers

What does the third check of the medication label ensure?

Ensures accuracy and prevents errors Signup and view all the answers

What should be included on the labels of the vials after opening?

Date and time opened Signup and view all the answers

Why is it crucial to hold the syringe at eye level during medication withdrawal?

To ensure accurate reading of the dosage Signup and view all the answers

What should be done if the correct amount of medication is not drawn up initially?

Discard the entire syringe and start over Signup and view all the answers

Study Notes

Medication Preparation: Single vs. Multidose Vials

When preparing medication from a single-dose and a multidose vial, draw medication from the multidose vial first to prevent contamination.
Cleanse the vial tops with an antimicrobial swab before each entry.
Use a sterile needle and syringe for each entry into a multidose vial.

Mixing Medications

Always ensure medications are compatible before mixing in a single syringe.
Incompatibility may lead to cloudiness or precipitation, requiring discard and preparation in separate syringes.
Some drugs have limited compatibility and should be administered within 15 minutes of preparation.
Mixing more than two drugs in one syringe is generally not recommended. Consult a pharmacist to determine compatibility in such cases.

Insulin Administration

Insulin is commonly combined in one syringe for injection.
There are different types of insulin with varying onset and duration of action: rapid, short, intermediate, and long acting.
Ensure proper food is available before administering insulin, considering peak and duration of effects.
Not all insulins are compatible (e.g., Lantus and Levemir). Refer to drug references for specific interactions.
Insulin dosages are calculated in units. The U100 scale, based on 100 units per 1 mL of solution, is commonly used.

Delegation Considerations

Preparing medication from two vials is not delegated to nursing assistive personnel (NAP) or unlicensed assistive personnel (UAP).
Delegation to licensed practical/vocational nurses (LPN/LVNs) may vary depending on state nurse practice acts and organizational policies.
Assess the patient's needs, circumstances, and the qualifications of the delegatee before delegating.

Essential Equipment

Two vials of the medication (insulin in this example)
Sterile syringe (insulin syringe in this example)
Antimicrobial swabs
Computer-generated Medication Administration Record (CMAR) or Medication Administration Record (MAR)

Nursing Assessment

Verify medication compatibility. Not all insulins can be mixed together.
Assess the vial contents. Unmodified insulin appears clear and should be free of particles. Modified insulin is typically a suspension.
Check for expiration dates.
Assess the appropriateness of the medication for the patient and review relevant data.
Verify patient name, dose, route, and time of administration.

Nursing Diagnoses

Risk for Infection
Deficient Knowledge
Risk for Injury

Outcome Identification and Planning

Ensure sterile withdrawal of medication into the syringe.
Accurate preparation of the prescribed dose.

Implementation Actions

Gather equipment, comparing the medication order with the original order.
Know the medication's actions, nursing considerations, safe dose ranges, purpose of administration, and adverse effects.
Perform hand hygiene.
Prepare medications for one patient at a time.
Read and select medications from the CMAR/MAR.
Compare labels with the CMAR/MAR, checking expiration dates and performing dosage calculations.
Cleanse rubber tops with antimicrobial swabs, allowing them to dry.
Remove the needle cap by pulling straight off, touching only the plunger knob.
Inject an amount of air into the syringe equal to the dose of medication.
Hold the modified insulin vial on a flat surface. Pierce the rubber stopper with the needle and inject air above the solution.
Withdraw the prescribed amount of medication, ensuring accuracy, while holding the syringe at eye level.
Recap the needle using the one-handed method.
Check the amount of medication in the syringe against the prescribed dose.
Perform a third label check prior to administration, according to facility policy.
Label vials with the opening date and time, storing remaining medication for future use.

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Description

This quiz covers essential practices in medication preparation, focusing on the differences between single-dose and multidose vials, as well as guidelines for mixing medications. It also includes critical information regarding insulin administration, including types and compatibility. Test your knowledge on safe practices in preparing and administering medications.