Parenteral Drug Administration Quiz

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Questions and Answers

Which of the following steps is NOT part of the preparation for using a syringe?

  • Discard the needle and syringe before using them (correct)
  • Compare the name and concentration of the drug
  • Collect all required materials
  • Wash your hands

What does the Luer lock fitting on a syringe allow?

  • A quick release of the needle
  • Easy measurement of fluid volume
  • A secure connection between the syringe and needle (correct)
  • Automatic disposal of the needle

What does the gauge code of a needle signify?

  • The length of the needle in millimeters
  • The color of the needle wrapper
  • The type of injection fluid used
  • The width of the needle's lumen (correct)

Which of the following substances is NOT typically found in vials or ampules?

<p>Cotton pads (D)</p> Signup and view all the answers

What should you do immediately after using a needle and syringe?

<p>Dispose of them in a special container (D)</p> Signup and view all the answers

Which part of the syringe has the calibration marks?

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

What is the recommended needle size for sucking up fluid as mentioned?

<p>0.8 x 40 mm (C)</p> Signup and view all the answers

Which characteristic is crucial in preventing infections during injections?

<p>Maintaining an aseptic procedure (B)</p> Signup and view all the answers

What is the primary goal of a safe approach during parenteral administration?

<p>To minimize the risk of infection for the patient. (D)</p> Signup and view all the answers

Which type of injection is administered into muscle tissue?

<p>Intramuscular (i.m.) (C)</p> Signup and view all the answers

What is a key factor that determines the choice of injection method?

<p>Absorption rate of the drug. (C)</p> Signup and view all the answers

Which action is NOT part of preparing a syringe for drug administration?

<p>Dispensing the drug to an unsterilized surface. (D)</p> Signup and view all the answers

What must be done with the needle after use?

<p>Deposit it in a sharps container. (A)</p> Signup and view all the answers

Which of the following best defines parenteral drug administration?

<p>Any non-oral means of administering medication. (B)</p> Signup and view all the answers

What is the appropriate location for subcutaneous injections?

<p>Connective tissue between skin and muscles. (A)</p> Signup and view all the answers

Which of the following is NOT a type of injection mentioned?

<p>Intradermal (i.d.) (D)</p> Signup and view all the answers

What factors determine the appropriate length of an injection needle?

<p>The patient's age and condition (A), The thickness of subcutaneous tissue (B), The thickness of the muscle (C)</p> Signup and view all the answers

What should be done before administering the injection?

<p>Wait until the disinfectant has dried (D)</p> Signup and view all the answers

What is the first step in taking fluid from a vial?

<p>Disinfect the rubber stopper. (A)</p> Signup and view all the answers

How should the needle be inserted into the tissue?

<p>With a swift motion at a 90-degree angle (A)</p> Signup and view all the answers

Why is it necessary to suck up an amount of fluid plus 10%?

<p>To accommodate fluid loss during transfer. (B)</p> Signup and view all the answers

What indicates that the needle has hit a vein during the injection process?

<p>Fluid in the syringe is mixed with blood (B)</p> Signup and view all the answers

What should you do with the needle before injecting air into the vial?

<p>Remove the protective cap. (A)</p> Signup and view all the answers

What should you do if you experience severe pain upon needle insertion?

<p>Immediately remove the needle (D)</p> Signup and view all the answers

What protective measure should be taken when breaking a vial?

<p>Position the vial between cotton pads. (C)</p> Signup and view all the answers

What actions should be taken after injecting the fluid into the muscle?

<p>Massage the tissue gently after removing the needle (A)</p> Signup and view all the answers

Which action is crucial after sucking air from a syringe?

<p>Check if air bubbles have moved to the hub. (D)</p> Signup and view all the answers

What is the correct position of the fingers while holding the syringe before the injection?

<p>The little finger beside the needle for stability (B)</p> Signup and view all the answers

How should you position the syringe to remove air bubbles effectively?

<p>Vertically, with the needle pointing upwards. (B)</p> Signup and view all the answers

What is the purpose of using a dry cotton pad before and after the injection?

<p>To prevent blood from oozing at the injection site (A)</p> Signup and view all the answers

What should you do before attaching a new, sterile needle to the syringe?

<p>Remove air from the syringe. (B)</p> Signup and view all the answers

What is the purpose of replacing the protective cap on the needle after expelling air?

<p>To maintain sterility. (B)</p> Signup and view all the answers

What should be done immediately if discolouration of the injection fluid with blood is observed?

<p>Stop the injection and replace the syringe (A)</p> Signup and view all the answers

What is the main indication for administering a subcutaneous injection?

<p>To ensure prolonged release of medication (D)</p> Signup and view all the answers

What technique is employed to limit leakage of injection fluid into subcutaneous tissue?

<p>Z-tract technique (B)</p> Signup and view all the answers

Which of the following sites is NOT suitable for subcutaneous injections?

<p>Over a major joint (D)</p> Signup and view all the answers

What is the generally recommended length of a needle for subcutaneous injections in adults?

<p>25 mm (A)</p> Signup and view all the answers

At what angle should the needle be inserted into the skin fold for a subcutaneous injection?

<p>30 degrees (A)</p> Signup and view all the answers

What action should be taken immediately after disinfecting the skin before an injection?

<p>Wait until the disinfectant has dried (C)</p> Signup and view all the answers

Why is it necessary to palpate the subcutaneous tissue before performing an injection?

<p>To assess the thickness of the tissues (C)</p> Signup and view all the answers

What is the primary aim of an intramuscular (IM) injection?

<p>To ensure the fluid reaches the bloodstream via diffusion. (D)</p> Signup and view all the answers

Which situation is NOT an indication for an intramuscular drug administration?

<p>Patient undergoing a minor surgical procedure. (A)</p> Signup and view all the answers

What is a contraindication for administering an intramuscular injection?

<p>Bleeding tendency. (C)</p> Signup and view all the answers

How should the needle be positioned when inserting for an intramuscular injection?

<p>Perpendicular to the skin towards the femur. (D)</p> Signup and view all the answers

What must be done to the syringe before performing an intramuscular injection?

<p>Remove air and surplus fluid from the lumen. (D)</p> Signup and view all the answers

Where should the injection site be identified on the musculus gluteus maximus?

<p>Upper outer quadrant of the buttock. (C)</p> Signup and view all the answers

What should be done if there is a drop hanging from the needle tip before injection?

<p>Shake off the drop if necessary. (C)</p> Signup and view all the answers

Which of the following is a recommended step before giving an intramuscular injection?

<p>Ask the patient to lie on their back. (A)</p> Signup and view all the answers

Flashcards

Parenteral Drug Administration

Any method of administering medication that bypasses the digestive system, typically involving injection directly into the body.

Injection

The process of delivering a liquid substance into the body using a needle and syringe.

Intracutaneous (IC) Injection

Injection into the skin, used for allergy testing and small-volume medications.

Subcutaneous (SC) Injection

Injection into the subcutaneous tissue, a layer of fat and connective tissue under the skin, often used for insulin and vaccines.

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Intramuscular (IM) Injection

Injection into a muscle, used for larger volumes of medication and faster absorption.

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Intravenous (IV) Injection

Injection directly into a vein, allowing immediate and complete absorption of medication.

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Indication

The reason for choosing a specific injection method, based on the medication's properties and patient needs.

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Absorption Rate

How quickly the medication is absorbed into the bloodstream, depending on injection route and medication properties.

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Syringe

A medical device used to inject fluids into the body. Consists of a cylinder with calibrations, a plunger (for pushing the fluid), and a hub to connect the needle.

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Injection Needle

A hollow, sharp instrument attached to a syringe for injecting fluids. It has a cannula with a lumen and a conus for connecting to the syringe.

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Gauge (G)

The measurement of the inner diameter of an injection needle. Smaller gauge numbers indicate larger needle diameters.

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Ampule

Glass containers holding a single dose of medication. They are broken open to access the solution.

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Vial

Glass containers holding multiple doses of medication. A rubber stopper is sealed with a metal cap.

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Aseptic Technique

A method to ensure a sterile environment when preparing injections, minimizing the risk of infection.

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Drug Verification

The process of matching the correct medication to the patient and verifying the dosage.

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Sharps Container

A designated disposal container for used syringes and needles, ensuring safe and hygienic disposal.

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Why disinfect a vial's rubber stopper?

Disinfecting the top of a vial before drawing medication helps prevent contamination and infection.

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Why inject air into a vial?

When drawing medication from a vial, it's crucial to inject air into the vial to create equal pressure. This allows you to easily draw the desired volume of medication.

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Why suck up air before drawing liquid from a vial?

Drawing air into the syringe before adding the medication helps to accurately measure the dosage and prevents air bubbles from forming.

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Why keep the needle tip below the fluid level?

Always keep the needle tip below the fluid level to avoid drawing air into the syringe. This ensures you're only getting the medication, not air.

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Why break the neck of an ampule?

Breaking the ampule's neck correctly allows for easy access to the medication while minimizing the risk of glass shards.

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Why use cotton pads around an ampule?

Placing cotton pads around the ampule protects your fingers from sharp glass fragments when breaking it.

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Why remove air bubbles from a syringe?

Expelling air bubbles from the syringe ensures a clean injection and prevents medication from being wasted.

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Why replace the protective cap on the needle?

Replacing the protective cap prevents accidental needle sticks and ensures sterility until the injection is ready.

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What is an Intramuscular (IM) injection?

Administering medication directly into a muscle, allowing the drug to enter the bloodstream and have a systemic effect.

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When is an IM injection indicated?

Intramuscular injections are preferred when oral administration is not possible or desirable, such as for unconscious patients, those who can't swallow, or those with gastrointestinal issues.

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What are contraindications for an IM injection?

Conditions that increase the risk of bleeding or circulation problems, as well as muscles with degenerative changes or inflammation.

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Where is the injection site for the gluteus maximus muscle?

The upper outer quadrant of the gluteus maximus muscle, located between two imaginary lines drawn on the hip.

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What is the injection site for the quadriceps muscle?

The point between the thumbs, at the level of the trochanter and patella line, when the patient's leg is slightly flexed.

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How should the needle be inserted during an IM injection?

The needle should be inserted perpendicular to the skin, in the direction of the femur, ensuring proper drug delivery.

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What is the importance of removing air and excess fluid from the syringe?

Removing air and excess fluid from the syringe before injection, ensuring clean delivery and accurate dosage.

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Why is it important to check the drug details before injecting?

Checking the drug name, concentration, and dosage before injection, ensuring proper medication is administered.

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What is an Injection?

The process of delivering a liquid substance into the body using a needle and syringe.

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What determines the length of the needle used for an injection?

The length of the needle used for an injection should be determined by the thickness of the muscle and subcutaneous tissue, as well as the patient's age and condition.

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What is palpation in the context of injections?

Gently feeling the area where the injection will be given to determine the thickness of the tissue layers and to check for any abnormalities.

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At what angle should a needle be inserted into the muscle for an injection?

The needle should be inserted into the muscle at a 90-degree angle to ensure the medication reaches the target area and minimizes discomfort.

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Why is it important to aspirate after inserting the needle for an injection?

After inserting the needle, gently pull back on the plunger to check if the needle has entered a vein. If blood is present, the needle should be removed and the injection process restarted.

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How should the medication be injected into the muscle?

The medication should be injected slowly into the muscle, typically at a rate of 1 ml every 4-5 seconds, to minimize discomfort and distribute the medication evenly.

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What is the purpose of applying pressure after removing the needle?

Immediately after removing the needle, apply pressure to the injection site with a dry cotton pad to help control bleeding and reduce bruising.

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Why is documentation important after giving an injection?

It's important to document the time, medication, dose, and your name in the patient's file after administering an injection.

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What's the reason to stop an IM injection if blood mixes with the injection fluid?

The most common reason for stopping an intramuscular injection immediately: it means the needle has pierced a blood vessel.

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What is the "Z-tract" technique?

A technique used for intramuscular injections, where the needle is inserted at an angle, creating a zigzag path to prevent leakage and potential tissue damage.

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What is a subcutaneous injection?

Administering medication directly into the subcutaneous tissue, allowing for gradual absorption and sustained effects.

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What is the primary indication for subcutaneous injections?

The most common reason for using a subcutaneous injection: insulin requires slow absorption for proper blood glucose control.

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What's a suitable site for SC injections?

An example of a suitable site for subcutaneous injections: the outer part of the upper arm, free from major nerves and blood vessels.

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What step is essential before giving a subcutaneous injection?

Important step in subcutaneous injections: disinfecting the skin with an antiseptic solution before injecting.

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How do you prepare the skin for a subcutaneous injection?

A key step in the process of subcutaneous injections: forming a skin fold with the thumb and index finger to secure the injection site.

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What's the optimal angle for inserting a needle for a subcutaneous injection?

The correct angle for inserting the needle during a subcutaneous injection: inserted at a 30-degree angle to avoid hitting underlying structures.

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Study Notes

Safe Approaches of Parenteral Administration (Injection - I)

  • Parenteral drug administration involves injecting drugs directly into the body, bypassing skin and mucous membranes. This is a non-oral method.
  • Injection is a way to administer liquid using a needle and syringe. This method is used in various tissues in daily practice.
  • The objectives of the training are to raise awareness of safe procedures (patient, doctor, environment)
  • To gain sufficient knowledge of different injection types and sites
  • To be able to select correct materials for subcutaneous, intracutaneous/intradermal, and intramuscular injections

Objectives of the Training

  • Increase awareness of safe injection practices for all involved (patients, medical staff, and the environment).
  • Cover different types of injections and their corresponding injection sites
  • Learn how to choose proper materials for administering various types of injections (intracutaneous/intradermal, subcutaneous, and intramuscular).

Safe and Aseptic Manner Procedures

  • Properly connect and disconnect syringe and needle
  • Remove and replace needle caps as needed
  • Open ampoules/vials and draw fluid
  • Correctly prepare a syringe for drug administration (remove air, connect needle, measure correct amount)
  • Administer subcutaneous and intramuscular injections on a model
  • Dispose of needles in sharps containers.

Introduction

  • Parenteral administration is typically a non-oral injection method.
  • Common injection sites include skin (intracutaneous), subcutaneous tissue, muscle tissue (intramuscular), and veins (intravenous).

Important Points of Attention for All Injection Methods

  • Always verify the correct patient.
  • Maintain aseptic technique to prevent infection.
  • Dispose of used needles and syringes in appropriate containers after use.
  • Factors determining the choice of administration method include indication, absorption rate, amount of fluid, and fluid characteristics.

Syringes

  • Composed of a cylinder with calibration marks, a plunger, and a hub for the needle attachment.
  • Some syringes have a Luer lock fitting which allows for the screw-on attachment of the needle.

Anatomy of a Syringe

  • A syringe's key parts are the plunger tip (used to push fluid), the volume markings (measuring the fluid amount), the barrel (the syringe's main body), and the flange(the part connected to the plunger).

Types of Syringes

  • Different syringe types for different purposes include regular, Luer lock, eccentric, catheter, and Toomey.
  • Syringes that have permanently attached needles are also available.

Needles

  • Divided into needle cannula, lumen, and conus.
  • Standardized by their dimensions (e.g., 0.8 x 40 mm) or gauge (e.g., 14G to 27G).
  • Some brands use color-coded needles for easier size identification.

Needle Gauges

  • Needle gauge sizes range from 14 to 27.
  • Gauge size is directly related to outer diameter (with smaller gauges having wider lumens).

Injection Fluids

  • Typically packaged in vials or ampoules.
  • Examples of packaged injection fluids are lidocaine, ProZinc, and others.

Other Required Materials

  • Materials used in addition to syringes, needles and fluids: alcohol swabs, cotton, bandages, sterile trays, and medical waste containers.

Preparing a Syringe

  • Essential materials: syringe, needle (0.8 x 40 mm, 18G typically), disinfectant, cotton pads, kidney bowl or vial, injection fluid and a file (if needed).

Method (Step by step)

  • Preparation: Wash hands, gather materials, verify drug amount, and carefully remove packaging for needle and syringe.
  • Only touch protective caps and syringe parts.

2A. Taking Fluid from Vials

  • Clean the rubber stopper around the vial.
  • Remove the protective cap of the needle
  • Draw up the required dose of air into the syringe.

2B. Taking Fluid from Ampoules

  • Break the ampule safely.
  • Secure the ampule with cotton pads for safety.
  • Draw up the amount of fluid required from the ampoule (including buffer).

3. Removing Air from a Syringe

  • Hold the syringe vertically, needle upwards.
  • Check for and remove air bubbles.
  • Slowly push the plunger until air is expelled.

Angles for Inserting Injections

  • Specific angles are used for different injections (Intramuscular - 90°, Subcutaneous - 45°, Intravenous - 25°, Intradermal - 10-15°).

Intramuscular (IM) Injection

  • Administered into muscles to achieve systemic effect
  • Indications include unconsciousness, inability to swallow, and gastrointestinal issues.
  • Contraindications include bleeding disorders, problematic/damaged muscles, and inflammatory reactions

Injection Sites

  • Specific regions for intramuscular and subcutaneous injections. The gluteus muscle and quadriceps femoris are typical sites.

Injection Needle Length

  • The length of the needle depends on muscle/subcutaneous tissue thickness and patient factors (condition, age).

Procedure (Step-by-step Instructions)

  • Detailed steps for administering different types of injections (intramuscular, subcutaneous, etc.) including site selection, material preparation, and disposal.

Complications

  • Potential issues include severe pain (nerve involvement), discoloration with blood (vessel entry), and fluid leakage

Z-tract technique

  • A technique used to prevent medication from seeping into subcutaneous tissue during intramuscular injections.
  • The Z-tract technique is used to limit leakage at the injection site.

Subcutaneous (SC) Injection

  • Administered into subcutaneous tissue for gradual absorption into the bloodstream.
  • Suitable injection sites are the upper arms, fronts of thighs, buttock areas, and the abdomen—areas with minimal blood vessels.
  • A shorter needle with a smaller gauge is often used for subcutaneous injections

Subcutaneous Injection Sites

  • Injection sites: upper outer arms, abdomen, buttocks, and upper outer thighs are commonly used.

Procedure for Subcutaneous Injection

  • Detailed steps for subcutaneous injections, from preparation to cleaning/disposal.

References

  • Standard therapeutic skills injections handbook (MU)
  • SIM booklet.

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