Med Admin Part 2 F24-Student PDF

SAFE INJECTIONS Parenteral Medications  Intradermal  TB tests  Subcutaneous administration  Insulin administration  Heparin  Intramuscular administration  Deltoid site  Ventral Gluteal  Vastus Lateralis sites Needles  Length  Gauge  Needleless Systems  Safet...

SAFE INJECTIONS Parenteral Medications  Intradermal  TB tests  Subcutaneous administration  Insulin administration  Heparin  Intramuscular administration  Deltoid site  Ventral Gluteal  Vastus Lateralis sites Needles  Length  Gauge  Needleless Systems  Safety Guards  Sharps Containers D. Filos RN, MSN 10/28/24 D. Filos RN, MSN 10/28/24 D. Filos RN, MSN 10/28/24 lntradermal Sub Cutaneous  DRUG SPECIFIC SYRINGES  ¼ - ½ INCH  3/8 -5/8 INCH  25G, 27G  25G – 30G  LESS THAN 0.5  1 mL Maximum Volume mL  45 – 90 degree Angle  Angle 5-15  To Pinch or Not to Pinch degrees  No Aspiration and No Massage of sites  No Aspiration  Don’t Forget to Rotate and No Massage Sites of sites D. Filos RN, MSN 10/28/24 Intradermal D. Filos RN, MSN 10/28/24 Sub Cutaneous Sites D. Filos RN, MSN 10/28/24 D. Filos RN, MSN 10/28/24 Intra-Muscular  5/8 Inch – 1.5 Inch Needle  20G – 25 G  Know Your Sites  Up to 3 mL Volumes in large muscles  Gentle pressure NOT Massage  What is the Z-track method?  Never recap used needles  No Aspiration D. Filos RN, MSN 10/28/24 Information from Dr. Linda Diggle, Immunization Nurse Specialist and internationally known expert in injection procedures & technique What is the evidence for the aspiration technique during SC and IM medication Administration D. Filos RN, MSN 10/28/24  History & Facts about Aspiration The practice of aspiration of blood during injections is a tradition that has been taught in nursing for the past 40 years The Center for Nursing History Collection (16) This precautionary technique is performed to ensure that a low flow blood vessel or artery has not been penetrated  Results: Key Summary of the Evidence There is no reported evidence that aspiration with or without blood return confirms needle placement eliminates the possibility of an intramuscular injection into a non-subcutaneous blood vessel Recommendations for Consideration  Aspiration is not indicated for SC injections  Aspiration is not indicated for IM injections of vaccines and immunizations  Aspiration may be indicated for IM injections of large molecule medications, such as penicillin Organizations which state aspiration is not necessary for immunizations & vaccines are:  Centers for Disease Control (CDC)  Advisory Committee on Immunization Practices (ACIP)  Department of Health Services (DHS)  American Academy of Family Physicians (AAFP)  U.K. Department of Health (DoH)  World Health Organization (WHO) D. Filos RN, MSN 10/28/24 D. Filos RN, MSN 10/28/24 D. Filos RN, MSN 10/28/24 Younger Nurses Are More Likely to Follow the Latest Recommendations on IM Injections AJN D. Filos RN, MSN 10/28/24 Reconstituting Medications D. Filos RN, MSN 10/28/24 What volume is needed for the dose?  The nurse has an order to administer 500 mg of Cefazolin.  The vial of medication in powder form states there are 500 mg per vial.  The powder must be reconstituted before it can be administered. The reconstitution instructions on the label state to add 2 mL of sterile water to the vial to reconstitute the powder into a liquid form for injection.  The label states that after the powder is reconstituted with the 2 mL of diluent, the concentration of fluid will be 225 mg/mL. D. Filos RN, MSN 10/28/24  A vial of Doxorubicin reads 36 mg per vial  Instructions say to reconstitute each 12mg with 2.5mL of NS. How many mL of NS will be needed to reconstitute the vial of the recommended concentration? D. Filos RN, MSN 10/28/24  Instructions on a 2.5g vial of Chlorothiazide reads to reconstitute with 20mL of sterile water. This will provide a concentration of _____ mg/mL D. Filos RN, MSN 10/28/24 Never recap, bend or break a used needle – straight to the sharps container D. Filos RN, MSN 10/28/24 Controlled Substances  Locked  Narcotic Counts  Report any Discrepancies  Record Partial Doses D. Filos RN, MSN 10/28/24 Stryker Cactus Smart Sink Medication Disposal System D. Filos RN, MSN 10/28/24 What We Need To Document  Electronic Charting  Drugs Given: Sites and parameters  Doses Missed: Explanation of why  Refused Medications  Incident Reports for Medication Errors (SHARE)  Patient Education/Teaching D. Filos RN, MSN 10/28/24 Medication Errors  Check patient’s condition immediately; observe for adverse effects.  Obtain a set of VS  Notify nurse manager and primary care provider.  Complete form used for reporting errors, as dictated by the facility policy. These forms are not mentioned in the patient chart.