Transcript Chapter 10
Chapter 10 Preparing and Administering Medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 1 Learning Objectives Outline procedures for giving medications parenterally and percutaneously List processes to prevent transmission of human immunodeficiency virus (HIV) and other blood-borne pathogens Outline procedures for giving medications parenterally and percutaneously Identify anatomy landmarks used for giving parenteral medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 2 Parenteral Administration “Into the skin” Routes for administration Parenteral rationale/Advantages Disadvantages Costs Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 3 Standard Precautions Protect health care workers Centers for Disease Control (CDC) Sharps container for disposal of needles Never recap a used needle!!!! Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 4 Basic Equipment Syringes Types of syringes: Figure 10-3 Volume of medication: mL Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 5 Practice Each person safely remove the syringe from the paper wrapper. Note the tip of the syringe. Note the barrel. Maneuver the plunger using only the end of the plunger. Never touch the part of the plunger that will go into the barrel. Note size of syringe, measurement increments and type of tip. Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 6 Needles Needles: gauge Hub Specialized needles Guide for needle selection: Table 10-1 Needleless system: Figure 10-6 Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 7 Memory Tool • The lower the gauge, the higher (bigger) the diameter. Diameter Gauge Practice • The needle hub attaches to the plunger tip. • Ensure the needle is secure before you attempt to remove the needle cover. • Note the angle of the needle bevel. • Think: How should the needle enter the skin? Question 1 The Z-track method is used to give medicines: Select all that apply 1. 2. 3. 4. 5. Orally. Rectally. That should be absorbed slowly. That are irritating to the skin. That may stain the skin. Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 11 Procedure for Preparing and Administering Parenteral Medications Procedure for medication administration: Procedure 10-3 Determine site for administration Use of equipment Package Medication characteristics Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 12 Forms of Parenteral Medications Vials Ampulae Ampules Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 13 Mix-o-vial Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 14 Multidose vial Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 15 Forms of Parenteral Medications (cont.) Combining drugs in one syringe Mixing insulin Prefilled syringes IV solutions Secondary or “piggyback” Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 16 Administering Intradermal Injections Uses Skin anatomy and needle angle Bleb Equipment and technique Do not massage Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 17 0.01 to 0.1 mL intradermal Administering Subcutaneous Medications 2 mL into the loose connective tissue Slow onset, longer duration Placement Sites Technique Do not massage Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 19 Administering Intramuscular Medications Location Absorption Equipment Sites Technique Do not massage Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 20 Practice • Put on your clean gloves. • Practice darting the needle into the injection pod. • Do NOT ever let go of the syringe! • “The hand that darts doesn’t let go!” Mrs. M. • Practice placing the injection in the proper site and injecting fluid to the site. • Use a dry sterile gauze on the site with pressure after removing the needle Assess the needle length and angle Giving insulin • Rotate the sites. • Mixing: ensure the insulins are compatible • NPH: Regular then Regular: NPH • Air in NPH (cloudy), Air in Regular (clear), turn over bottle, Draw up Regular (clear) then Draw up NPH (cloudy)