INTRAVENA INJECTION

A. Giving Injection

Injecting is an invasive procedure that must be performed using sterile

techniques. After the needle penetrates the skin appears the risk of infection.

The nurse gives the drug parenterally via route SC, IM, ID, IV. Each type of

injection requires certain skills to ensure the drug reaches the right location.

Parenteral drug effects may develop rapidly, depending on the rate of

absorption of the drug. The nurse closely observes the client's response. (Potter

& Perry 2005)

B. Equipment

There are various syringes and needles available and each is designed to

deliver certain drugs to certain types of tissues. Nurses practice assessing

when determining which syringe or needle will be most effective. (Potter &

Perry 2005)

a. Spuit

It consists of a cylindrical barrel with a tip designed precisely in pairs with

a hypodermic needle and a proper plunger occupying the syringe. Spuits

are generally classified as Luer-lok or nonLuer-lok. This nomenclature is

based on the design of the tip of the syringe. The Luer-lok syringe requires

a special needle, which is twisted up to the tip of the syringe and securely

locked in place. This design prevents the needle off due to lack of caution.

NonLuer-lok Spuit requires a needle that can be directly attached to the tip

of the syringe. Most healthcare institutions use disposable plastic syringes

 that are inexpensive and easily manipulated. Spuits are wrapped separately

with or without a sterile needle in a paper wrap or a rigid plastic container.

The nurse fills the syringe with aspiration, pulling the sucker out while the

needle tip remains submerged in the solution provided. The nurse may

hold the exterior of the syringe body and the suction handle. To maintain

sterility, the nurse avoids non-sterile objects touching the tip of the syringe

or the inside of a tube, hub, sucker or needle. Spuit consists of various

sizes, from 0.5 to 60 ml. It is not unusual to use syringes larger than 5 ml

for SC or IM injection. Larger volumes cause discomfort. Larger sized

syringes prepared for IV medicines. Insulin syringe is 0.5 - 1 ml and

calibrated in units. A 0.5 ml insulin syringe is known as a low-dose

syringe (50 microns per 0.5 ml) and is easier to read. Tuberculin syringes

have long, thin bodies with thin needles that have been previously

installed. The syringes are calibrated in sizes of one sixteenth of minims

and one hundredth of ml and have a capacity of 1 milli. The nurse uses a

tuberculin syringe to prepare a small amount of hard drugs. Tuberculin

syringes are used to prepare small and precise doses for infants and young

children. The nurse uses a large hypodermic syringe to provide a specific

IV and adds the drug to IV solution. (Potter & Perry 2005)

b. Needle

Some needles are not installed on standard sized syringes. Most needles

are made of stainless steel and are used only once. The needle has three

parts: the hub, which is precisely attached to the tip of a syringe; A shaft,

connected to a central part; And bevel, ie the sloping edge.

 Each needle has three main characteristics: the bevel slope, the length of

the needle rod, and the size or diameter of the needle. The long bevel is

sharper so as to minimize the discomfort due to SC and IM injection. The

length of the needle varies from to 5 inches. The smaller the size of the

needle, the larger the diameter. (Potter & Perry 2005)

C. Prevent Infections During Injection

To prevent contamination of the solution, suction the drug from the

ampoule quickly. Do not leave the ampoule open.

To prevent needle contamination, prevent needles from touching

contaminated areas (eg outside ampoules or vials, outer surface of needle

cover, nurse hand, medication top, table surface)

To prevent contaminated syringes, do not touch the plunger or the inside

of the barrel. Keep the tip of the syringe covered with a cover or needle.

To prepare the skin, wash dirty skin due to dirt, drainage, or feces with

soap and water and dry. Perform sweeping and circular movements when

cleaning the wound using an antiseptic swab. Wipe from the center and

move outwards within two inches.

(Potter & Perry 2005)

D. Definition of Intravenous Injection

Inserting the drug fluid directly into the vein so that the drug directly into the

blood circulation system. Injection in blood vessels produces the fastest effect

within 18 seconds, ie the time of one blood circulation, the drug has spread
 throughout the network. However, the duration of drug work is usually only

short. This method is used to achieve proper and reliable calibration, or a very

fast and powerful effect. Not for drugs that are insoluble in water or cause

sediment with protein or blood granules.

The danger of intravenous injection is that it can interfere with blood colloid

substances with great reactions, because in this way the "foreign body" is

directly inserted into the circulation, for example sudden drop in blood

pressure and the onset of shock. This danger is greater when the injection is

done too quickly, so the local drug levels in the blood increase too rapidly.

Therefore, any intravenous injection should be performed very slowly,

between 50-70 seconds duration. (Health tips.blog spot)

E. Purpose

1. Drugging quickly

2. Accelerate drug absorption

F. Indications

1. In someone with severe illness

Intravenous administration of drugs directly into the bloodstream. For

example in cases of bacterial infections in the blood circulation (sepsis).

So it gives more advantages than giving oral medication. But often,

although intravenous antibiotics are indicated only in serious infections,

hospitals provide this type of antibiotic regardless of the degree of

infection. Oral antibiotics (mostly by mouth) in most patients treated in

hospitals with bacterial infections, as effective as intravenous antibiotics,

 and more advantageously in terms of hospital administration ease,

maintenance costs, and length of care.

2. The drug has limited oral bioavailability (effectiveness in the blood if

inserted by mouth).

Or only available in intravenous preparations (as injectable drugs). For

example, the aminoglycoside group of antibiotics whose chemical

makeup is "polications" and so polar, so it can not be absorbed through

the gastrointestinal tract (in the gut until it gets into the blood). Then it

should be inserted into the blood vessels directly.

3. Patients can not drink because of vomiting

Or it can not swallow the drug (there is a blockage in the upper

gastrointestinal tract). In such circumstances, consideration should be

given to other routes such as the rectal, sublingual (under the tongue),

subcutaneous (under the skin), and intramuscular (injected in the

muscle).

4. Awareness decreases and risks aspiration (choking - medicine goes into

the breathing), so giving through another route is considered.

5. The peak blood levels of the drug need to be achieved immediately, so

that it is given by bolus injection (direct injection to the vein). A rapid

increase in blood drug concentration is achieved. For example in people

who have severe hypoglycemia and life-threatening, in people with

diabetes mellitus. This reason is also often used for the administration

of antibiotics by injections, but keep in mind that many antibiotics have

 good oral bioavailability, and are able to attain adequate levels in the

blood to kill bacteria.

G. Contraindication

Inflammation (swelling, pain, fever) and infection at the intravenous

injection site.

The forearm area in patients with renal failure, because this location will

be used for the installation of arterial fistula (A - V shunt) in the action of

hemodaliasis (dialysis).

Drugs potentially irritant to small venous blood vessels with slow blood

flow (eg venous pembers in the legs and feet). (Somelus.wordpress)