Professional Documents
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Parenteral Medication
Parenteral Medication
College of Nursing,
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Subcutaneous
Intramuscular and IV injections.
Types of Injections
Intradermal Injection: Injected into the dermis, chiefly used for diagnostic purposes e.g. Skin test for sensitivity Subcutaneous (hypodermic) injection: into fatty tissues. Intramuscular Injection: Injected between the layers of muscles. This route is used when rapid action is required or when a drug would irritate upper layers of tissues.
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Barrel:
It may be touched anywhere outside except the tip but one should not touch anywhere to the piston except the flat surface at the top called flange. There is a marking over the outside of the barrel. The usual sizes of the syringes are 2cc, 2.5cc, 5cc, 10cc, 20cc, 50cc (rarely used), etc.
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Syringes (Conti.)
Tuberculin syringes have a small slender holding 1 ml. An insulin syringe has a same size and shape of a tuberculin syringe, but with marking in the units specially made for insulin.
Syringes (Conti.)
Needle:
The hub (hilt) fits on the rip of the syringe. The hub of the needle can be touched when preparing to give an injection.
The shaft is long and slender. It has a flat surface diagonally across the end called the bevel, which is very sharp for piercing the skin. The opening inside the shaft is called lumen.
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Syringes (Conti.)
Sizes:
The gauge of the needle is selected according to the viscosity of the medication to be given. Water preparations are given 10 with 22 25 gauge needles.
Syringes (Conti.)
Length: Vary from 0.6 - 5.0 cm.
The length of the needle is selected according to the site of the injection and the size of the patients.
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2. Vial
3. Prefilled cartridges
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Ampoule:
An ampoule is a glass flask that contains a single dose of medication for parenteral administration. If all medications are not used, the remainder must be discarded. Medication can be removed from an ampoule by breaking its thin neck
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Vial:
A glass bottle with a self-sealing stopper through which medication is removed. The rubber stopper that exposed is the means of entrance into the vial, to facilitate the removal of medication, the nurse should inject air into the vial. The amount of the air is the same as desired quantity of solution.
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Prefilled cartridges
Before giving the injection, the nurse should check the dosage in the cartridge and clears the cartridge of excess air. Most Prefilled cartridges are over filled and the nurse should eject any excess medications to give an exact dose and avoid medication errors.
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Purposes (Conti..)
To get the rapid and systemic effect of the drugs. Some medications are not given by mouth. Some drugs are rendered ineffective in the GI tract by the action of gastric juice (insulin) . Some drugs are not retained in the intestines for sufficient periods for its absorption due to diarrhea, vomiting, or gastric suction.
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Purposes (Conti..)
Some drugs are poorly absorbed from GI tract and some drugs are toxic and irritating to the gastric mucosa. To give required effects when the patient is unconscious, unable to swallow due to surgical or neurological problems or when the patient is not cooperative.
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Purposes (Conti..)
To get local effects at the site of injection:
For diagnostic purposes (tuberculin test) For local anesthesia (xylocaine) For allergy test (penicillin test) and For treating local condition (hydrocortisone injection into joint cavity).
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Purposes (Conti..)
To restore blood volume and electrolyte balance by replacing fluids e.g. shock.
To give nourishment when it can not be taken by mouth.
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Equipment needed
Two vials of insulin Cardex
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Procedure
Gather equipment. Wash your hands. If necessary, remove the metal cap that protects the rubber stopper in the vial. If insulin is a suspension, rotate the vial between your palms to mix before withdrawal. Cleanse the rubber tops with alcohol swabs.
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Procedure (Conti..)
Remove cap from needle. Inject air into the modified insulin preparation (e.g. NPH insulin). Use an amount of air equal to the amount of medication to be withdrawn in the vial. Remove the needle.
Inject air into the clear insulin without additional protein (regular insulin). Use an amount of air equal to the amount of medication to be withdrawn in the vial. Do not bubble the air through the medication.
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Procedure (Conti..)
Invert the vial of clean insulin and aspirate the amount prescribed. Remove the needle from the vial. Clear the rubber top of the modified insulin vial. Insert the needle into the vial, invert it and withdraw the medication. Cap the needle.
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Reconstitution (Conti..)
Many drugs are supplied as powers in vials.
A liquid or diluents must be added to the powder before it is administered as a solution. The technique of adding diluents to a powdered drug is called reconstitution. The nurse must know the amount and types of diluents to be added to the powders. 33
Reconstitution (Conti..)
Common dilutes are water for injection and normal saline.
After the diluents are added to the solution, the nurse reads the label further to determine the concentration of the drug per millimeter of solution. This is essential to the dose computation.
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Reconstitution (Conti..)
If all the medication is not given at the time of reconstitution, the nurse refers to the vial label for storage instruction. Additional source of information about reconstitution of medication are package inserts and the pharmacists.
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