fundamentals of nursing- Parenteral adm.pptx

lecture about how to perform SC, IM, ID

1. Parenteral Medications

2. Parenteral came from the word PAR meaning “beyond”, ENTRAL meaning “INTESTINAL” Parenteral medications  enter the body by injection through the tissue and circulatory system. Injection medications are absorbed more quickly and are used with patients who are nauseated, vomiting, restricted from taking oral fluids, or unable to swallow. Parenteral medications can be effective and safe when prepared and administered correctly. However, because they are invasive and absorbed readily and quickly into the body, there are numerous risks associated with administering them (Perry et al., 2014). Advantages: Bioavailability is faster and more predictable Gastric irritation and vomiting are avoided Parenteral routes could be used in unconscious, uncooperative and vomiting patient Disadvantages: It is generally more risky The preparation must be sterile The technique is intensive and painful Bioavailability- the extent a substance or drug becomes completely available to its intended biological destination

3. vial ampoule -is a small cylindrical container made of glass for holding liquid Medication -vial contains multiple doses -is a sealed vial that contains or stores a sample, usually liquid or solid

4. A  syringe  (see Figure 7.7)is a sterile, single-use device that has a Luer lock (see Figure 7.8) or non- Luer lock tip, which influences the name of the syringe. Syringes come in various sizes from 0.5 ml to 60 ml. Syringes may come with or without a sterile needle and will have a safety shield on the needle.

5. Insulin is only given using an insulin syringe (see Figure 7.9). Insulin is ordered in units. It is important to use the correct syringe and needle for the specific injection. Always examine the measurement scale on the syringe to determine that you have the correct syringe (Lynn, 2011). Needles  are made of stainless steel, are sterile and disposable, and come in various lengths and sizes. The needle is made up of the hub, shaft, and bevel. The bevel is the tip of the needle that is slanted to create a slit into the skin. The hub fits onto the tip of the syringe. All three parts must remain sterile at all times. The length of the needle will vary from 1/8 in. to 3 in., depending on the injection. The  gauge of a needle  is the diameter of the needle. Gauges can vary from very small diameter (25 to 29 gauge) to large diameter (18 to 22 gauge). A needle will have its gauge and length marked on the outer packaging; choose the correct gauge and length for the injection ordered (Lynn, 2011) (see Figures 7.10, 7.11, and 7.12).

6. There are four routes for parenteral medications Subcutaneous (SC):  This injection places medication/solution the loose connective tissue just under the dermis. Intradermal (ID):  This injection places the medication into the dermis just under the epidermis. Intramuscular (IM):  This injection places the medication into the body of a muscle. Intravenous (IV):  This injection places the medication/solution into a vein through an existing IV line or a short venous access device (saline lock). Medications given by the intravenous route can be given as an IV bolus, as an intermittent (piggyback) medication, or in a large volume continuous infusion.

7. Placed in the loose connective tissue under the dermis Optimum sites include vascular areas Outer aspect of the upper arms Peri-umbilical area of the abdomen Anterior aspect of the thighs Only suitable for small volumes (0.5- 1ml) of water soluble medications Use a 25G (orange) needle inserted at 90° degrees to the skin Pinch up a fold of skin Depress plunger slowly and wait for 6 seconds then withdraw needle Subcutaneous Injection (SC/ SQ)

8. Most often used for PPD Site: the inner aspect of the forearm Needle size is 25-27 gauge. ½ to 5/8 in Insert needle at 15° angle Injection made just below the outer layer of the skin If injection does not form a wheal or if bleeding is noted, the injection was probably too deep and should be repeated Intradermal Injection Procedure: Inject the solution intradermally and just enough to form a wheal Remove the needle quickly but gently at the same angle used for injection Wipe the site correctly and write the time when to check the injection site to determine reaction to the drug. Check the site after 30 minutes

9. Deltoid muscle is located in the arm and is the site most commonly used for vaccines. However, its small muscles mass limits the volume of medication that can be injected (typically no more than 1 ml) Vastus Lateralis is a muscle in the thigh and is used when other sites are not available of if the medication is to be self administered. Ventro -gluteal muscle is the safest site for adults and children over seven months; this muscle in the hip is deep and not close to any major blood vessels or nerve. Dorsogluteal muscle – is located in the buttocks. Recently, there are considered no advantages to using this site with greater emphasis placed on using the ventrogluteal site instead for deep IM injections due to slower absorption rate using this as well as risk to sciatic nerve injury