Transcript What You Need to Know To Administer an Injection

Injections 101
7 Rights of medication
administration
1.
2.
3.
4.
5.
6.
7.
Right Drug
Right Dose
Right Time
Right Patient
Right Route
Right Technique
Right Documentation
Injection Sites
see pages 459, 460
Routes of Administration
View Video clip
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DVD 3 11-5
Do
Workbook page 527 E & H
 Hypodermic Syringe Calibrations
 3cc syringe
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Insulin Injection Sites
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Alternate sites include the back of the
arms, thighs, and buttocks
– Slower onset with alternate sites
Film Clip
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DVD 3 11-4
Workbook
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Questions 31-40, p 515
Preparing Syringe
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Maximum volumes
– Deltoid – No more than 0.5-1mL
– Large muscle (gluteus medius)
• Adult – no more than 4mL
• Child – no more than 1-2mL
• Vaccines:
• Vastus Lateralis in child
• Deltoid in Adult
Workbook
Page 529 K
 Reading Syringe and Needle Labels
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Preparing Needle
Choose correct needle LENGTH and
GAUGE
 Minimize tissue injury and SQ leakage
 Allow easy passage (21 vs. 25 gauge)
 Needle length depends on injection
site
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– Adults 5/8” vs. 1” vs. 1.5”
– Children 5/8” vs. 1”
– If less SQ fat, use smaller needle
Do & Check
Workbook page 528 I
 Insulin Syringe Calibrations
 U-100 syringe
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Check your vials!!!!!
Drawing medication into
Syringe (see page 462-466)
Get Organized
Get all supplies ready
 ex: Band-Aid, alcohol pad, cotton
ball
 Double Check
– Correct med, dose, & expiration
date
– Go over med with pt
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Record
– Medication name, dose, route,
time, date
– Location of administration (L/R
deltoid)
– Your signature & title
Do & Check
Workbook page 528 J
 Tb Syringe Calibrations
 1-ml Tb syringe
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Administer the injection
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Cleanse area with alcohol swab
– Allow alcohol to dry
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Target/landmarks
– C technique and shoot (IM)
– Bunch skin (SQ)
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Aspirate (IM) then inject
– smooth motion with steady pressure
Final Steps
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Do not recap needle
Sharps container
Apply pressure to injection site with
cotton ball (PRN)
Apply adhesive bandage PRN
Chart
Have pt remain for ~15 minutes
Workbook
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Key Terms Assessment page 510
1-30
Managing
Adverse Reactions
Vasovagal Syncope
(Fainting)
Be aware of pt behavior
 Have pt sit before administration
 Lay pt down if necessary
 Check airway, breathing and vital
signs
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Anaphylaxis
Rare but potentially fatal
 Occurs within 15 minutes
 Call 911
 Lay pt down, check airway, breathing,
vital signs
 Be prepared and ready to administer
epinephrine (Epipen)
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Delayed Adverse Reactions
Child – fever, fussy, crying, injection
site
 Adult – injection site discomfort
 Symptomatic relief
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– Fluids
– Pain medications
Reporting Adverse
Reactions
Incident Report
 Required for:
- Rare, serious or
unexpected
events
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Workbook
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Page 530 section M
Correct state the principle reason
why we do that…..
 Incorrect explain why………
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The Z-Track Method (page
461)
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Used with irritating meds
meds that may discolor the skin
you need to pull the skin to the side
prior to inserting the needle
Then inject the medication
release the skin,
the med will not be able to seep back
to the skin’s surface
DVD 3 11-6
Intradermal (ID) Injection
Small amount of liquid is injected within
the top layer of skin
 a small “wheal” or bubble appears on
the skin
 Do not rub
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Intradermal (ID) Injection cont.
 Common sites
– upper chest
– upper back
– anterior forearm
– DVD 3 11-7
Intradermal Skin Test
Tuberculin Skin Test
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Administered intradermally
Exposure to Tb
A small amount of TB protein (antigens) is
injected
the skin will react by developing a firm
red bump at the site within 2 days ~
Positive skin test
cannot tell if the infection is active or
inactive (latent)
Positive TB skin test
Performing a Tuberculin Skin
Test
A circle may be drawn around the test
area with a pen
 Do not cover
 redness at the skin site is expected and
the site may itch, DO NOT scratch
 pt MUST return to the office within 2 to 3
days after the test for reading
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Tuberculin Skin Test Results
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Redness alone is a negative reaction
A firm bump is a positive reaction
The size of the firm bump (not the red
area) should be measured 2 to 3 days
after the test
MA reports the findings of “positive” or
“negative”
interpreting” such test results is MD job
Measuring Mantoux Test
Reactions
Workbook Page 531
 Section N
 Measure and Chart
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Charting example see page 488 Textbook
What is Intravenous Therapy?
 involves
administering fluids and
solutions directly into the
bloodstream
 Not legal for CA MA’s