N221 Module 6 Exam

IM routes

-Vastus lateralis, Ventrogluteal, Deltoid -90 degrees

The nurse is preparing the following order for administration: Morphine sulfate 7 mg and hydroxyzine hydrochloride (Vistaril) 25 mg IM postoperatively. The Morphine sulfate label states 1 mL=10 mg. The Vistaril label states 1 mL=50 mg. The nurse obtains the MAR, clean gloves, alcohol swabs, a 1 mL syringe, and a 1.5 inch 22 gauge needle. The nurse wipes the top of both vials with an alcohol swab, inserts the needle, injects the air into each vial, and withdraws the medication from the first vial. The nurse keeps the needle in the vial and taps on the syringe to remove any air bubbles. While the vial is inverted the nurse's finger touches the needle shaft. The nurse withdraws the needle from the vial and inserts it into the second vial and withdraws the correct amount of medication. The nurse uses the one-handed scoop method to recap the needle and labels the syringe before going to the patient's room. The nurse uses two patient identifiers to identify the correct patient. The nurse locates the ventrogluteal site, using the nurse's left hand on the patient's right hip. The nurse cleans a 2-inch circle and quickly inserts the needle at a 90-degree angle. The nurse injects the medication slowly, waits 10 seconds and removes the needle. Which of the following actions made by the nurse require correction? (Select all that apply.)

-The equipment obtained. -Touching the needle shaft. -Method of administering the injection.

Subcutaneous insulin

Medication administration record Unopened an alcohol swab 50- or 100-unit syringe 25- to 27-gauge needle Disposable gloves Medication vial 3/8 to 5/8 inch needle

The nurse is working with a NAP who she knows has helped care for her diabetic mother. The nurse is busy with the admission of a new patient. What can the nurse delegate to the NAP?

Reporting if the patient is exhibiting signs of hypoglycemia.

Which of the following is a correct sequence for the description of medication preparation (assume that an alcohol swab is being used when appropriate)?

The correct sequence is - draw up air and inject it into the modified insulin vial, draw up air and inject it into the regular insulin vial, draw up regular insulin, and draw up modified insulin. The modified insulin could contaminate the regular insulin so always draw up from the regular vial first. The vial should be rolled between your hands; shaking will create foam or bubbles and inaccuracy in dosage. Also, air bubbles should be expelled into the vial's airspace, the correct dose obtained, and then the needle should be removed from the vial once the ordered dose is obtained. Air is injected only into vials.

Subcutaneous routes

-Anterior thigh, Outer posterior arm, Abdomen, Upper back -45-90 degrees

Which of the following are correct statements you need to remember for safely administering an IM injection?

-Check the patient's name band and ask the patient to tell you his or her name. -Check the patient's allergies. -Wear clean gloves when administering the medication.

Intradermal routes

-Inner forearm -5-15 degrees

Intradermally from ampule

Medication administration record Filter needle 4 Small gauze pad and unopened an alcohol swab/Medication ampule Disposable gloves 1-mL syringe 26- to 27-gauge needle 3/8 inch needle

Intramuscularly, requiring reconstitution

Medication administration record Needle for withdrawing Unopened an alcohol swab Diluent 1- to 3-mL syringe Disposable gloves Medication vial 21- to 25-gauge needle 1-1.5 inch needle