Ch 64
Safety syringe
-a safety syringe has a sheath that is pulls down after drawing meds and again after administering meds, the safety part locks when the sheath is pulled out and twists, another safety syringe is a sheath that is pushed by the index finger to push over the needle after injection is finished-if needle stick happens the staff member and client involved are tested for infections
what are methods of injections?
-common are : intradermal, subcutaneous (SubQ), intramuscular (IM), and intravenous (IV) - other methods- intracardiac/medullary/osseous/peritoneal
Describe different types of syringes and parts of a syringe. State the intended use of each type of syringe.
-safety syringes- has a plastic sheath that will pull down to protect the needle after drawing up medications, used for drawing blood-needleless syringes- allows meds to be drawn up and injections made into IV tubing without a needle, used for saline flushes
what are parts of a syringe?
-tip- is the portion of the syringe attached to the needle or needless adapter- barrel- clearly marked with a measurement scale, meds are drawn up in the barrel section- plunger- the inner portion that fits inside the barrel, is pulled out to create a vacuum to withdraw medication
What important considerations should the nurse keep in mind when using the Z track method to inject medication? Select all that apply.
A- select a muscle that will ensure deep muscle penetration, D- insert the needle, aspirate, and inject the med, F- pull the skin at the injection site to one side
How are all needles, syringes, ampules, and glass vials disposed?
A- sharps container
Which part of a syringe is attached to the needle or needleless adaptor?
A- tip
A nurse must collect blood from a client via venipuncture. Which device will the nurse use to collect the sample?
A- vacutainer system
what is a z track?
recommended for meds that may irritate the skin and other body functions, meds are injected deeply into the muscle tissue, z method aids prevention of the meds leaking back onto the skin and is used only in the gluteal muscle, - injection given by pulling the skin site to one side, giving the injection, keep the skin taut, pull needle out and allow skin to return to normal place slowly
A nurse is caring for several clients receiving fluids through central venous catheters. For which client could a Broviac-tunneled central venous catheter be used?
B) A client who needs a saline infusion
A nurse injecting a client diagnosed with HIV/AIDS is accidentally stuck with the needle. What action is included in the protocol when this type of incident occurs?
B) An incident report must be filed immediately.
The nurse is teaching a student nurse how to draw medications into a syringe. In what part of the syringe would the medications be drawn?
B) Barrel
What is a recommended guideline when caring for the client receiving IV therapy?
B) Be sure to replace IV bags before they are totally empty.
A nurse is caring for a client diagnosed with pancreatic disease. The client is receiving total parenteral nutrition (TPN) to help maintain adequate levels of carbohydrates, proteins, fats, vitamins, minerals, water, and electrolytes. Which measure should the nurse follow when providing TPN?
B) Check the client's vital signs for evidence of developing infection.
The nurse is preparing a syringe using medication from a vial. Which guideline is recommended for this procedure?
B) Draw an amount of air into the syringe equal to medication needed.
The nurse is explaining to the student nurse the purposes of IV administration. Which descriptions of this procedure are accurate? Select all that apply.
B) In tandem infusion, the smaller bag is connected at the same level as the primary bag.D) Medications are absorbed more rapidly via the IV route than any other route. E) Large quantities of a solution may be given IV by way of an infusion.
The nurse is preparing to administer an IV infusion to a client. Which step is recommended in this procedure?
B) Invert the bag and spike it with the IV tubing.
A client is ordered heparin following open heart surgery. What method would the nurse use to administer this medication?
B) Subcutaneous
What guidelines should the nurse follow when performing an allergy skin test?
B) Withdraw the needle at the same angle at which it was inserted.
The nurse is preparing to inject a subq injection. What gauge needle would the nurse obtain in order to administer the med.
B- 25- G
The nurse performs a tuberculin skin test on a client. How will the nurse document this injection?
B- intramuscular
A nurse caring for a client is required to inject a medication subq. What important measures should the nurse take when drawing up this medication from an ampule?
B- snap off the ampules neck away from the
The nurse is ordered to infuse 1,000 mL of normal saline in 8 hours. What would the nurse calculate to be the number of drops to be delivered per minute?
C) 125
The nurse is giving an IM corticosteroid injection to a client with rheumatoid arthritis. What type of syringe and needle would the nurse use for this injection?
C) 2- to 3-mL syringe with 1- to 11/2-in needle
Which client would be the best candidate for the insertion of a peripherally placed catheter?
C) A client who is receiving fluids postoperatively
A client diagnosed with pneumonia has been prescribed an antibiotic that is to be administered rapidly. The client is also at risk for fluid overload. Which IV device would most likely be used for this client?
C) IV bolus
18. A nurse is administering medication to a client using an intravenous (IV) infusion. What considerations should be kept in mind when using infusion pumps?
C) Infusion pumps automatically regulate the rate and amount of IV fluid.
The nurse is administering an iron medication to a client via the Z-track method. Which guidelines/steps are recommended for this procedure? Select all that apply.
C) Insert the needle, aspirate, and inject the medication.E) Do not massage the injection site. F) Allow the skin to return to its original position slowly, while removing the needle.
What device consists of an IV catheter in a vein and left in place, either for intermittent administration of med or to provide an open line in case of an emergency?
C- saline lock
An adult client been prescribed an intravenous infusion of 0.9% normal saline with 1000 mg of the bronchodilator aminophylline. Which measures must the nurse perform when caring for a client receiving IV infusion therapy?
C- stop the infusion if redness or swelling is observed at the site
The nurse receives report from the prior shift indicating the client is receiving a blood product via the IV route. The nurse would document this as what type of procedure>
C- transfusion
what is intramuscular injection?
(IM)- given in the muscle in the side or back hip, upper arm, side or front thigh, meds are given here to get into the body systems more rapidly bc of the rich blood vessels in these areas
what are parts of a needle?
- hub/ hilt- attaches to the top of the syringe- shaft- elongated portion-bevel- the area containing the hole (bore), can be long or regular, - gauge- the needles inner diameter to give meds through
The nurse is choosing the gauge and length of a needle for a subcutaneous injection of vitamin B12 for a client who has pernicious anemia. Which type of needles would be the best choice?
A) 25-G, 3/8 in
The nurse is performing venipuncture on a client to obtain blood for ordered tests. Which guideline is recommended for this procedure?
A) Apply the tourniquet about 4 to 6 in above the proposed site.
The nurse is administering a tuberculin test (PPD skin test) to a client. What method of injection should the nurse use for this type of testing?
A) Intradermal
The nurse who is monitoring an IV site for a client receiving normal saline watches out for the signs and symptoms of infiltration. Which is a sign of this adverse condition?
A) Swelling
The nurse is administering an injectable medication for a client who is unconscious and unable to swallow oral medications. What are other reasons that injectable medications may be ordered? Select all that apply.
A) The medication is more effective by injection.C) The medication is not available by any other route. D) The client must obtain the entire dose.F) The client is nauseated or vomiting.
A nurse at a rehabilitation center is required to administer medications to clients via enteral and parenteral routes. Which should the nurse be aware of with reference to enteral and parenteral administration?
D) Among parenteral injections, intravenous medications are most rapidly absorbed.
The nurse is converting a client's continuous IV infusion to a saline lock. Which guideline is recommended for this procedure?
D) Flush the lock with 2 to 3 mL of saline every 8 hours or as ordered.
Which medication would not be delivered via patient-controlled analgesia (PCA) or portable pump?
D) Vancomycin
A nurse is administering an IM injection of diphtheria-tetanus with pertussis (DTaP) to a 4-month-old infant. What would be the appropriate site for this injection?
D) Vastus lateralis
A nurse is preparing to administer medication is packaged in an ampule. What should the nurse do with the unused portion of the medication?
Discard any unused portion of the lidocaine in the ampule.
Which guideline is recommended to prevent needlestick injuries when injecting clients?
If a safety syringe is not available, the needle can be injected into a special cap, the Point-Loc device, which locks the tip of the needle in place.
The nurse is withdrawing medication from a new multiuse vial. After use, what action does the nurse perform? Select all that apply.
a. Label the vial with the time opened. b. Label the vial with the nurse's initials. d. Label the vial with the date first used.
The nurse is preparing to administer a medication via the subcutaneous route that requires 1.5 mL of medication. What is the priority action by the nurse?
b. Divide the dose and use 2 sites.
The nurse is administering an immunization to an 18-month-old child. What site does the nurse use to administer this injection?
c. Vastus lateralis
what is subq injection?
can be injected into the upper arm where bone and blood vessels are not near skin surface, these meds are ones that require slow, systemic absorption, common meds are: insulin, heparin, allergy injections, some pain meds
The nurse is preparing to administer an intradermal tuberculin skin test. What type of needle should the nurse place on the syringe?
d. 25 G with a ⅜ in bevel
When preparing to administer an intramuscular injection into the dorsogluteal area, what instructions should the nurse give to the client?
d. Lie on your side and bend the knees.
what are places to give IM injections?
deltoid, vastus lateralis, dorsogluteal, rectus femoris
