Med math week 4

• Medications are given parenterally when they cannot be taken by mouth or when rapid action is required.
• Parenteral refers to outside the alimentary canal or GI tract
• Parental medications are absorbed directly into the bloodstream
• Parenteral is adminsitered for the uncooperative patient or unconcious as well as NPO
• Advantage of IV medications is the patient does not need to endure multiple injections
• Parenteral medications are administered by subcutaneous injection, intramuscular injection, or intradermal injection
• Nurses must use sterile technique when administering Parenteral medications
• Drugs for Parenteral use are supplied as liquids or powders
• Liquids are contained in ampules
• An ampule is a single-dose container that must be broken at the neck to withdraw the drug
• A vial is a glass or plastic container that is sealed with a rubber stopper
• A mix-o-vial or Act-O-Vial works by pushing the top down. This allows for the powder to drop into the liquid for mixing

  
• Medications can be supplied in prefilled Syringes
• A syringe must be used for accurate measurement of medications to be administered by the Parenteral route
• The tip of the syringe holds the needle
• The barrel of the syringe holds the medication
• The plunger is used to withdraw and measure the medication, then it is pushed forward to inject the medication into the patient.
• There are three types of syringes: hypodermic, tuberculin and insulin
• The most commonly used syringe sizes are 2, 2.5, 3 and 5mL
• Longer lines on a syringe mark the half and whole number milliliters
• Shorter lines on a syringe mark the decimal fractions. Each line indicates one tenth of a milliliter
• Tuberculin syringes are used in pediatrics and to measure medications given in very small amounts
• Tuberculin syringes are thin 1mL syringes which include markings on the side for hundredths of a milliliter
• OSHA recommends administration of Parenteral medications with a needleless system
• A needleless system provides a shield that protects the needle device and are only used for IV’s
• Always use a leading zero for dosages less than a whole number
• Do not use a trailing zero after a whole number. Ex: 4 mL NOT 4.0 mL
• Parenteral dosages may be diluted and administered alone, in conjunction with existing IV fluids, or in addition to IV fluids
• Subcutaneous injection

  
• The nurse must choose correct needle size, location of injection and read the label for the strength/concentration
• Solutions, powders and suspensions are all liquid medications used for injections
• A 3mL syringe is used when measuring 1mL or greater
• needle size is determined by type of medication, depth of tissue, volume of medication, viscosity (thickness, stickiness) and size of the patient
• 25-27 gauge, 5/8” is used for subcutaneous needles
• 25 gauge needle inserted at 45 degrees is used for IM on children or smaller person
• 25,27 or 29 gauge needle 1/2” length is used for intradermal. Insert at 15 degrees
• IM injections use a 21-23 gauge 1-1.5” length inserted at 90 degrees
• IV therapy uses an 18-24 gauge needle
• Blood transfusion uses an 18 gauge needle
• The higher the gauge number the thinner and finer the needle