Fundamentals of Nursing: The Art and Science of Person-Centered Care, 10th Ed., Taylor, Lynn & Bartlett |  Registered Nurse (RN) School Study Aid
Parenteral Medications
- Fast-Acting
 - Greatest Risk
 - Common Injections Sites: Deltoid, Vastus Lateralis, Ventrogluteal, and Dorsogluteal Muscles
 - Absorbed Fast
 - Vaccines and Epinephrine
 - 3 mL Limit
 - Common Injections Sites: Abdomen, Arm, and Thigh
 - Absorbed Slower
 - Insulin and Hormones
 - Small Volumes
 - Common Injection Sites: Back of Forearm and Upper Back
 - Longest to Absorb
 - Tuberculosis and Allergy Testing
 - Under 0.5 mL
 
Transdermal Medication Administration
- Patch or Disc
 - Directly on Skin of Arms, Chest, Upper Back
 - Avoids First Pass Metabolism
 - Sustained Administration of Medication
 - Clean Skin After Removal
 - Rotate Sites of Patches
 - Apply to Dry Skin
 - Avoid Shaved Skin
 - Avoid Heat
 - Nitro Effects Lost After 24 Hours
 
Eye Medication Administration
- Supine with Neck Hyperextended
 - Wash Away Crusts
 - Cotton Ball on Cheekbone
 - Instill Drops into Conjunctival Sac
 - Repeat if Missed or Patient Blinks
 - 5 Minutes Before 2nd Medication
 - Thin Stream Along Inner Edge
 - Inner Canthus to Outer Canthus
 
Intradermal Medication Administration
- Tuberculin Screening
 - Allergy Testing
 - Dermis
 - Inner Forearm or Upper Back
 - 1mL Syringe (26 or 27 Gauge Needle)
 - 5 to 15 Degrees
 - Small Bleb
 
6 Rights of Medication Administration
- Right Patient
 - Right Medication
 - Right Dose
 - Right Time
 - Right Route
 - Right Documentation
 - Three Checks
 - Check for Allergies
 - Assess the Patient
 - Education
 
Intramuscular Medication (IM) Administration
- Injury to Nerves, Bone, and Blood Vessels
 - Deltoid
 - Vastus Lateralis
 - Ventrogluteal
 - Selection of Needle Length
 - Aseptic Technique for Drawing Up
 - Z-Track
 - 90 Degree Angle
 - Max Amount (2-5 mL Adult, 1 mL Child)
 - Techniques to Reduce Pain
 
Ear Drops Medication Administration
- Earwax Buildup
 - Ear Infections
 - Child - Back and Downward
 - Adult - Back and Upward
 - Side-Lying with Ear Up
 - Instill Medication
 - Stay for 2-3 Minutes
 - Room Temperature
 - May Massage Tragus
 - Perforated Eardrum
 
Enema Administration
- Tap Water/Soapsuds
 - Normal Saline
 - Hypertonic Solution
 - Medication
 - Oil Retention
 - Procedure Education
 - Wear PPE
 - Put Patient in Sims Position
 - Insert Tip
 - Start Flow Slowly
 - Stop With Discomfort
 - Potential for Vagus Response
 
Routes of Administration Part One
- Oral
 - Sublingual
 - Buccal
 - Rectal
 - Tubes
 - Transdermal
 - Drops/Spray
 - Vaginal
 - Inhalation
 
Routes of Administration Part Two (Parenteral)
- Intradermal
 - Subcutaneous
 - Intramuscular (IM)
 - Intravenous
 - Epidural
 - Intrathecal
 - Intraosseous
 - Intraperitoneal
 
IV Anesthetics
- Barbiturates
 - Benzodiazepines
 - Respiratory Depression
 - Hypotension
 - Ketamine
 - NMDA Receptor Antagonist
 - Hallucinations
 - Opioids
 - Propofol
 - Potentiates GABA-A
 
IV Solutions
- Hypotonic (< 280 mOsm/L)
 - 1/4 Normal Saline (0.225% NaCl)
 - 1/2 Normal Saline (0.45% NaCl)
 - Isotonic (280-300 mOsm)
 - Normal Saline (0.9% NaCl)
 - Lactated Ringer's (LR)
 - Dextrose 5% in Water  (D5W)
 - Hypertonic (> 300 mOsm)
 - 3% or 5% NaCl
 - Dextrose 5% in 0.45% NaCl
 - Dextrose 10% in Water  (D10W)
 
IV Calculation Formulas
- Drop Factor
 - Macrodrip
 - Microdrip
 - Total Volume to Infuse (mL) X Drop Factor/ Time in Minutes = Drops/Minute (gtt/min)
 - Total Volume to Infuse / mL per Hour Being Infused = Infusion Time
 - Total Volume in mL / Time in Hours = Number of mL per Hour
 
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
 - Subcutaneous Injections
 - 3/8 or 5/8 inch
 - Intramuscular (IM)
 - 1-1.5 inches
 
Total Parenteral Nutrition (TPN)
- Nutrition Given Outside GI
 - Hyperglycemia
 - Hyperlipidemia
 - Refeeding Syndrome
 - Nausea and Vomiting
 - Slow IV Infusion
 - Use Large Central Vein
 - No Added Meds to TPN Line