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NUR 112 TEST 3
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
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
2 mins
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
2 mins
Intradermal Medication Administration
SKIN TESTING
Tuberculin Screening
Allergy Testing
INTRADERMAL SITES
Dermis
Inner Forearm or Upper Back
INTRADERMAL Injection
1mL Syringe (26 or 27 Gauge Needle)
5 to 15 Degrees
Small Bleb
2 mins
Ear Drops Medication Administration
Indications
Earwax Buildup
Ear Infections
Pulling The Pinna
Child - Back and Downward
Adult - Back and Upward
Procedure
Side-Lying with Ear Up
Instill Medication
Stay for 2-3 Minutes
Nursing Considerations
Room Temperature
May Massage Tragus
Perforated Eardrum
2 mins
Eye Medication Administration
Procedure
Supine with Neck Hyperextended
Wash Away Crusts
Cotton Ball on Cheekbone
For Ophthalmic Drops
Instill Drops into Conjunctival Sac
Repeat if Missed or Patient Blinks
5 Minutes Before 2nd Medication
For Ophthalmic Ointment
Thin Stream Along Inner Edge
Inner Canthus to Outer Canthus
2 mins
Mixing NPH and Regular Insulin for Injection
Verify Order
Roll NPH Insulin
Alcohol to Multiuse Vials
Inject Air into NPH Insulin (Cloudy)
Inject Air into Regular Insulin (Clear)
Withdraw Regular Insulin Units
Withdraw NPH Units
Verify with 2nd Nurse
Discard if Error
3 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
1 min
Parenteral Medications
Intravenous (IV)
Fast-Acting
Greatest Risk
Intramuscular (IM)
Common Injections Sites: Deltoid, Vastus Lateralis, Ventrogluteal, and Dorsogluteal Muscles
Absorbed Fast
Vaccines and Epinephrine
3 mL Limit
Subcutaneous (SC)
Common Injections Sites: Abdomen, Arm, and Thigh
Absorbed Slower
Insulin and Hormones
Small Volumes
Intradermal (ID)
Common Injection Sites: Back of Forearm and Upper Back
Longest to Absorb
Tuberculosis and Allergy Testing
Under 0.5 mL
5 mins
Insulin
Rapid Acting
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)
Short Acting
Regular Insulin (Humulin R)
Intermediate Acting
Isophane NPH (Humulin N)
Long Acting
Detemir (Levemir)
Glargine (Lantus)
2 mins
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
2 mins
Peak and Trough
Peak
Highest Concentration
Trough
Lowest Level of Therapeutic Range
Obtain Before Next Dose
Half-Life
2 mins
Urinary Excretory Anatomy
Characteristics
Renal Medulla
Renal Cortex
Nephron
Bowman's Capsule
Glomerulus
Proximal Tubule
Loop of Henle
Distal Tubule
Collecting Duct
Ureter
Urinary Bladder
Urethra
2 mins
pH - Blood and Urine Lab Value
Blood
7.35 - 7.45
Urine
4.0 - 8.0
1 min
Urine Specific Gravity Lab Value
1.003-1.030
1 min
Pyelogram
Indications
Visualizes Urinary Tract
Diagnose Urinary Disorders
Considerations
Bowel Prep (Enema)
IV Contrast Media
X-Ray (Radiopaque)
Increase Fluid Intake
Contraindications
Iodine Allergy
Decreased Renal Function
2 mins
Urinary Tract Infection Symptoms
More Common in Elderly
Most Common in Females and Babies
Change in LOC
Dehydration
Fever
Urgency
Urethral Infection
Burning
Smelly Urine
Dark Cloudy Urine
Frequency of Urination
2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
2 mins
Renal Calculi Assessment
Cause/Mechanism
Hypercalcemia (Most Commonly)
Signs and Symptoms
Flank Pain
Radiates Toward Bladder
Renal Colic
Urinary Tract Infection
Urinary Retention
Hematuria
Considerations
Stone Recurrence
2 mins
Renal Calculi Interventions
Interventions
Increase Fluid Intake
Opioids
NSAIDs
Antibiotics
Lithotripsy
Surgical Stone Removal
Considerations
Identify Type CT-KUB
Low Sodium Diet
2 mins
Chronic Kidney Disease Early Symptoms Assessment
Characteristics
GFR < 60mL/min
Accumulation of Waste Products
Clinical Features
General Malaise
Hypertension
Proteinuria
Hyperkalemia
Mineral and Bone Disorders
Neuropathy
2 mins
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