Chapter 10 Preparing and Administering Medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 1.

Chapter 10

Preparing and Administering Medications

Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 1

Learning Objectives Outline procedures for giving medications

parenterally and percutaneously List processes to prevent transmission of

human immunodeficiency virus (HIV) and other blood-borne pathogens

Outline procedures for giving medications parenterally and percutaneously

Identify anatomy landmarks used for giving parenteral medications

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Parenteral Administration

“Into the skin” Routes for administration Parenteral rationale/Advantages Disadvantages Costs

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Standard Precautions

Protect health care workers Centers for Disease Control (CDC) Sharps container for disposal of needles Never recap a used needle!!!!

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Basic Equipment

Syringes Types of syringes: Figure 10-3 Volume of medication: mL

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Practice

Each person safely remove the syringe from the paper wrapper.

Note the tip of the syringe. Note the barrel. Maneuver the plunger using only the end of

the plunger. Never touch the part of the plunger that will go into the barrel.

Note size of syringe, measurement increments and type of tip.

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Needles Needles: gauge Hub Specialized needles Guide for needle selection: Table 10-1 Needleless system: Figure 10-6

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Memory Tool

• The lower the gauge, the higher (bigger) the diameter.

Diameter

Gauge

Practice

• The needle hub attaches to the plunger tip.• Ensure the needle is secure before you

attempt to remove the needle cover.• Note the angle of the needle bevel. • Think: How should the needle enter the skin?

Question 1

The Z-track method is used to give medicines: Select all that apply

1. Orally.2. Rectally.3. That should be absorbed slowly.4. That are irritating to the skin.5. That may stain the skin.

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Procedure for Preparing and Administering Parenteral Medications

Procedure for medication administration: Procedure 10-3

Determine site for administration Use of equipment Package Medication characteristics

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Forms of Parenteral Medications

Vials

Ampules

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Ampulae

Mix-o-vial

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Multidose vial

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Forms of Parenteral Medications (cont.)

Combining drugs in one syringe Mixing insulin Prefilled syringes IV solutions Secondary or “piggyback”

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Administering Intradermal Injections

Uses Skin anatomy and needle angle Bleb Equipment and technique

Do not massage

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0.01 to 0.1 mL intradermal

Administering Subcutaneous Medications

2 mL into the loose connective tissue Slow onset, longer duration Placement Sites Technique

Do not massage

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Administering Intramuscular Medications

Location Absorption Equipment Sites Technique

Do not massage

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Practice • Put on your clean gloves.• Practice darting the needle into the injection

pod. • Do NOT ever let go of the syringe!• “The hand that darts doesn’t let go!” Mrs. M.• Practice placing the injection in the proper site

and injecting fluid to the site. • Use a dry sterile gauze on the site with

pressure after removing the needle

Assess the needle length and angle

Giving insulin• Rotate the sites.• Mixing: ensure the insulins are compatible• NPH: Regular then Regular: NPH• Air in NPH (cloudy), Air in Regular (clear), turn over bottle,Draw up Regular (clear) thenDraw up NPH (cloudy)