1. Parenteral Medications Part 1 Equipment

2. What is meant by the term “Sterile”?

3. Identify the parts of a needle and syringe that must remain STERILE when preparing an injection.

4. Needle Gage Parts of a Needle

5. Sterile Parts of the Syringe

6. List three examples of how contamination can occur while preparing an injection. How can contamination be avoided?

7. How are the following syringes calibrated?

8. 3 cc or 3 ml Syringe

9. Tuberculin or TB Syringe

10. Insulin Syringe

11. Needles are sized by gage and length Which is larger? 18 gauge needle 28 gauge needle Common lengths 3/8 to 1 1/2 inches

12. Bevel- The slanted opening. Always go “bevel up” Shaft-The steel part Hub-The plastic, colored part

13. The best size is the smallest needle that will do the job! This means that the needle must be large enough to place the medication in the correct place without unnecessary trauma to the site.

14. NEVER, NEVER, NEVER recap a dirty needle! Dispose of it immediately in the sharps container You MAY recap clean needles (needles that have not entered skin) Recapping If you must recap, use the one-handed SCOOP method Lay the cap down and scoop the needle into the cap Click the lid closed using the other hand but not pushing from the top This Is Important You need to have a healthy respect for needles. It’s easy to stick yourself.

15. Describe the protocol to be followed if you stick yourself with a contaminated needle. &

16. Working with an Ampule

17. Drawing up a medication from an ampule: Move fluid to the bottom Safely open the ampule with alcohol wipe Break away from you Use a filter needle if possible Change needles and inject Demo http://irtreal.austincc.edu/ramgen/de partments/ahs/emsp/mDrwAmp.smilhttp://irtreal.austincc.edu/ramgen/de partments/ahs/emsp/mDrwAmp.smil Use alcohol instead of 4x4

18. Working with a Vial

19. Once opened, how long can a multi-dose vial be used assuming that it has not been contaminated?

20. Differentiate between the 2 expiration dates found on an opened multi-dose vial.

21. Labeling a Newly Opened Vial Date & Time Opened and Your Initials: 2/5/09 @ 0930 CM Date & Time Vial Expires - 30 Days: 3/5/09 @ 0930

22. How can a multi-dose vial be protected from contamination?

23. How much air is injected into a multi-dose vial prior to withdrawing the desired volume of liquid? http://irtreal.austincc.edu/ramgen/departmen ts/ahs/emsp/mDrwVial.smil Immediately put new needle on or cap with sterile caphttp://irtreal.austincc.edu/ramgen/departmen ts/ahs/emsp/mDrwVial.smil

24. Intramuscular Syringe? –Up to 4 ml except in deltoid. No more than 1ml in deltoid Needle? –21-23g, 1-1.5” long Angle? –90 degrees Always aspirate for blood return –You will be very close to blood vessels and nerves –If you see blood return, withdraw the needle immediately

25. Let’s give it a try! Draw up 1 ml. of saline consider.2ml for airlock Prep a site Give an injection Demo http://irtreal.austincc.edu/ramgen/de partments/ahs/emsp/mIM.smilhttp://irtreal.austincc.edu/ramgen/de partments/ahs/emsp/mIM.smil –2x2 gauze

26. Subcutaneous Syringe? –TB or insulin syringe Needle? –25-29 g 3/8-5/8” Angle? –Short needle-- 90 degrees –Long needle-- 45 degrees –Don’t aspirate with insulin and heparin Do not massage site Pinch up skin or hold taut Demo

27. Evidence based practice Research is the basis for nursing practice, The buzz word for this research or analysis is Evidenced based practice. An example is this article on how fast to inject heparin sq http://www.blackwell- synergy.com/doi/abs/10.1046/j.1365- 2648.2001.01925.x?cookieSet=1&journalCode=ja nhttp://www.blackwell- synergy.com/doi/abs/10.1046/j.1365- 2648.2001.01925.x?cookieSet=1&journalCode=ja n

28. Intradermal Syringe? –Tuberculin—Up to 1 ml Needle? –25-27g, ¼-1/2 “ long Angle? –10-15 degrees –Bevel up Make a wheal or bleb Demo

29. Dissolving a powdered Drug: Common diluents Volume selection Mixing techniques Which do you use?

30. Let’s reconstitute the Practi-Powder, prepare a dose, and actually give an injection! Practi Powder

31. Preparing a Dose Using a Powdered Medication Reconstitute with 6 ml of Bacteriostatic N/S Each ml. of reconstituted Practi-medication contains 500 mg of medication Order states administer 750 mg IM How much medication will you administer? Demo Practi - Powder