8-1 © 2012 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8Equipment for Dosage...

8-1

© 2012 The McGraw-Hill Companies, Inc. All rights reserved.

Chapter 8 Equipment for Dosage Measurement

PowerPoint® Presentation to accompany:

Math and Dosage Calculations for Healthcare Professionals

Fourth Edition

Booth, Whaley, Sienkiewicz, and Palmunen

8-2


Learning Outcomes

8-1 Recognize medication dosage volumes in different enteral equipment.

8-2 Recognize medication dosage volumes in different parenteral equipment.

8-3


Key Terms Ampule

Calibrated spoons

Calibrations

Cartridges

Eccentric

Enteral

Hypodermic syringes

Jejunostomy tube

Leading ring

8-4


Key Terms Meniscus

Nasogastric

Parenteral

PEG tube

Trailing ring

Transdermal

Vial

8-5


Introduction

To prepare the correct dosage, it is important to be familiar with and use equipment properly.

8-6


Enteral Administration

Measuring devices are calibrated at varying intervals. Calibrations – measure the amount of liquid

in the container

Should match physician’s order units

8-7


Enteral Administration (cont.)

Equipment

Medicine cups

Droppers

Calibrated spoons

Oral syringes

8-8


Enteral Administration (cont)

Medicine cups may show measurements from all three systems.

Metric Household Apothecary

A meniscus is a curve in the surface of the liquid.

Measure quantity at the bottom of the curve.

8-9


Oral Administration (cont.)

Rule 8-1Rule 8-1

Do not use medicine cups for doses less than 5 mL.

To ensure accuracy use a dropper; calibrated spoon; or oral syringe.

8-10


Droppers

Droppers measure and administer small amounts of liquid medication. They deliver medication to the eyes, ears,

and nose. They are used for oral pediatric doses.

Units of measurement vary with dropper.

8-11


Calibrated Spoons

Used with pediatric and elderly patients

Administer medication directly into the mouth or into a food or beverage

8-12


Patient Education

Instructions for proper use Medicine cup

Locate appropriate calibration.

Place cup on flat surface while pouring liquid medicine.

Check measurement with cup at eye level.

Make measurement at lowest level of meniscus.

8-13


Patient Education (cont.)

Instructions for proper use Dropper

Measure proper amount before

delivery.

Hold dropper vertically.

Count slowly and allow drops to

fully form.

8-14


Patient Education (cont.)

Instructions for proper use Calibrated spoons

are for medications measured by teaspoons, tablespoons, or milliliters;

should not be replaced with household spoons.

Check medication for expiration date and changes in clarity, color,or consistency.

8-15


Oral Syringes

Used for quantities less than 5 mL

Safety features Eccentric tips Tips of different shape

or size Tinted

Not sterile

8-16


Oral Syringes

Rule 8–2 Rule 8–2 1. Never attach a needle to an oral syringe.

2. Never inject an oral dose.

3. In emergencies, you may use a hypodermic syringe without a needle to measure and administer liquid oral doses.

8-17


Other Equipment for Enteral Medications

When a patient cannot take medication orally, medications can be administered through a tube.

Types of tubes Nasogastric tube Nasal-small bowel tube PEG tube Jejunostomy tube

8-18


Error Alert! Utensil used must provide the

calibration needed to accurately measure the dose.

ExampleExample

Which would you select to administer ½ tsp of a liquid medication?

8-19


Practice

True or False

1. A hypodermic syringe with a needle can be used to measure liquid for oral administration.

2. Oral and hypodermic syringes are identical in appearance.

3. Measuring spoons used for baking are acceptable for measuring liquid medications.

False

False

True

8-20


Practice

4. Oral medication comes in a bottle labeled 200 mg/5 mL. The dose to be administered is 600 mg. Which of the following is the correct dose?

a) 1 tspb) 2 tspc) 1 tbspd) 2 tbsp

= 15 mL

8-21


Parenteral Medication Administration Devices

Parenteral administration Topical and transdermal medications

Inhalers

Sublingual medications

Injections

8-22


Parenteral Medication Administration Devices (cont.)

Administer medications by injection Intravenous (IV)

Intramuscular (IM)

Intradermal (ID)

Subcutaneous (Subcut)

8-23


Standard Syringes Calibrated in milliliters (mL)

Allow for measurement of small doses

Are usually 3-mL

8-24


Standard Syringes (cont.)

Zero calibration – edge of barrel near needle

Leading ring - tip of plunger closest to needle

Trailing ring – ring farthest from needle

Click to view syringe

8-25


Hypodermic Syringe

Plunger

Needle

Barrel

Trailing Ring Leading Ring

Syringe hub

Needlestick prevention safety device

8-26


Safety Syringes

Have same components as standard syringes

Include a safety mechanism

Reduce the chance of needlestick injury

8-27


Prefilled Syringes Prefilled syringes contain a single,

standard dose of medication.

When using a prefilled syringe, measure

the dose carefully.

Discard any excess medication in a

prefilled syringe prior to injection.

8-28


Prefilled Syringes

Rule 8-3Rule 8-3When using a prefilled syringe, 1. examine the markings to determine

whether the syringe is calibrated in milliliters or milligrams;

2. calculate the dose accordingly.

8-29


Insulin Syringes

Insulin syringes are used only to measure and administer insulin. U-100 insulin most common form

They are calibrated in units.

U-100 insulin syringes are available in 50 and 100 unit capacities.

8-30


Insulin Syringes (cont.)

100 Unit Insulin Syringe

50 Unit Insulin Syringe

8-31



50 unitsyringe

100 unitsyringe

Comparison of insulin syringes:

8-32


Rule 8-4Rule 8-4Never use any type of syringe other than an insulin syringe to measure and administer insulin.


8-33


Tuberculin Syringes

Uses Subcutaneous

injections Intradermal

injections Doses less than 1

mL

Examples: PPD skin test Vaccines Heparin Pediatric

medicines Allergen extracts

8-34


Tuberculin Syringes (cont.)

Calibrated in hundredths of a mL

Require careful measurement Calibrations are close together. Carefully align leading ring with correct

calibration.

8-35



1 mL Tuberculin Syringe

0.5 mL Tuberculin Syringe

8-36



Comparison of tuberculin syringes:

0.5 mL syringe

1 mL syringe

8-37


Syringes for Established IV Lines

Used to administer medication and fluids directly into a patient’s vein

Use the injection port of an IV line

8-38


Syringes for Established IV Lines

Advantages eliminate repeated punctures decrease risk of needlestick injuries allow compatible drugs to be administered

together enable periodic drug delivery enable dilution of the medication

8-39


Large-Capacity Syringes

Syringes with 5 mL, 6 mL, 12 mL Volume is measured in milliliters but

calibrations may vary.

Look carefully at the marks to measure an accurate amount of medication.

8-40


Large-Capacity Syringes (cont.)

10 mL syringe

8-41


Error Alert!

Pay close attention to the calibration of any syringe you use.

Check the marks carefully.

Always align the leading ring with the calibration.

8-42


Ampules, Vials, and Cartridges

Cartridge Vial

Ampule

8-43


Cartridges Prefilled container shaped like a syringe

barrel

One dose of medication

Fits a reusable syringe

Examples Tubex®

Carpuject®

8-44


Ampule

An ampule is a sealed container holding one dose of medication.

It snaps open.

Use a standard syringe to withdraw the medication.

8-45


Vials

Container covered with a rubber stopper

Contains one or more doses of medication

May contain either liquid or powder medication

8-46


Preparing the Syringe

Rule 8-5Rule 8-5 In most circumstances, the person who prepares a syringe for injection should deliver the injection.

8-47


Preparing the Syringe

Rule 8-5 Rule 8-5 Exceptions include:1. pharmacy technicians who pre-fill

syringes;

2. nurses or medical assistants preparing a syringe for a physician;

3. healthcare workers teaching a patient to administer his or her own medication.

8-48


Needle Gauge and Length Choose appropriate needle for injection.

Gauge The gauge is the interior diameter.

Smaller gauges correspond to larger diameters.

Length is determined by the injection site.

8-49


Needle Gauge and Length (cont.)

Type of Injection Needle GaugeAvailable Lengths

(inches)

Intradermal 25 – 26

Subcutaneous 23 – 27

Intramuscular 18 – 23

85

83

43

21

21

85 1

8-50


Practice

Plunger

Needle

Barrel


D.

E. F.

A. B.

G.

C.

8-51


Practice

Syringe hub

Plunger

Needle

Barrel


D.

E. F.

A. B.

C.

Needlestick prevention safety device

G.

8-52


Practice

You have an order to administer 1.5 mL of a medication. It comes in a 3 mL prefilled syringe. What should you do?

ANSWER: Carefully check the calibration and discard the excess medication prior to giving the injection. In this case, you would discard 1.5 mL medication. You should NEVER attempt to inject the correct dose without removing the excess medication first.

8-53


In Summary

In this chapter you learned about

enteral medication administration devices.

8-54


In Summary (cont.)

parenteral medication administration devices.

8-55


Apply Your Knowledge

Which type of delivery device is used to administer medication to the eyes and ears?

ANSWER: Dropper

What kind of syringe is used to deliver vaccinations?

ANSWER: Tuberculin

8-56


Apply your Knowledge

How many mL are indicated on this syringe?

ANSWER: 1.6 mL

8-57


End of Chapter 8

Nothing will work unless you do.

~Maya Angelou

8-1 © 2012 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8Equipment for Dosage...

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Transcript of 8-1 © 2012 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8Equipment for Dosage...