Parenteral Administration
-
Upload
alexa-abidin -
Category
Health & Medicine
-
view
1.341 -
download
14
description
Transcript of Parenteral Administration
![Page 1: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/1.jpg)
ALEXA C. ABIDIN, RN,MN
PARENTERAL ADMINISTRATION
![Page 2: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/2.jpg)
Is injection an
invasive
procedure?
![Page 3: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/3.jpg)
![Page 4: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/4.jpg)
![Page 5: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/5.jpg)
![Page 6: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/6.jpg)
Assessment Injection siteDrug allergiesPatient condition – be alert to changes that can affect drug therapy
Consent forms
![Page 7: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/7.jpg)
Parenteral Medications are given through a route other than the alimentary canal; these routes are:
Intradermal (ID) Subcutaneous (SC or SQ) Intramuscular (IM) Intravenous ( IV)
Parenteral Administration
![Page 8: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/8.jpg)
Needles Available in different gauges – the
smaller the number, the larger the gauge (inside diameter)
Length – long enough to penetrate the appropriate layers of tissue
Syringes Barrel Plunger With or without needle Calibrated in milliliters or units
EQUIPMENT
![Page 9: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/9.jpg)
NeedlesA needle has three parts, the hub, the shaft, and the bevel.
![Page 10: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/10.jpg)
The hub is at one end of the needle and is the part that attaches to the syringe.
The shaft is the long slender stem of the needle that is beveled at one end to form a point. bevel- is the slanted part at the tip of the shaft
The hollow bore of the needle shaft is known as the lumen.
![Page 11: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/11.jpg)
The length of a needle is measured in inches from the juncture of the hub and the shaft to the tip of the point. Needle lengths range from 3/8 inch to 3 1/2 inches; some special use needles are even longer.
The gauge of a needle, used to designate the size of the lumen, ranges from 27 (the finest) to 13 (the largest).
Needle Size-is designated by LENGTH AND GAUGE
![Page 12: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/12.jpg)
The smaller the number, the larger the gauge (inside diameter).
![Page 13: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/13.jpg)
![Page 14: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/14.jpg)
![Page 15: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/15.jpg)
![Page 16: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/16.jpg)
Tip-which connects the needle Barrel-outside part, which contains
measurement calibrations Plunger-which fits the inside the barrel and
has a rubber tipTHE NURSE MUST ENSURE THAT THE
SYRINGE TIP, INSIDE OF THE BARREL, SHAFT & RUBBER PLUNGER TIP & SHAFT OF THE NEEDLE ARE KEPT STERILE.
SYRINGES
![Page 17: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/17.jpg)
Parts of a Syringe
![Page 18: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/18.jpg)
Standard- comes in 3ml,5 and 10ml
Insulin-designed specially for use with the ordered dose of insulin
Tuberculin-narrow syringe, use to administer small or precise doses such as pediatric dosages.
Should be used for doses of 0.5ml or less
TYPES OF SYRINGES
![Page 19: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/19.jpg)
![Page 20: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/20.jpg)
![Page 21: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/21.jpg)
PRE-FILLED SINGLE-DOSE SYRINGES
![Page 22: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/22.jpg)
Ampule – glass or plastic container that is sealed and sterile (open with care)
Vial – small bottle with rubber diaphragm that can be punctured by needle
Parenteral Drug Packaging
![Page 23: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/23.jpg)
![Page 24: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/24.jpg)
![Page 25: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/25.jpg)
![Page 26: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/26.jpg)
![Page 27: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/27.jpg)
Rules for administration Give only drugs the doctor orders – use drug reference, if necessary Wash your hands
Prepare in a well-lit area Focus on task; avoid distractions
Calculate the dose carefully Do not leave a prepared drug unattended – never give a drug that someone else has prepared
Preparing to Administer a Drug (cont.)
![Page 28: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/28.jpg)
Rules for administration Identify patient properly Physician should be in the office Observe patient following administration Discard any ungiven medications properly Report error to physician immediately Document properly
Preparing to Administer a Drug (cont.)
![Page 29: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/29.jpg)
Parenteral preparations must be sterile free of microorganisms
To ensure sterility, parenterals are prepared using aseptic techniques special clothing (gowns, masks, hair net,
gloves) laminar flow hoods placed in special rooms
Parenteral Dose Forms
![Page 30: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/30.jpg)
Seven Rights of Drug Administration 1. Right patient2. Right drug3. Right dose4. Right time5. Right route6. Right technique7. Right documentation
Preparing to Administer a Drug (cont.)
![Page 31: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/31.jpg)
![Page 32: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/32.jpg)
Apply Your Knowledge
How do you properly identify the patient before administering a drug?
ANSWER: To ensure that you have the right patient, you should check the name and date of birth on the patient record and ask the patient to state his/her name and date of birth.
![Page 33: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/33.jpg)
Techniques for Administering Drugs (cont.)
Methods of injection Intradermal
Into upper layer of skin Used for skin tests
Subcutaneous Provides slow,
sustained release and longer duration of action
Rotate sites
Intramuscular More rapid absorption Less irritation of tissue Larger amount of drug Z-track method
Intravenous Not usually given by
medical assistants
![Page 34: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/34.jpg)
-to diagnose TB, identify allergens, administer local anesthetics
-drugs are absorb slowly from this site -commonly used for ID injection are the INNER ASPECT OF THE FOREARM (upper chest and upper back beneath the scapula)
-drug’s dosage contained in a small quantity of solution (0.01 to 0.1 ml)
Intradermal or Intracutaneous
![Page 35: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/35.jpg)
![Page 36: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/36.jpg)
Given into capillary-rich layer just below epidermis for local anesthesia diagnostic tests immunizations
Intradermal Injections
![Page 37: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/37.jpg)
Examples of ID injections include skin test for tuberculosis (TB) or fungal
infections typical site is the upper forearm, below the area
where IV injections are given allergy skin testing
small amounts of various allergens are administered to detect allergies
usually on the back
Intradermal Injections
![Page 38: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/38.jpg)
![Page 39: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/39.jpg)
![Page 40: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/40.jpg)
Given at a 45-degree angle 25- or 26-gauge needle,
3/8 to 5/8 inch length No more then 1.5 mL
should be injected into the site to avoid pressure on
sensory nerves causing pain and discomfort
Subcutaneous Injections
![Page 41: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/41.jpg)
Administer medications below the skin into the subcutaneous fat outside of the upper arm top of the thigh lower portion of each side of the abdomen not into grossly adipose, hardened, inflamed, or
swollen tissue Often have a longer onset of action and a
longer duration of action compared with IM or IV injection
Subcutaneous Injections
![Page 42: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/42.jpg)
Insulin is given using 28- to 30-gauge short needles in special syringe that measures in units
Insulin is administered following a plan for site rotation to avoid or minimize local skin reactions
Absorption may vary depending on site of administration activity level of the patient
Subcutaneous Injections
![Page 43: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/43.jpg)
Keep insulin refrigerated Check expiration dates frequently
opened vials should be discarded after one month
A vial of insulin is agitated and warmed by rolling between the hands and should never be shaken
The rubber stopper should be wiped with an alcohol wipe
Subcutaneous Injections
![Page 44: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/44.jpg)
Subcutaneous Injections
Do not shake insulin.
![Page 45: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/45.jpg)
Medications administered by this route include: epinephrine (or adrenaline)
for emergency asthmatic attacks or allergic reactions
heparin or low molecular–weight heparins to prevent blood clots
sumatriptan or Imitrex for migraines
many vaccines
Subcutaneous Injections
![Page 46: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/46.jpg)
Normally given with the syringe held at a 45-degree angle in lean older patients with less tissue and obese
patients with more tissue, the syringe should be held at more of a 90-degree angle
Correct length of needle is determined by a skin pinch in the injection area proper length is one half the thickness of the
pinch
Subcutaneous Injections
![Page 47: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/47.jpg)
When administering insulin, air is injected into vial equal to the amount of insulin to be withdrawn
Air is gently pushed from syringe with the plunger
Patient should plan meals, exercise, and insulin administration to gain the best advantage of the medication avoid chances of creating hypoglycemia
Subcutaneous Injections
![Page 48: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/48.jpg)
Typical needle is 22- to 25-gauge ½- to 1-inch needle
Intramuscular (IM) injections are administered at a 90-degree angle volume limited to less
than 3 mL
Intramuscular Injections
![Page 49: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/49.jpg)
![Page 50: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/50.jpg)
Care must be taken with deep IM injections to avoid hitting a vein, artery, or nerve
In adults, IM injections are given into upper, outer portion of the gluteus maximus large muscle on either side of the buttocks
For children and some adults, IM injections are given into the deltoid muscles of the shoulders
Intramuscular Injections
![Page 51: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/51.jpg)
Used to administer antibiotics vitamins iron vaccines
Absorption of drug by IM route is unpredictable not recommended for patients who are
unconscious or in a shocklike state
Intramuscular Injections
![Page 52: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/52.jpg)
Intramuscular Injection Promote rapid drug absorption. Provide an alternate route when drug is
irritating to subcutaneous tissue. Sites Gauge and needle length
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 30-52
Parenteral Administration
![Page 53: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/53.jpg)
![Page 54: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/54.jpg)
![Page 55: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/55.jpg)
Intravenous (IV) injections are administered at a 15- to 20-degree angle
Intravenous Injections or Infusions
![Page 56: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/56.jpg)
Intramuscular (IM) injections into a muscle
Subcutaneous injections under the skin
Intradermal (ID) injections into the skin
Parenteral Dose Forms
![Page 57: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/57.jpg)
The IV route is the fastest method for delivering systemic drugs preferred administration in an emergency situation
It can provide fluids, electrolytes, and nutrition patients who cannot take food or have serious
problems with the GI tract It provides higher concentration of drug to
bloodstream or tissues advantageous in serious bacterial infection
Advantages and Disadvantages of the Parenteral Route
![Page 58: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/58.jpg)
Traumatic injury from the insertion of needle Potential for introducing:
toxic agents microbes pyrogens
Impossible to retrieve if adverse reaction occurs injected directly into the body
Advantages and Disadvantages of the Parenteral Route
![Page 59: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/59.jpg)
Intramuscular (IM) and subcutaneous routes of administration are convenient ways to deliver medications
Compared with the IV route: onset of response of the medication is slower duration of action is much longer
Practical for use outside the hospital Used for drugs which are not active orally
Advantages and Disadvantages of the Parenteral Route
![Page 60: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/60.jpg)
For intramuscular (IM) and subcutaneous routes of administration, the injection site needs to be “prepped” using alcohol wipe
Correct syringe, needle, and technique must be used
Rotation of injection sites with long-term use prevents scarring and other skin changes can influence drug absorption
Advantages and Disadvantages of the Parenteral Route
![Page 61: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/61.jpg)
The intradermal (ID) route of administration is used for diagnostic and allergy skin testing patient may experience a severe local
reaction if allergic or has prior exposure to a testing antigen
Advantages and Disadvantages of the Parenteral Route
![Page 62: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/62.jpg)
Most parenteral preparations are made up of ingredients in a sterile-water medium the body is primarily an aqueous (water-
containing) vehicle
Parenteral preparations are usually: solutions suspensions
Dispensing and Administering Parenteral Medications
![Page 63: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/63.jpg)
IV injections and infusions are introduced directly into the bloodstream must be free of air bubbles and particulate matter introduction of air or particles might cause
embolism, blockage in a vessel, or severe painful reaction at the injection site
Dispensing and Administering Parenteral Medications
![Page 64: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/64.jpg)
Fast-acting route because the drug goes directly into the bloodstream often used in the emergency department and
in critical care areas
Commonly used for fluid and electrolyte replacement to provide necessary nutrition to the patient
who is critically ill
Intravenous Injections or Infusions
![Page 65: Parenteral Administration](https://reader035.fdocuments.in/reader035/viewer/2022081412/53f82b078d7f72fb508b4605/html5/thumbnails/65.jpg)
ANY QUESTIONS SO FAR?