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97 Cards in this Set
- Front
- Back
IM Injections sites?
|
ventrogluteal
vastus lateralis deltoid |
|
SQ Injections Sites?
|
outer aspect of upper arms
middle 2/3rds of anterior thigh subscapula area of upper back upper dorsogluteal and ventrogluteal area andominal above the iliac crest and below diaphragm, 1.5 to 2 in from belly button |
|
ID volume that can be used
|
0.1 to 0.2 ml
|
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Volume used for SQ?
What meds are usedSQ Aspirate-Y or N Degree of angle SQ? |
Insulin, heparin, vitamins, vaccines
amounts--0.5 to 1 ml Aspirate- NO 45-90 |
|
IM volume to be injected?
|
2 to 3 ml recommended but can go up to 4ml
deltoid and triceps should only have 1 ml |
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Size of needle and syringe for ID?
|
tuberculin or 1 ml syringe
with 26 to 27 gauge, 3/8 to 5/8 needle |
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How to inject ID?
Aspirate-Y or N? |
Bevel up at a 10-15 degree angle
Aspirate-NO |
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Size of needle and syringe SQ?
|
Syringe-1-3 ml
Needle-23-25 gauge, 1/2-5/8 needle HEPRIN-3/8-25-26 gauge needle |
|
IM injection needle, gauge size
Aspirate- Y or N? Angle? |
20-23 gauge
1-1.5 in needle Aspirate-Yes 90 degree |
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6 Rights of Administration
|
Person
Time Med Dose Route Documentation |
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Define Anaphylaxis?
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acute allergic responce to an antigen that results in severe hypotension and may lead to life threatening shock if untreated
|
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How is anaphylaxis treated
|
epinephrine
|
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Sx of anaphylaxis
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anxiety, bronchoconstriction, wheezing, dyspnea, cyanosis, hives, facial edema, hypotension
|
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Where are drugs metabolized at ?
|
liver (main site) kidneys and cells of intestinal tract have high rate
|
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Name routes of administration?
|
Enteral (oral)
Topical Parenteral |
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Name Enteral routes?
|
Tablets, capsules, liquid
sublingual buccal nasogastric--gastrostomy |
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Name Topical routes?
|
Dermatologic
Instillations Irrigations Inhalations |
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Where can a topical be administered to
|
eyes, ears, nose, respiratory tract, urinary tract, vagina and rectum
|
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Name Parenteral Routes
|
intradermal, subcutanous, intramuscular and IV
|
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Name Insulins?
|
Insulin Analogs
Insulin Mixtures Short Acting Intermediate Acting Long Acting |
|
Name Insulin Rapid
|
NovoLog (aspart)
Humalog (lispro) |
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Name Insulin Mixtures
|
Humulin 70/30 NPH/Reg
Novolin 70/30 NPH/Reg 50/50 NPH/Reg |
|
Name some Reg Insulin
Short Acting |
Humulin R
Novolin R |
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Name some Intermediate Insulins
|
Humulin N
Novolin N |
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Name Long Acting insulin
|
Ultralente
Long acting Basil-Lantus (glargine) give at HS, no peak |
|
Onset, Peak, Duration of NPH
Color? |
Onset--1-4 hours
Peak--6-10 hours Duration-12-16 hours Cloudy |
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When is NPH is administered
|
30 minutes before meals
|
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Onset, Peak, Duration of Reg
Color |
Onset-30-60 mins
Peak-2-3 hrs Duration- 3-6 hrs clear glucose drops late morning |
|
Onset, Peak, Duration of Rapid
Color |
Onset-10-15 mins
Peak-1 hr Duration-under 5 hrs Clear |
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When do you administer Rapid
|
10-15 mins before meals to avoid hypoglycemia
|
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Onset, Peak, Duration of Long
|
Ultralente Lantus
onset-4-8 hrs onset-1-2 hours peak-10-30 hrs peak-none duration-36 hrs Duration-24 hrs is a zinc suspension |
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When is highest risk of hypoglycemia long
|
early am before breakfast day after administered
|
|
24 hour glargine (Lantus)
onset duration Time administered Color |
onset-1-2 hrs NO PEAK
duration-24 hrs Admin at HS Clear |
|
Premix Insulin
Onset Peak Duration Risk for hypoglycemia |
onset-reg 30-60 rap 0-15 min
peak-2-10 hrs duration-12-16 hrs midafternoon |
|
Insulin---
needle angle sites fastest area for absorptions aspirate or message? y or n |
90 degree
abd, arms, legs, back, butt, abd is fastest NO aspirate, message |
|
Insulin syringe and needles
|
syringes- 1, 0.3, 0.5 ml
needle- 8-12.7 mm |
|
which dm pts need insulin
|
type 1 and some type 2
|
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Pyridium indication
|
Provides relief from the following urinary tract symptoms, assoc. with infection or following urologic procedures: Pain, Itching, Burning, Urgency, Frequency.
|
|
Pyridium Action
|
Acts on the urinary tract mucosa to produce analgesic or local anesthetic effects.
Has no antimicrobial activity. Diminished urinary tract discomfort. |
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Pyridium Contraindictions
|
Hypersensitivity
Glomerulonephritis Severe hepatitis, uremia, or renal failure Renal insufficiency Use Cautiously in: Hepatitis Pregnancy or lactation |
|
Pyridium SE
Drug Interactions |
bright-orange urine
NONE |
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Rhogam Indication
|
IM IV: Administered to Rh negative patients who have been exposed to Rh positive blood by: Pregnancy or delivery of a Rh-positive infant,
|
|
Rhogam Action
|
Prevent production of anti-Rh antibodies in Rh-negative patients who were exposed to Rh-positive blood.
Therapeutic Effects: Prevention of antibody response and hemolytic disease of the newborn in future pregnancies of women who have conceived a Rh-positive fetus. Prevention of Rh sensitization following transfusion accident. |
|
Rhogam Countraindiction
|
Prior hypersensitivity reaction to human immune globulin
|
|
Rhogam SE
|
dizziness, headache.
hypertension, hypotension. rash. diarrhea, nausea, vomiting. anemia, intravascular hemolysis arthralgia, myalgia. pain at injection site. fever. |
|
Rhogam Drug Interactions
|
May decrease antibody response to some live-virus vaccines (measles, mumps, rubella).
|
|
Rhagam Administration
|
26-28 wk pregnancy
72 hrs of delivery |
|
Digoxin Indication
|
Treatment of CHF.
Atrial fibrillation and atrial flutter, Paroxysmal atrial tachycardia. |
|
digoxin action
|
Increases the force of myocardial contraction.
Prolongs refractory period of the AV node. Decreases conduction through the SA and AV nodes. Therapeutic Effects: Increased cardiac output and slowing of the heart rate |
|
Digoxin Countraindication
|
Hypersensitivity
Uncontrolled ventricular arrhythmias AV block Idiopathic hypertrophic subaortic stenosis Constrictive pericarditis Known alcohol intolerance |
|
digoxin SE
|
fatigue, headache, weakness.
blurred vision, yellow or green vision. ARRHYTHMIAS, bradycardia, anorexia, nausea, vomiting, diarrhea. |
|
digoxin interaction
|
Thiazide, loopdiuretics, benzodiazepines, quinidine, quinine, verapamil, St. John's wort
|
|
What should be assessed before giving digoxin
|
apical pulse for 1 full min before administering. Withhold dose and notify physician if pulse rate is <60 bpm in an adult, <70 bpm in a child,
|
|
Aspirin (SALICYLATES)
Class |
antipyretics, nonopioid analgesics
|
|
Aspirin Indications
|
Mild to moderate pain.
Fever. Aspirin: Prophylaxis of transient ischemic attacks and MI. |
|
Aspirin Action
|
Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreases platelet aggregation.
|
|
Aspirin Counterindication
|
Hypersensitivity to aspirin, Cross-sensitivity with other NSAIDs, Bleeding disorders or thrombocytopenia, Children or adolescents with viral infections,
|
|
Aspirin SE
|
tinnitus. GI bleeding, nausea, abdominal pain, anorexia, dizziness, drowsiness increased bleeding time.
|
|
Aspirin Intractions
|
warfarin, heparin, heparin-like agents, thrombolytic agents, Ibuprofen, cefoperazone, cefotetan, and valproic acid, diuretics, and antihypertensives. chamomile, clove, feverfew, garlic, ginger, ginkgo, Panax ginseng,
|
|
Nitro class
|
antianginals
|
|
Nitro Indication
|
Acute and long-term prophylatic (oral, buccal, transdermal) management of angina pectoris. PO: Adjunct treatment of CHF .
IV: Adjunct treatment of acute MI. Treatment of CHF associated with acute MI. |
|
Nitro Action
|
Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions.
Produces vasodilation. Decreases left ventricular end-diastolic pressure and left ventricular end-diastolic volume (preload). Reduces myocardial oxygen consumption. |
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Nitro Countraindications
|
anemia
pericarditis Concurrent use of sildenafil. Use Cautiously in: Head trauma or cerebral hemorrhage Glaucoma Hypertrophic cardiomyopathy Severe liver impairment |
|
NItro SE
|
dizziness, headache, hypotension, tachycardia, flushing, tolerance.
|
|
Nitro interactions
|
sildenafil, tadalafil, and vardenafil antihypertensives, alcohol, beta blockers, calcium channel blockers, phenothiazines.
|
|
Dilantin class
|
antiarrhythmics, anticonvulsants
|
|
Dilantin Indication
|
Treatment/prevention of tonic-clonic (grand mal) seizures and complex partial seizures.
|
|
Dilantin Action
|
decreases cellular ion transport and may decrease synaptic transmission of abnormal impulses
|
|
Dilantin counterindications
|
Cardiac issues, Hypersensitivity, alcohal intolerance, liver and renal disease, resp disease
|
|
Dilantin SE
|
ataxia, diplopia, nystagmus. tachycardia.
nausea, rash, pruritus. |
|
Lasix Class
|
loop diuretics
|
|
Lasix Indication
|
Edema due to heart failure, hepatic impairment or renal disease.
Hypertension. |
|
Lasix Action
|
Blocks the reabsorption of sodium and chloride in the loop of henle
|
|
Lasix counterindications
|
Cross-sensitivity with thiazides and sulfonamides may occur
Hepatic coma or anuria Use Cautiously in: Severe liver disease Electrolyte depletion Diabetes mellitus |
|
Lasix SE
|
dehydration, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis.
|
|
Lasix Interactions
|
antihypertensives, nitrates, or acute ingestion of alcohol.
diuretics, stimulant laxatives, and corticosteroids. |
|
Mag sulfate class
|
mineral and electrolyte replacements/supplements
|
|
Mag sulfate Indication
|
Treatment/prevention of hypomagnesemia.
Treatment of hypertension. Anticonvulsant associated with severe eclampsia, pre-eclampsia, or acute nephritis. |
|
Mag sulfate Action
|
Essential for the activity of many enzymes.
Plays an important role in neurotransmission and muscular excitability. Therapeutic Effects: Replacement in deficiency states. Resolution of eclampsia. |
|
Mag Sulfate Counterindications
|
Hypermagnesemia
Hypocalcemia Anuria Heart block Active labor or within 2 hr of delivery (unless used for preterm labor). Use Cautiously in: Any degree of renal insufficiency Digitalized patients. |
|
Mag Sulfate SE
|
drowsiness. decreased respiratory rate.
arrhythmias, bradycardia, hypotension. diarrhea. muscle weakness. flushing, sweating. hypothermia. |
|
Mag Sulfate Interactions
|
Potentiate calcium channel blockers and neuromuscular blocking agents.
|
|
New borns need to be monitored for what with mag sulfate
|
hypotension, hyporeflexia, and respiratory depression
|
|
Insulin class
|
antidiabetics,
|
|
Pyridium class
|
nonopioid analgesics
Pharmacologic: urinary tract analgesics |
|
Rhogam glass
|
vaccines/immunizing agents
Pharmacologic: immune globulins |
|
Digoxin Class
|
antiarrhythmics, inotropics
Pharmacologic: digitalis glycosides |
|
Nicotinic Acid Class
|
lipid-lowering agents,
B class vitamins |
|
Nicotinic Acid Indication
|
Treatment and prevention of niacin deficiency (pellagra).
Adjunctive therapy in certain hyperlipidemias (niacin only). |
|
Nicotinic Acid Action
|
Vit B in low doses
Lipid lowering agent used in high doses Decreases VLDL, LDL, triglycerides and increasing HDL |
|
Nicotinic Acid counterindication
|
Diabetes mellitus. car raise fasting glucose levels
History of gout and liver disease PUD |
|
Nicotinic Acid SE
|
Flushing and hot flashes happen in almost all, nausea, gas, diarrhea are common.
Gout and hepatotoxicity Taking aspirin 30 mins taking this med reduces flushing |
|
Nicotinic Acid Interactions
|
HMG-CoA reductase inhibitors.
|
|
Name a generic name for nicoinic acid
|
Niacin
|
|
Nicotinic Acid Nursing
|
take aspirin 30 before reduces flushing/puritis
no high doses take with cold water. hot increases flushing take with or after meals |
|
Report what to HCP with Nicotinic Acid
|
flank, joint, stomach pain.
skin color change yellow eyes |
|
Dililantin Nursing
|
with food or at meals to decrease GI upset
monitor LOC changes monitor blood glucose monitor gingival hyperplasia Predispose PG mom to eclampsia. NEVER give IM Bleeding issues with depakoe |