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ATiredNursingStudent Inglés 71 fichas

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  1. 1Subcutaneous injectionBeneath the skin layers
  2. 2Intradermal injectionsInto the dermis
  3. 3Tuberculin SyringeGraduated measurements to 1 mL. A fine 25-, 27-, or 29-gauge needle is used at a 5- to 15-degree angle of insertion.
  4. 4BlebVisible elevation of the epidermis
  5. 53-mL syringePopular, large enough for subcutaneous and most IM injections.
  6. 6U-100 SyringeInsulin syringe. Calibrated to measure 100 units of insulin.
  7. 7Luer-LokSyringe tip that is choice for an IM injection because the locking mechanism prevents sudden separation of the needle and syringe when pressure is applied.
  8. 8Non-Luer LokAcceptable for ID injection because little pressure is needed to inject the medication.
  9. 9BevelSlanted part of the needle tip
  10. 10Positive TB skin TestSwelling at the site of injection is more than 5mm in people who have a history of contact with TB.
    10mm in diameter - positive in recent immigrants from country where TB is prevalent, medically underserved groups, and homeless.
    15mm - People at low risk.
  11. 11Negative TB Skin TestInduration measures less than 5 mm.
  12. 12ID Injection UseFor TB or allergy skin test. Small amounts of solution is used. Tuberculin syringe and short needle are used (1/4 - 1/2 inch). 5-15 degree insertion angle.
  13. 13TuberculinBiologic product used for skin testing for exposure to tuberculosis.
  14. 14SubQ Injection UseAbsorbed more slowly by the body. Used for insulin, heparin, and some pre-op meds and narcotics. (Do not aspirate when giving heparin.)
  15. 15IM Injection UseUsed if patient absolutely cannot take medicine orally, not available in an oral form, or faster action. Onset of action is 15 minutes because muscular tissue is highly vascular. (If more than 3 mL of medication must be given at one time, the dose should be divided in half and given in two different large muscle sites.)
  16. 16Mid-Deltoid MuscleCommon site for IM injection. Triangular area, with the base of the triangle beginning 1-2 inches below the acromion process and extending down to just above the axilla fold. Place four fingers across the deltoid muscle with the pinky finger on the acromion process, the site is three fingerwidths below the acromion process. (Not used in infants or children with underdeveloped muscles.)
  17. 17DorsoglutealNo longer recommended for IM injections because of high potential for injury to the sciatic nerve. Might be reasonable if needed to control a patient (psychiatric patient). Patient must be prone.
  18. 18VentroglutealIM injection site involving the gluteus medius and minimus muscles. Layer is thick, and site has a very small fatty layer. Can be used for both adults and children. Place palm over greater trochanter, and put the index finger on the anterior iliac spine, and spread the middle finger as far as possible toward the posterior iliac crest. The center of the V created by the index and middle fingers is the injection site.
  19. 19Vastus LateralisMuscle is a preferred IM injection site for adults, children, and infants. Extends from the antero-lateral aspect of the thigh to the midlateral thigh, a hand's width below the proximal end of the greater trochanter and a hand's width about the upper knee. Used the patient is recumbent with knee slightly flexed in the Sims position or is sitting upright.
  20. 20Rectus FemorisMuscle used as an IM site in the adult and when other sites are contraindicated in children. Located on anterior aspect of the thigh and is used by people who give their own IM injections.
  21. 21Intramuscular Injections in ChildrenPreferrable to find another way to give medication to children because these are painful and traumatic for the child. Some immunizations must be given IM, however. IM immunizations for children over 13 months of age can be given in the deltoid site, unless the muscle is underdeveloped.
  22. 22Z-Track TechniqueCausing a needle track, or pathway, in the shape of a Z. Can be used any time an IM injection is given. It must be used whenever a deep IM injection of iron dextran (Imferon) and other irritating solutions (like hydroxyzine hydrochloride (Vistaril) and several antipsychotic agents are given. Reduces pain caused by irritating drugs that leak or escape along the track into the subQ tissue when the needle is withdrawn.
  23. 23Anaphylactic ShockReaction to medication by a sensitized person. Can range from mild to severe, and death can occur in minutes. Symptoms: Urticaria (reddened, slightly elevated patches known as wheals), bronchiolar constriction that can be wheezing or difficulty breathing, edema, and circulatory collapse.
  24. 24Isotonic SolutionHave the same concentration, or osmolality, as blood and are used to expand the body's fluid volume.
  25. 25Hypotonic SolutionContain less solute than extravascular fluid and may cause fluid to shift out of the vascular compartment.
  26. 26Hypertonic SolutionsHave a greater tonicity than blood. They are used to replace electrolytes and when given as concentrated dextrose solutions, produce a shift in fluid from intracellular compartment to the extracellular compartment.
  27. 270.9% SalineIsotonic. For trauma, diabetic ketoacidosis, blood transfusions, hyponatremia.
  28. 280.45% SalineHypotonic. Supplies normal daily salt and water requirements.
  29. 29Vehicle for some IV piggyback medications, hyperkalemia. Isotonic.5% Dextrose in Water
  30. 30If TPN is abruptly discontinued. Hypertonic.10% Dextrose in water.
  31. 31Early treatment of burns. Hypertonic.5% Dextrose in 0.9% saline
  32. 32Postoperative; common maintenance fluid. Hypertonic.5% Dextrose in 0.45% Saline
  33. 33Postoperative; common maintenance fluid. Isotonic.5% Dextrose in 0.225% saline.
  34. 34Trauma, dehydration from severe diarrhea or vomiting. Isotonic.Ringer lactate
  35. 35Burns, dehydration from severe diarrhea or vomiting. Hypertonic.5% Dextrose in Ringer lactate.
  36. 36Primary Intravenous SetBag of solution, regular tubing set, needleless connector, and an IV stand. Filter may be added. IV tubing set has a spike end, which is inserted into the bag; drip chamber, the tubing, a flow regulator or clamp, and a Luer-Lok connector. Primary line has 1-2 injection ports. Used for everything but administering blood products.
  37. 37Regular Drops10-20 gtt/mL of fluid as specified by the manufacturer, used for administering IV therapy to most adult patients.
  38. 38Macrodrops10 gtt/mL. Used for viscous (sticky or gummy) fluids, such as blood. Can be used for regular fluids.
  39. 39Microdrops60 gtt/mL. Used when small amounts of fluid are required or when extreme care must be used to measure the exact amount; most often for children and infants, also for elderly with fragile veins.
  40. 40Second (Piggyback) IV setMedications to be given intravenously are often added to an existing IV line by piggyback. Primary infusion is interrupted to infuse medications such as antibiotics and antineoplastic drugs. Diluted in 50-150 mL of solution and given by infusion. The secondary bag is hung higher than the level of fluid in the primary IV so that it empties first. Do not clamp or alter the flow of the primary bag.
  41. 41Parallel, or Y, Intravenous SetInfuse certain blood products. The blood product is placed on one side, and a bag of normal saline is placed on the other side. The saline is started first. The saline is stopped while the blood is running. When the transfusion is complete, the tubing is flushed with the normal saline solution.
  42. 42Controlled-Volume IV SetDose of diluted medication can be given this way. Used as a safety backup between the primary IV bag and the entry to the infusion pump to prevent free flow of fluid. Decreases likelihood of fluid overload because only a specified amount of fluid is available to be infused at any one time.
  43. 43Infusion PumpMachine that delivers IV fluids at a rate that is set by the nurse.
  44. 44BuretteTubelike chamber that holds 150 mL of fluid. Medication is injected along with a specified volume of fluid from the primary bag, which is then clamped off. If an IV infusion pump is not used, the medication from the burette goes into the drip chamber.
  45. 45Intermittent Intravenous Device (Saline or PRN Lock)Preferred for patients who receive intermittent antibiotics, heparin, corticosteroids, antimetabolites, and some other drugs. Established by applying a Luer-Lok cap or an extension set, to the IV cannula. The peripheral device is called a saline lock, PRN lock, or INT (intermittent) lock. No constant infusion, so saline or a dilute heparin flush is used to keep a clot from forming at the tip of the catheter.
  46. 46FiltersTrap small particles such as undissolved medication or salts that have precipitated from solution. Prevent particles from entering a vein. 0.22-micron filter used for most solutions. With lipids or albumin, 1.2-micron filter is used. Special filter needed for blood components.
  47. 47Total Parenteral Nutrition (TPN)Technique of providing needed nutrition through IV.
  48. 48InfiltratedSolution is deposited in tissue outside the vein.
  49. 49Infusion PumpsRegulate flow of routine IV fluids, especially those containing potassium, or when medications that require critical accuracy, such as heparin, insulin, cardiovascular meds, chemotherapy drugs, or meds used to induce labor.
  50. 50Programmed infusion pumpsMore accurate. These pumps deliver IV fluids automatically at a rate that is programmed by the nurse. They have alarms that warn when the IV container is empty, when air is present in the tubing, or when there is an occlusion.
  51. 51Insulin PumpSmall, self-contained pump device used to deliver doses of medication. Small and portable that can be programmed to deliver a continuous infusion of regular insulin that mimics normal physiology. Insertion site must be changed every 2-3 days, refilled with insulin, reprogrammed, and blood glucose must be checked 4-6 times a day, while also monitoring for infection.
  52. 52Safety Venous Access DevicesDecrease the risk of accidental needle sticks. Have either a stylet that retracts into a closed sleeve or a plastic sleeve that advances over the stylet as it is removed from the skin.
  53. 53Winged-Tip or Butterfly NeedleMeant for short-term therapy, such as to give single-dose IV medication or to obtain blood samples. Supplied in odd numbered gauges. Frequently used for pediatric or elderly patients because of the smaller gauges for use in smaller vessels. Needles are rigid and may cause more discomfort than other needles.
  54. 54Over-the-needle cathetersConsist of a needle with a catheter sheath over it. After the device is placed into the vein and the cannula is threaded, the needle is removed, leaving the flexible catheter in the vein. Cause less irritation, thereby decreasing the incidence of infection and phlebitis.
  55. 55Central Venous CathetersInserted into a large subclavian vein and positioned in the superior vena cava or the right atrium. Can be left in place 6-8 weeks. The nurse assists by providing the sterile catheter tray, draping the patient, opening sterile packages, and preparing the IV admin for use. If the central line is needed for more than 6-8 weeks, a long-term catheter such as a tunneled Broviac, HIckman, or Groshong is inserted.
  56. 56Peripherally Inserted Central Catheters(PICCS) or midline catheters (MLs) are often used in children or in adults who need peripheral IV therapy that requires placement where there is high blood flow. They are also a first choice in home care IV therapy of 6-8 weeks. Catheters are long and inserted in the larger basilic or cephalic vein of the upper arm. The ML ideally sits just inside the subclavian vein.
  57. 57Vascular Access DevicesDevices such as a needle or catheter that allow direct access to the circulatory system in the form of central venous catheters or implanted infusion ports are used for patients who need long-term drug therapy, fluid therapy, or chemotherapy. Short-term catheters are inserted into a large vein, usually the subclavian or jugular, by the physician.
  58. 58Long-term central venous cathetersThreaded to the tip of the right atrium of the heart are placed by surgical tunneling through subQ tissue and then through the subclavian vein into the superior vena cava. The surgeon enters the vein and then makes the subQ tunnel or pocket. Catheters range from 15-30 cm in length. Some have single lumens; others have two, three or more. Periodically flushed. Correct placement of subclavian catheters must be verified by radiographic studies before any fluid can be infused through them.
  59. 59Infusion PortSingle-or dual-lumen catheter can be implanted. Placed subq on the chest beneath the right clavicle, and the catheter is threaded through a large vein and into the superior vena cava. Ports are implanted in other areas sometimes for intraspinal or intraperitoneal infusion. Specially designed Huber noncoring needles are used.
  60. 60Catheter EmbolusPiece of the catheter obstructing flow. Medicare and Medicaid do not reimburse for this.
  61. 61Infiltration IICommon. Fluid or medication leaks out of the vein into the tissue. Signs and symptons: edema around the site and cool, pale tissue. Flow can be slow and sluggish. Blood flow and lymphatic drainage will be affected, as well as sensation. If it occurs, discontinue the infusion, remove the catheter, and reestablish another IV line at a different site. Fluid that is in the tissue will usually reabsorb within 24 hours.
  62. 62Extravasationis the infiltration of a vesicant drug from an IV line. The appearance of the site and the patient's subjective complaints may initially be similar to those with an infiltration, but the damage may go unnoticed for 48-72 hours. Results can be infection, disfigurement, or loss of function. Assess the site before administering the dose, dilute the drug, avoid vein sites such as the dorsum of the hand or the antecubital fossa, and be aware of available antidotes so that an order can be obtained. If it does occur, do not discontinue the IV, since the antidote must be delivered directly to the problem area. Report to physician.
  63. 63VesicantChemical irritant that causes tissue destruction. Drugs that have vesicant properties (examples: antibiotics, some antineoplastic drugs).
  64. 64PhlebitisIrritation of the vein by the needle, the catheter, medications, or additives in the IV solution. Signs: erythema, warmth, swelling, and tenderness. IV must be discontinued and another site found for reinitiating therapy. Application of warm compresses to the inflamed site decreases discomfort.
  65. 65Bloodstream InfectionSepticemia occurs when infectious pathogens are introduced into the bloodstream. Signs and symptoms: fever, chills, pain, headache, nausea, vomiting, and extreme fatigue. Blood cultures are ordered, and aggressive antibiotic therapy is started. IV site is immediately discontinued.
  66. 66Air embolusOccurs when changing bags or when opening the line of a subclavian catheter.
  67. 67Speed shockOccurs when fluids or medications given by bolus are administered too rapidly. Signs: light-headedness, tightness in the chest, flushed face, and irregular pulse. Patient may lose consciousness, go into shock, and suffer cardiac arrest.
  68. 68ThrombophlebitisSite red, tender, warm, IV infusion sluggish. Never irrigate the IV catheter, remove the catheter, notify the physician, and restart IV in opposite extremity.
  69. 69IV site infectionSite hot, red, painful but not hard or swollen; IV infusion sluggish. Remove IV catheter; restart in opposite extremity, use new tubing and solution.
  70. 70Catheter embolusDecrease in BP; wek, rapid pulse; cyanosis of nail beds, loss of consciousness. Pain along vein. Remove IV catheter and inspect, place a tourniquet high on limb of IV site, notify doctor, obtain X-ray film, and prepare for surgery to remove the catheter pieces.
  71. 71Circulatory overloadIncreased BP, distended neck veins, rapid breathing, dyspnea, moist cough, crackles. Elevate head of the bed, keep warm, assess for edema, slow the infusion rate, and notify the physician.

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Fichas sobre Sin título, creado por ATiredNursingStudent el 04/01/2015.
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