Fundamentals of Nursing: The Art and Science of Person-Centered Care, 10th Ed., Taylor, Lynn & Bartlett | Registered Nurse (RN) School Study Aid
Parenteral Medications
- Fast-Acting
- Greatest Risk
- Common Injections Sites: Deltoid, Vastus Lateralis, Ventrogluteal, and Dorsogluteal Muscles
- Absorbed Fast
- Vaccines and Epinephrine
- 3 mL Limit
- Common Injections Sites: Abdomen, Arm, and Thigh
- Absorbed Slower
- Insulin and Hormones
- Small Volumes
- Common Injection Sites: Back of Forearm and Upper Back
- Longest to Absorb
- Tuberculosis and Allergy Testing
- Under 0.5 mL
Transdermal Medication Administration
- Patch or Disc
- Directly on Skin of Arms, Chest, Upper Back
- Avoids First Pass Metabolism
- Sustained Administration of Medication
- Clean Skin After Removal
- Rotate Sites of Patches
- Apply to Dry Skin
- Avoid Shaved Skin
- Avoid Heat
- Nitro Effects Lost After 24 Hours
Eye Medication Administration
- Supine with Neck Hyperextended
- Wash Away Crusts
- Cotton Ball on Cheekbone
- Instill Drops into Conjunctival Sac
- Repeat if Missed or Patient Blinks
- 5 Minutes Before 2nd Medication
- Thin Stream Along Inner Edge
- Inner Canthus to Outer Canthus
Intradermal Medication Administration
- Tuberculin Screening
- Allergy Testing
- Dermis
- Inner Forearm or Upper Back
- 1mL Syringe (26 or 27 Gauge Needle)
- 5 to 15 Degrees
- Small Bleb
6 Rights of Medication Administration
- Right Patient
- Right Medication
- Right Dose
- Right Time
- Right Route
- Right Documentation
- Three Checks
- Check for Allergies
- Assess the Patient
- Education
Intramuscular Medication (IM) Administration
- Injury to Nerves, Bone, and Blood Vessels
- Deltoid
- Vastus Lateralis
- Ventrogluteal
- Selection of Needle Length
- Aseptic Technique for Drawing Up
- Z-Track
- 90 Degree Angle
- Max Amount (2-5 mL Adult, 1 mL Child)
- Techniques to Reduce Pain
Ear Drops Medication Administration
- Earwax Buildup
- Ear Infections
- Child - Back and Downward
- Adult - Back and Upward
- Side-Lying with Ear Up
- Instill Medication
- Stay for 2-3 Minutes
- Room Temperature
- May Massage Tragus
- Perforated Eardrum
Enema Administration
- Tap Water/Soapsuds
- Normal Saline
- Hypertonic Solution
- Medication
- Oil Retention
- Procedure Education
- Wear PPE
- Put Patient in Sims Position
- Insert Tip
- Start Flow Slowly
- Stop With Discomfort
- Potential for Vagus Response
Routes of Administration Part One
- Oral
- Sublingual
- Buccal
- Rectal
- Tubes
- Transdermal
- Drops/Spray
- Vaginal
- Inhalation
Routes of Administration Part Two (Parenteral)
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal
IV Anesthetics
- Barbiturates
- Benzodiazepines
- Respiratory Depression
- Hypotension
- Ketamine
- NMDA Receptor Antagonist
- Hallucinations
- Opioids
- Propofol
- Potentiates GABA-A
IV Solutions
- Hypotonic (< 280 mOsm/L)
- 1/4 Normal Saline (0.225% NaCl)
- 1/2 Normal Saline (0.45% NaCl)
- Isotonic (280-300 mOsm)
- Normal Saline (0.9% NaCl)
- Lactated Ringer's (LR)
- Dextrose 5% in Water (D5W)
- Hypertonic (> 300 mOsm)
- 3% or 5% NaCl
- Dextrose 5% in 0.45% NaCl
- Dextrose 10% in Water (D10W)
IV Calculation Formulas
- Drop Factor
- Macrodrip
- Microdrip
- Total Volume to Infuse (mL) X Drop Factor/ Time in Minutes = Drops/Minute (gtt/min)
- Total Volume to Infuse / mL per Hour Being Infused = Infusion Time
- Total Volume in mL / Time in Hours = Number of mL per Hour
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
- Subcutaneous Injections
- 3/8 or 5/8 inch
- Intramuscular (IM)
- 1-1.5 inches
Total Parenteral Nutrition (TPN)
- Nutrition Given Outside GI
- Hyperglycemia
- Hyperlipidemia
- Refeeding Syndrome
- Nausea and Vomiting
- Slow IV Infusion
- Use Large Central Vein
- No Added Meds to TPN Line