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  1. Print the notecards
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  2. Select Back of pages for Viewing and print the back of the notecards
    NOTE: Since the back of the pages are printed in reverse order (last page is printed first), keep the pages in the same order as they were after Step 1. Also, be sure to feed the pages in the same direction as you did in Step 1.
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64 notecards = 16 pages (4 cards per page)

Viewing:

Medication Tips

front 1

g = _______________

back 1

gram

front 2

kg = ________________

back 2

Kilogram

front 3

mcg= ________________

back 3

microgram

front 4

mg = _______________

back 4

milligram

front 5

mL= __________

back 5

milliliter

front 6

PO = __________________

back 6

by mouth

front 7

IM= ________________

back 7

intramuscular

front 8

subcut =__________________

back 8

subcutaneous

front 9

ac = ________________

back 9

Before meals

front 10

pc = __________________

back 10

after meals

front 11

qAM = __________________

back 11

every morning

front 12

b.i.d = _______________

back 12

twice a day

front 13

t.i.d. = ___________________

back 13

Three times a day

front 14

qh = ____________________

back 14

every hour

front 15

STAT= ______________

back 15

immediately

front 16

PRN = __________________

back 16

as needed

front 17

1 gram = _________ milligrams

back 17

1000

front 18

1 milligram = _______ micrograms

back 18

1000

front 19

30 milliliters = ________ ounce

back 19

1

front 20

2.2 pounds = ____ kilogram

back 20

1

front 21

1 teaspoon = _______ mL

back 21

5

front 22

1 tablespoon= __ teaspoons = __ mL

back 22

3, 15

front 23

Procedure for Medication Administration at Bedside:

back 23

  • Wash hands
  • Position patient if needed
  • Assess patient’s ability to swallow medications
  • Open and administer medications
  • Never leave medications at the bedside
  • Take them with you or lock them until the patient is ready for them
  • Document medication was given via protocol

Remember to document assessment findings if needed

front 24

Document medication held or refused per facility policy and why:

back 24

  • Away for test or procedure
  • NPO
  • Assessment findings did not meet parameters or administering the medication would not be safe
  • BP 90/52 (BP med not needed)
  • Potassium 6 (above normal range, so potassium tablet not needed)
  • Patient diarrhea (did not need stool softener)
  • Notify physician if needed

front 25

Eye Drops (gtts)

back 25

  • Clean away any drainage
  • Give patient a tissue
  • Extend head upwards
  • Retract lower eyelid
  • Place in conjunctival sac
  • Close eye and apply gentle pressure on nasal-lacrimal

front 26

Eye Ointment

back 26

  • Thin line from inner canthus to outer
  • Do not touch eye with tube

front 27

For ear drops in adults and children>3 years, position patient on side and _______________________. Instill drops, patient should lay on their side for at least 5 min. Apply gentle pressure and massage tragus with finger

back 27

Pull pinna up and back

front 28

For ear drops in children under 3 years, position patient on side and _______________________. Instill drops, patient should lay on their side for at least 5 min. Apply gentle pressure and massage tragus with finger

back 28

pull the pinna down and back

front 29

Procedure for Administering
Nasal Spray:

back 29

  • Patient to clear passage way
  • Occlude opposite nasal passage
  • Shake spray
  • Insert tip into nostril
  • Squeeze bottle to give dose
  • Have patient inhale when squeezing
  • Allow patient self administer if they are able

front 30

Procedure for Administering
Inhalers:

back 30

  • Inhaler Shake container for 2 to 5 seconds
    • Place in mouthpiece in mouth
    • Lips may or may not touch inhaler
    • Have patient exhale
    • Inhale slowly as the inhaler is depressed (5-10 seconds)
    • Wait 1-5 minutes between puffs
  • Allow patient self administer if they are able
  • Consider using a spacer

front 31

Procedure for Administering topical:

back 31

  • Powder, cream, oil, ointment, lotion
  • Absorbed through the skin
  • Wear gloves
  • Assure skin clean
  • Apply per order

front 32

Procedure for Administering transdermal:

back 32

  • Remove old patch
  • Check skin for irritation
  • Apply new patch in new site
  • Apply medication to patch if ordered

ie Nitroglycerin Paste 1 inch

Date, Time and Initial patches

front 33

Procedure for Administering Rectal Medications:

back 33

  • Sims position
  • Only expose rectal area
  • Don gloves
  • Lubricate suppository with water-soluble lubricant
  • Patient take deep breath
  • Insert suppository into anus
    • 4 inches for adults
    • 2 inches for children
  • Remain on side for 5 minutes

front 34

Procedure for Administering all Injections need to assess _____________________.

back 34

circulation, adipose tissue and muscle atrophy

front 35

If using ampule must use ______________ and open it away from user with gauze or protective device

back 35

filter needle

front 36

What size needle to you use for intradermal injections?

back 36

3/8 to 5/8 inch

front 37

Procedure for Administering
all Injections:

back 37

  • Wash Hands/Gloves
  • Select Site
  • Place patient in comfortable position
  • Cleanse Site- Center to outward
  • Remove cap or slide safety barrel back
  • Hold syringe between thumb and forefinger
  • Inject as per procedure
  • Discard in sharps container

front 38

__________________ is the purpose for intradermal injections.

back 38

Skin testing

front 39

A small hypodermic 25-27 g syringe is part of the equipment needed for an _______________ injection.

back 39

Intradermal injection

front 40

What is the amount for an intradermal injection?

back 40

Less than 0.5 mL

front 41

What are some sites for an intradermal injection?

back 41

Injection into the dermis- inner aspect of arm, or upper back below the scapula

front 42

The needle angle needs to be 5 to 15 degrees, for what type of injection?

back 42

intradermal

front 43

You need to pull skin taut, insert bevel up, do not aspirate and inject solution slowly to from small bleb, for what type of injection?

back 43

intradermal

front 44

If no bleb on a intradermal injection then the test is _________________

back 44

invalid

front 45

The purpose for a ________________ injection is for slow absorption and a sustained effect.

back 45

subcutaneous

front 46

The equipment for a _______________ injection includes:

Syringe 0.5 to 3mL

Needle 25 to 30 g, 3/8 to 5/8 inch

back 46

subcutaneous

front 47

Upper arm, abdomen, thigh, back, ventrodorsal gluteal area are location sites for a ____________________ injection

back 47

subcutaneous

front 48

The amount for _________________ injections is 1mL or less

back 48

subcutaneous

front 49

For Subcut: You need to choose site, cleanse site, pinch/bunch skin to gather subcut tissue for thinner. Insert___________ degree angle. Release tissue and inject slowly, remove and apply gentle pressure.

Discard syringe in sharps container

back 49

45 to 90

front 50

Insulin is administered __________________ to control blood glucose levels.

back 50

subcutaneously

front 51

The nurse must verify _______________ before giving an insulin shot.

back 51

blood glucose

front 52

Remember ___________ must be verified with another licensed nurse

back 52

insulin

front 53

______ - long acting (cloudy)

back 53

NPH

front 54

________- short acting (clear)

back 54

regular

front 55

_____- rapid acting (clear)

back 55

rapid

front 56

Order: “NPH insulin 50 units and Regular 10 units subcut every am”

back 56

1.Inject 50 units air into NPH Cloudy (long acting)

2.Inject 10 units of air into Regular

3.Withdraw 10 units of Regular

4.Insert same syringe into NPH and withdraw 50 units of NPH

front 57

With a _________________ shot: if drawing up from vial, change to new sharp needle after drawing up, site: lower abdomen fat pad, inject slowly at 90 degree angle, wait 10 seconds before with drawing and DO NOT APPLY PRESSURE

back 57

anticoagulant

front 58

Intramuscular injections is to promote ____________ absorption.

back 58

rapid

front 59

Equipment for ________________:

Syringe: 1-5 mL syringe

Needle:

Deltoid: 23-25g, 5/8"- 1" needle

Vastus/ventrogluteal: 18-23g, 1" to 1 1/2 " needle

Amounts: normal adult up to 3mL; children, older adult and thin patients 2 ML; infants and small children 1 mL

back 59

Intramuscular

front 60

The ___________ muscle can only hold 1 to 2 mL

back 60

deltoid

front 61

Procedure for Administering Intramuscular Injections:

back 61

Choose site

  • Cleanse site
  • Pull skin taut and in Z track fashion ~ Laterally 2.5 to 3.5 cm and hold until medication injected
  • Insert needle at 90 degree angle
  • Depends on patient mass
  • Remove needle and apply gentle pressure but do not massage area
  • Discard syringe in sharps container

** Z track method not required for deltoid

front 62

Deltoid:

back 62

Technique:

  • Upper arm, 1 to 2 inches below acromion process, inject 90 degree angle
  • OR place four fingers across deltoid and it is at the 3rd finger
  • Advantage:
  • Faster absorption
  • Easily accessible w/minimal exposure
  • Less pain & fewer local side effects from vaccines
  • Disadvantage:
  • Small muscle limited amts
  • Possible radial nerve & axillary nerve damage

front 63

Vastus Lateralis

back 63

Technique

  • Supine position
  • Locate greater trochanter & lateral femoral condyl; inject 90o angle into mid 3rd & anterior lateral aspect of thigh
  • Child under 2 yr
  • Advantages:
  • Large muscle tolerate large amt fluid
  • Easily accessible
  • Disadvantages:
  • Thrombosis of femoral artery from injection in mid thigh
  • More painful site

front 64

Ventrogluteal

back 64

Technique

  • Place patient on side
  • Locate greater trochanter, palm at site; point index finger toward patient’s groin; middle finger along posterior iliac crest; form “V”
  • Inject at 90 degree angle
  • Advantages:
  • Free of important nerves/vessels
  • Easily identified
  • Accommodates large amt fluid
  • Less painful
  • Disadvantages:

Nurses unfamiliar w/site