Name: subcutaneous injection setup and safety
Uploaded: 2017-02-24T16:36:27.000Z
Duration: 8 min 54 s
Channel: JoVE

<ol>
	<li>Institute of Medicine. To Err is Human: Building a Safer Healthcare System. Academic Press. Washington, DC. (2000).</li>
	<li>Centers for Disease Control and Prevention. http://www.cdc.gov/. (2017).</li>
	<li>Potter, P. A., Perry, A. G., Stockert, P. A., Hall A. Essentials for Nursing Practice, Eighth Edition. Elsevier. St. Louis, MO. (2015).</li>
</ol>

וידאו זה מדגים את הממשל של תרופות תת עוריות ודן שיקולים בגישת הממשל בשל וריאציות ברקמת השומן המטופל. חשוב להבטיח כי אתרי הזרקה תת עורית מסתובבים כדי להפחית את הנזק לרקמות ולמנוע סיבוכים רקמת שומן, כגון lipodystrophy מקומי. טעויות נפוצות בניהול תרופות תת עוריות כוללות: זיהום אתר ההזרקה על ידי נשיפה או ניגוב האזור לאחר ניקוי עם מגבון אלכוהול; באמצעות מחט עם מד או אורך לא הולם עבור זריקות תת עוריות, וכתוצאה מכך ניהול בשוגג לתוך רקמות שרירים או עוריים; והסרת המחט מהר מדי לאחר מתן, אשר יכול לגרום לאובדן תרופות וניהול של מינון...

הכנה וניהול תרופות תת עוריות

מקור: מדלן לאשה, MSNEd, RN וקייטי בראקי, MSN, RN, המכללה לסיעוד, אוניברסיטת יוטה, UT

מתן תרופות תת עוריות הוא גישה parenteral לנהל כמויות קטנות של תרופות (פחות מ 2 מ"ל) לתוך שכבת הרקמה ממש מתחת לעור. תרופות נפוצות הניתנות דרך המסלול התת עורי כוללות תרופות נוגדות קרישה, כגון הפרין או אנוקספרין; אפינפרין מנוהל לתגובות אלרגיות; אינסולין; וכמה חיסונים.
הכנות הזרקה תת עורית מסופקות בדרך כלל בקבוקונים או אמפולות לגמילה לתוך מזרק תת עורי. מחטים תת עוריות יש אורך קצר יותר וקוטר קטן יותר מאשר מזרקים המשמשים עבור זריקות תוך שריריות, הם בדרך כלל פחות מ 5/8th של אינץ ', והם 26 מד או פחות. ספיגת התרופות וההתהוות איטיות יותר מאשר במסלולים תוך ורידי, עם שיעורי ספיגה מסוימים הנמשכים 24 שעות או יותר. גישה זו נבחרת עבור תרופות רבות שעשויות להיות denatured או מנוטרל אם ניתנו דרך המסלול האוראלי, בהתחשב בחומציות של מערכת העיכול.
הכנות הזרקה תת עורית מסופקות בדרך כלל בקבוקונים או אמפולות לגמילה לתוך מזרק תת עורי. האחות צריכה לקבוע את מינון התרופה המתאים על פי הריכוז המסופק על המיכל. הדגמה זו תציג כיצד להכין ולנהל תרופות תת עוריות לאחר קבלת התרופה ממכשיר חלוקת התרופות. הדיון כולל גם את חמש "הזכויות" ואת תיעוד התרופות ברשומה של מינהל התרופות האלקטרוניות (MAR).

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT
Subcutaneous medication administration is a ...

preparing-and-administering-subcutaneous-medications

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Preparing and Administering Subcutaneous Medications

subcutaneous injection setup and safety

Subcutaneous medication administration places a small dose of medicine just below the skin. This route is used for medications that need to be absorbed more slowly than by an intravenous route. It is also chosen for some drugs that may be broken down by the acidic environment of the gastrointestinal tract if taken by mouth.

Common subcutaneous medications include anticoagulants such as heparin or enoxaparin. Epinephrine for allergic reactions, insulin, and some immunizations can also be given this way. The medication usually comes in a vial or ampule, and it is drawn up into a subcutaneous syringe before use.

Subcutaneous needles are short and thin. They are typically less than 5/8 inch long and 26 gauge or smaller. The nurse determines the correct dose based on the concentration listed on the container. This demonstration shows how to prepare and give the medication after it has been obtained from the medication dispensing device.

Safe practice also includes the ten rights of medication administration and documentation in the electronic Medication Administration Record, or MAR. The MAR is the record used to track medication given to a patient. These steps help support accurate subcutaneous medication administration.

Subcutaneous Injection Setup and Safety

safety checks and ten rights of medication administration

safety-checks-ten-rights-medication-administration

Medication Safety Checks Before Drug Pickup

Medication safety checks are an important part of safe medication administration. Nurses use the Ten Rights of medication administration to reduce the risk of medication errors and improve patient safety. These rights include the right patient, right medication, right dose, right time, right route, right documentation, right education, right to refuse, right assessment, and right evaluation. The acquisition phase of medication administration focuses on retrieving the medication. This process...

preparing and administering oral tablet and liquid medications

preparing-and-administering-oral-tablet-and-liquid-medications

Oral Medication Safety: Tablets and Liquids

Oral medication safety includes preparing and giving tablets and liquid medicines by mouth. Oral preparations are a common route used by providers and are usually swallowed with fluid. After swallowing, they are absorbed through the gastrointestinal tract. Oral medications come in solid forms and liquid forms. Solid forms include tablets, capsules, caplets, and enteric-coated tablets. Liquid forms include syrups, elixirs, spirits, and suspensions. Most oral medicines have a slower onset of...

preparing and administering topical medications

preparing-and-administering-topical-medications

Safe Skin, Eye, and Ear Medication Use

Topical medications are applied directly to body surfaces such as the skin and the mucous membranes of the eyes, ears, nose, vagina, and rectum. Common forms include creams, ointments, lotions, patches, and aerosol sprays. Some topical drugs are also transdermal, meaning they are placed on the skin to create a slow, controlled, systemic effect throughout the body. Transdermal absorption can change if the application site has lesions, burns, or skin breakdown. Many transdermal medications are...

preparing and administering inhaled medications

preparing-and-administering-inhaled-medications

Using a Metered-Dose Inhaler Properly

Inhaled medications are used to treat conditions that affect the bronchi and bronchioles in the lungs. These airways can be involved in acute conditions, such as acute bronchitis, pneumonia, tuberculosis, pulmonary edema, and acute respiratory distress syndrome. They can also be involved in chronic conditions, including COPD, asthma, chronic bronchitis, emphysema, cystic fibrosis, lung cancer, and pneumoconiosis. These medicines help open airways, reduce airway inflammation, and improve...

preparing and administering subcutaneous medications

Subcutaneous medication administration places a small dose of medicine just below the skin. This route is used for medications that need to be absorbed more slowly than by an intravenous route. It is also chosen for some drugs that may be broken down by the acidic environment of the gastrointestinal tract if taken by mouth. Common subcutaneous medications include anticoagulants such as heparin or enoxaparin. Epinephrine for allergic reactions, insulin, and some immunizations can also be given...

preparing and administering intramuscular injections

preparing-and-administering-intramuscular-injections

Selecting Sites for Intramuscular Injections

Intramuscular injections place medication deep into muscle tissue. Because muscle has a rich blood supply, this route can move medication into the body quickly and can handle relatively large volumes. Skeletal muscle also has fewer pain-sensing nerves than subcutaneous tissue, which can make it a better choice for irritating drugs such as chlorpromazine. IM injections are often used when a patient cannot take medicine by mouth or is not cooperative. Common examples include antibiotics,...

preparing and administering enteric tube medications

preparing-and-administering-enteric-tube-medications

Checking Enteric Tube Placement Before Meds

Enteric tube medications require a careful check of tube placement before each dose. An enteric tube is a tube inserted through the nose or mouth and passed into the stomach or intestines. These tubes may be used for stomach decompression, enteric feeding, or giving medications and oral contrast. Enteric tubes are used when a patient has trouble swallowing, has a neurological condition, or has another condition that raises aspiration risk. They are also used when a patient cannot take enough...

peripheral intravenous catheter insertion

peripheral-intravenous-catheter-insertion

IV Site Selection for Peripheral Catheters

Peripheral intravenous catheter insertion uses a careful site check before the catheter is placed. A peripheral IV, or PIV, is used to give medications, provide IV fluid therapy, or inject radioactive tracers for special examination procedures. Because it is an invasive procedure, it requires an aseptic, no-touch technique. Choosing the right venipuncture site is an important part of the process. In adults, common IV sites are the arms and hands. In children, the feet are also common, but the...

assessing and flushing a peripheral intravenous line

assessing-and-flushing-a-peripheral-intravenous-line

Peripheral IV Care: Site Checks and Flushes

Peripheral IV care includes regular site checks and normal saline flushes to keep the catheter working properly. After peripheral intravenous access is started, the line should be assessed and maintained according to institutional policies and nursing standards of practice. Careful maintenance helps preserve patency, which means the IV remains open and usable. The insertion site and the tissue around it must be checked often for signs of complications. These can include infiltration,...

initiating maintenance iv fluids

Gravity Setup for Maintenance IV Fluids

Maintenance IV fluids help keep a patient's fluid and electrolyte balance steady during hospital care. Patients who cannot drink by mouth may need IV fluids with or without electrolytes to help prevent hypovolemia, dehydration, and electrolyte imbalance. Patients who are NPO, or nil per os, before surgery or a procedure with anesthesia also need hydration while they are not eating or drinking. After surgery or other procedures, IV fluids may be used to restore intravascular volume after blood...

preparing and administering iv push medications

preparing-and-administering-iv-push-medications

IV Push Medication Safety and Dosing

IV push medication safety and dosing are shown in this nursing demonstration. An intravenous, or IV, push is the rapid delivery of a small amount of medicine into a vein through a previously placed IV catheter. These medications often come in vials or ampules, which are used to draw the drug into a syringe before it is given. This method is chosen when a fast response is needed or when a medication cannot be taken by mouth. The transcript gives moderate or severe pain treatment as one common...

preparing and administering intermittent intravenous medications with an infusion pump

preparing-administering-intermittent-intravenous-medications-with-an

Infusion Pump Steps for Intermittent IV Meds

Intermittent IV medications are given by infusion pump to deliver a set volume over a specific time. These infusions may be primary, meaning they run alone, or secondary, meaning they run with another IV fluid such as maintenance fluids. Medications like IV antibiotics are common examples of this type of treatment. Infusion pumps help control the fluid rate and keep medication effects more predictable. They also help reduce nurse medication errors. High-volume IV medications, often in the 50-...

preparing and administering secondary intermittent intravenous medications

preparing-administering-secondary-intermittent-intravenous

Secondary IV Piggyback Medication Setup

Secondary IV piggyback medication setup is used to give small, controlled amounts of IV solution, usually 25 to 250 mL. These infusions run longer than IV push medications. That slower delivery can lower the risk of problems linked to rapid infusion, such as phlebitis and infiltration. In secondary IV therapy, the medication tubing connects to the primary macrobore IV tubing, so the secondary line is tied to the main infusion. The secondary bag is usually hung higher than the primary bag. This...

discontinuing intravenous fluids and a peripheral intravenous line

discontinuing-intravenous-fluids-and-a-peripheral-intravenous-line

When IV Fluids Can Be Stopped

Intravenous (IV) fluids and peripheral IV catheters can be stopped when they are no longer needed. A patient may no longer need IV fluid therapy after returning to euvolemia, which means normal body fluid volume. IV fluids may also be stopped when the patient can drink enough fluids by mouth or is being discharged from the hospital. Peripheral IV catheters, or PIVs, also need regular checks for safety. In adults, the Centers for Disease Control and Prevention recommends replacing a PIV every...

central venous access device dressing change

central-venous-access-device-dressing-change

Sterile Care for Central Line Dressings

Central line dressings must be changed with sterile care to help protect the line from infection. Central venous access devices, or CVADs, are large IV catheters that go into the central circulation. They are also called central lines or central catheters. These devices usually end in the superior vena cava, just outside the right atrium of the heart. Some may end in other large veins, including the aorta, inferior vena cava, brachiocephalic vein, pulmonary artery, internal iliac vein, or...

nursing skills

This collection demonstrates medication preparation and administration, with videos highlighting important safety checks, considerations, dosage calculations, and common mistakes associated with improper medication administration.

Learn how subcutaneous medications are prepared, selected, and documented, including syringe setup, common drugs, the ten rights, and MAR charting.

Subcutaneous Injection Setup and Safety

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