Med injection cheat sheet-2 PDF

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Medication Administration/Injection Simulation Check list in PhasesPhase 1 Predrawing Phase Verify MD orders against MAR.. should match State that you checked the Medical chart State that you checked medical history, Medication history and allergies State that you checked height, weight and age Stat...

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Medication Administration/Injection Simulation Check list in Phases Phase 1 Predrawing Phase Verify MD orders against MAR...they should match State that you checked the Medical chart State that you checked medical history, Medication history and allergies State that you checked height, weight and age State that you checked pertinent lab results: Demerol and Dilaudid- state that when you go in room you will ask patient about pain and pain level Phenergan: state that when you go in room you will ask patient about his nausea or vomiting Heparin: state that you have checked PTT(partial thromboplastin time) or clotting time Insulin: state that you have checked Blood sugar level Rocephin: state the you have checked White Blood Cell count Phase 2 Draw up Phase Perform hand hygiene Check MAR and pull meds (1st check), check the name of med and dosage, do calculation if needed Check integrity of solution and expiration date If solution is NPH insulin remember to lightly roll vial in hands do not shake If plastic covering is over rubber stopper pop it off Clean rubber stopper with alcohol pull up the amount of air – should equal the amount of solution you will draw up while bottle is down inject air in vial (needle above the solution to prevent making bubbles) invert bottle and draw up the amonut of solution needed (do not touch the inside of plunger) recap needle by using the scoop method Once med is drawn, do 2nd check ( check the MAR, vial and syringe), if heparin or insulin state that you will get a second nurse to verify Gather all material and take to patient’s room:MAR,vials, syringes, alcohol preps, gloves Some things to remember: Insulin can only be drawn up with an insulin syringe TB needle should be used for drawing up heparin For IM, use one 22g- 1 1/2” needle to draw up med and change with same size needle for injection Supplies needed for walk thru: insulin syringe with needle, TB syringe with needle (27g -0.5”), 3ml syringe with needle (22g 1.5” x2), alcohol prep,gloves, basic calculator,sanitizer Vial dosages: Demerol 50mg/ml, Dilaudid 2mg/ml. Phenergan 25mg/ml, Heparin 5000 units/ml, Rocephin 500mg/ml. Remember insulin units ordered = units to draw up (no need for calculation)

Phase 3 Injection Phase Gather all material to take to patient’s room (Vials, syringes-take to room securely capped, alcohol preps, gloves, sanitizer, MAR) Knock on door Introduce self and let pt know what you are there to administer injections Wash hands Identify patient by using 2 identifiers-look at arm band while asking the 2 identifiers Do 3rd check (MAR, vial, syringes) can loosen the cap on the needle but do not contaminate Check patient’s Orientation ( Person, Place and time) Ask patient about allergies Ask patient if he knows what the meds are and if he does not explain meds Ask pt when and where he last received the meds (remember to rotate sites) Ask patient if he is able to move lower extremities, if he cannot you will delegate assistance Apply clean gloves now or anytime before this point State 2 areas where you would give an IM Z track and subcu...must give medical anatiomical locations Vastus Lateralis: 4 fingers below greater trochanter and 4 fingers above patella and inject in the middle 2/3 on lateral side of thigh Ventro Gluteal: Palm on greater trochanter, thumb toward groin, Index finger on anterior superior iliac spine other three fingers on iliac crest. Give in between index finger and middle finger Subcu should be given 2” from umbilicus and in the lateral aspect of upper arm Inspect and palpate area for bruises Assist patient to comfortable position and tell patient to relax the site where you are injecting Then just follow the skill technique for IM or Subcutaneous injection. Some things to remember: Cleanse site with alcohol pad from center of site and outward stabilize syringe inject needle quickly and firmly inject med slowly and smoothly For IM ztrack wait 5-10 seconds after injecting the medication before withdrawing(hold skin taught the entire 5-10 secs). Remember once you clean area with alcohol, DO NOT rub your hand across cleansed site and contaminate your area. For subcutaneous you can remove needle immediately after injecting medication. Subcutaneous you will inject needle at a 45 degree angle if they have minimal subcu tissue and 90 degrees if they have an excessive amount of subcu tissue. When giving subcu at 45 degrees, bevel of needle should be pointing upward. Also for subcu injection, you will pinch skin and then you will inject and let go of pinch and stabilize needle. apply pressure to site after injection, do not massage Do not recap needle after injection, state that you would place needle and syringe in sharp box Inspect and palpate areas for lump or bruises after each injection or inspect both sites after giving second injection. Clean area, bed to lowest position, side rails up x2, assure patient is comfortable, call bell within reach, bedside table near bed, if given a pain med or nausea med tell patient you will come back to check on them in 30 mins

Phase 4: Documentation Phasei Document: Only document after med is given In the Start/stop box put the date. In the box with the range of time (ex. 0700-1459) put your initial, time, and location (use the site code for location ex. If you gave the injection in Right vastus lateralis you would put RVL). At the bottom you would put your initials in the initial box and sign your signature in the signature box. Even though you gave 2 meds you only have to initial and sign once.

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