This document discusses parenteral administration, which is any route of medication administration other than through the digestive tract. It describes the equipment used including needles of varying lengths and gauges, syringes, and drug packaging like ampules and vials. The different types of parenteral injections are covered - intradermal, subcutaneous, intramuscular, and intravenous. Proper administration techniques, injection sites, and special considerations for different drugs are explained. The advantages and disadvantages of the parenteral route are also summarized.
6. Parenteral Medications are given through a route
other than the alimentary canal; these routes are:
Intradermal (ID)
Subcutaneous (SC orSQ)
Intramuscular (IM)
Intravenous (IV)
Parenteral Administration
7. Needles
Available in different gauges – the
smaller the number, the larger the
gauge (insidediameter)
Length – long enough to penetrate the
appropriate layers of tissue
Syringes
Barrel
Plunger
With or withoutneedle
Calibrated in milliliters or units
EQUIPMENT
9. The hub is at one end of the needle and is the
part that attaches to thesyringe.
The shaft is the long slender stem of the needle
that is beveled at one end to form a point.
bevel- is the slanted part at the tip of the shaft
The hollow bore of the needle shaft is known as
the lumen.
10. The length of a needle is measured in inches from
the juncture of the hub and the shaft to the tip of
the point. Needle lengths range from 3/8 inch to 3
1/2 inches; some special use needles are even
longer.
The gauge of a needle, used to designate the size
of the lumen, ranges from 27 (the finest) to 13
(the largest).
Needle Size-isdesignated by
LENGTHAND GAUGE
15. Tip-which connects the needle
Barrel-outside part, which containsmeasurement
calibrations
Plunger-which fits the inside the barrel and has a
rubber tip
THE NURSE MUST ENSURE THATTHE SYRINGE TIP,
INSIDE OF THE BARREL, SHAFT & RUBBER
PLUNGERTIP& SHAFT OFTHE NEEDLEARE KEPT
STERILE.
SYRINGES
17. Standard- comes in 3ml,5 and10ml
Insulin-designed specially for use withthe
ordered dose of insulin
Tuberculin-narrow syringe, use to administer
small or precise doses such aspediatric
dosages.
Should be used for doses of 0.5ml or less
TYPESOFSYRINGES
21. Ampule – glass or plastic container
that is sealed and sterile (open with
care)
Vial – small bottle with rubber
diaphragm that can be punctured by
needle
Parenteral DrugPackaging
22.
23.
24.
25.
26. Rules for administration
Giveonly drugs the doctor orders – use drug reference, if
necessary
Washyour hands
Prepare in awell-lit area
Focus on task; avoiddistractions
Calculate the dosecarefully
Do not leave aprepared drug unattended – never give a
drug thatsomeone else has prepared
Preparing to Administer a Drug (cont.)
27. Rules for administration
Identify patientproperly
Physician should be in the office
Observe patient following administration
Discard any ungiven medicationsproperly
Report error to physician immediately
Document properly
Preparing to Administer a Drug (cont.)
28. Parenteral preparations must besterile
free of microorganisms
To ensure sterility, parenterals are prepared using
aseptic techniques
special clothing (gowns, masks, hair net, gloves)
laminar flow hoods placed in special rooms
Parenteral DoseForms
29. Seven Rights of DrugAdministration
1. Right patient
2. Right drug
3. Right dose
4. Right time
5. Right route
6. Right technique
7. Right documentation
Preparing to Administer a Drug (cont.)
30.
31. Apply YourKnowledge
How do you properly identify the patient before
administering a drug?
ANSWER: To ensure that you have the right patient, you
should check the name and date of birth on the patient record
and ask the patient to state his/her name and date of birth.
32. Techniques for
Administering Drugs(cont.)
Methods of injection
Intradermal
Into upper layer of skin
Used for skintests
Subcutaneous
Provides slow,sustained
release and longer
duration of action
Rotate sites
Intramuscular
More rapidabsorption
Lessirritation of tissue
Larger amount ofdrug
Z-track method
Intravenous
Not usually givenby
medical assistants
33. -to diagnose TB,identifyallergens,
administer localanesthetics
-drugs are absorb slowly from this site
-commonly used for ID injection are the
INNERASPECTOFTHEFOREARM(upper
chest andupper backbeneath the scapula)
-drug’s dosage contained inasmall quantity
of solution (0.01 to0.1ml)
Intradermal or Intracutaneous
34.
35. Given into capillary-rich layer just below epidermis
for
local anesthesia
diagnostic tests
immunizations
Intradermal Injections
36. Examples of ID injectionsinclude
skin test for tuberculosis (TB) or fungal infections
typical site is the upper forearm, below the area where IV
injections aregiven
allergy skintesting
small amounts of various allergens are administered to
detect allergies
usually on theback
Intradermal Injections
37.
38.
39. Given at a45-degree
angle
25-or 26-gauge needle,3/8
to 5/8 inchlength
No more then 1.5mL
should be injectedinto
the site
to avoid pressure on
sensory nerves causingpain
and discomfort
Subcutaneous Injections
40. Administer medications below the skin into the
subcutaneous fat
outside of the upper arm
top of the thigh
lower portion of each side of the abdomen
not into grossly adipose, hardened, inflamed, or swollen
tissue
Often have alonger onset of action and a longer
duration of action
compared with IM or IV injection
Subcutaneous Injections
41. Insulin is given using 28- to 30-gauge short needles
in special syringe that measures in units
Insulin is administered following a plan for site
rotation
to avoid or minimize local skin reactions
Absorption may vary dependingon
site of administration
activity level of the patient
Subcutaneous Injections
42. Keep insulin refrigerated
Check expiration datesfrequently
opened vials should be discarded after one month
Avial of insulin is agitated and warmed by rolling
between the hands and should never be shaken
The rubber stopper should be wiped with an
alcohol wipe
Subcutaneous Injections
44. Medications administered by this route include:
epinephrine (or adrenaline)
for emergency asthmatic attacks or allergic reactions
heparin or low molecular–weight heparins
toprevent blood clots
sumatriptan or Imitrex
for migraines
many vaccines
Subcutaneous Injections
45. Normally given with the syringe held at a 45-degree
angle
in lean older patients with less tissue and obese patients
with more tissue, the syringe should be held at more of a
90-degree angle
Correct length of needle is determined by a skin
pinch in the injection area
proper length is one half the thickness of the pinch
Subcutaneous Injections
46. When administering insulin, air is injected into vial
equal to the amount of insulin to be withdrawn
Air is gently pushed from syringe with the plunger
Patient should plan meals, exercise, and insulin
administration
to gain the best advantage of the medication
avoid chances ofcreating hypoglycemia
Subcutaneous Injections
47. Typical needle is 22-to 25-
gauge ½-to 1-inchneedle
Intramuscular (IM)
injections areadministered
at a90-degreeangle
volume limited to less than 3
mL
Intramuscular Injections
48. Care must be taken with deep IM injections to avoid
hitting avein, artery, or nerve
In adults, IM injections are given into upper, outer
portion of the gluteus maximus
large muscle on either side of the buttocks
For children and some adults, IM injections are given
into the deltoid muscles of the shoulders
Intramuscular Injections
49. Used to administer
antibiotics
vitamins
iron
vaccines
Absorption of drug by IM route is unpredictable
not recommended for patients who are unconscious or in a
shocklike state
Intramuscular Injections
50. Intramuscular Injection
Promote rapid drugabsorption.
Provide an alternate route when drug is irritating to
subcutaneous tissue.
Sites
Gauge and needle length
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc. 30-52
Parenteral Administration
51.
52.
53. Intravenous (IV) injections are administered at a
15-to 20-degreeangle
Intravenous Injections orInfusions
55. The IVroute is the fastest method for delivering
systemic drugs
preferred administration in an emergency situation
It can provide fluids, electrolytes, and nutrition
patients who cannot take food or have serious problems
with the GItract
It provides higher concentration of drug to
bloodstream or tissues
advantageous in serious bacterialinfection
Advantages and Disadvantages of the
Parenteral Route
56. Traumatic injury from the insertion of needle
Potential for introducing:
toxic agents
microbes
pyrogens
Impossible to retrieve if adverse reaction occurs
injected directly into the body
Advantages and Disadvantages of the
Parenteral Route
57. Intramuscular (IM) and subcutaneous routes of
administration are convenient ways to deliver
medications
Compared with theIV route:
onset of response of the medication is slower
duration of action is much longer
Practical for use outside the hospital
Used for drugs which are not active orally
Advantages and Disadvantages of the
Parenteral Route
58. For intramuscular (IM) and subcutaneous routes
of administration, the injection site needs to be
“prepped”
using alcoholwipe
Correct syringe, needle, and technique must be
used
Rotation of injection sites with long-term use
prevents scarring and otherskin changes
can influence drugabsorption
Advantages and Disadvantages of the
Parenteral Route
59. The intradermal (ID) route of administration is
used for diagnostic and allergy skin testing
patient may experience asevere local reaction if
allergic or has prior exposure to atesting antigen
Advantages and Disadvantages of the
Parenteral Route
60. Most parenteral preparations are made up of
ingredients in asterile-watermedium
the body is primarily an aqueous (water-containing)
vehicle
Parenteral preparations areusually:
solutions
suspensions
Dispensing andAdministering
Parenteral Medications
61. IV injections and infusions are introduced directly
into the bloodstream
must be free of air bubbles and particulate matter
introduction of air or particles might cause embolism,
blockage in a vessel, or severe painful reaction at the
injection site
Dispensing andAdministering
Parenteral Medications
62. Fast-acting route because the drug goes directly
into the bloodstream
often used in the emergency department and in
critical careareas
Commonly used
for fluid and electrolyte replacement
to provide necessary nutrition to the patient who is
critically ill
Intravenous Injections orInfusions