Parenteral Medication
Meaning:
Administration of medications
by injection into body tissues,
Purposes of parenteral medications:
·
To get a rapid and systematic effect
of the drug.
·
To provide the needed effect
even when the client is unconscious, unable to swallow due to neurological or
surgical alterations affecting the throat and mouth or when the client is not
cooperative.
·
Assures that the total dosage
will be administered and the same will be absorbed,
·
Provides the only means of administered
for medications that cannot be given orally.
·
Medications that are rendered
ineffective by the action of the digestive juices.eg :insulin
·
Medications which cannot be retained
in the intestine for a sufficient period for its absorption due to diarrhea,
vomiting etc.
·
When a drug irritating to the
GI.
·
To restore blood volume by
replacing the fluid, e.g.: in shock
·
To give nourishment when it
cannot be taken by mouth
·
To obtain a local effect at the
site of injection,
·
Local anesthetics such
xylocaine
·
Diagnostic purposes as in
tuberculin test
·
To test allergy to a drug. Eg; penicillin
Types of parenteral Therapies:
Subcutaneous/ hypodermal injection:
medicine injected into the subcutaneous tissue. Eg: insulin
Intradermal: Medicines into the dermal
layer of the skin.eg: penicillin
Intramuscular: Medicines injected into
the muscles, eg: voveran
Intravenous: medicines introduced into a
vein,
Intra arterial: medicine given into the
arteries.
Intra osseous: drugs introduced into the
bone marrow.
Intra peritoneal: medicines introduced
into the peritoneal cavity
Intraspinal/ intrathecal: medicines injected
into the spinal cavity
Venesection/ cut down: is the opening of
a vein and a tube or a wide bore needle and giving medicines and fluid through
it. Usually done in emergencies.
Intra cardiac: into the heart
Pleural: into the pleural cavity.
Intra articular: into a joint.
Infusion, Means a
large quantity of fluid to be introduced into the body is as infusion. Usually
given intravenously.
Transfusion is the of
whole blood or plasma into a vein or artery.
An injection is an
invasive procedure because it breaks the skin As such, it must be performed using
proper aseptic technique to prevent risk of infection.
Types of syringes, needles, cannula & infusion sets:
Syringes
Syringe is a device
used for transfer of medication
·
From storage container
·
To administration container
·
To patient
·
System for maintenance of
sterility
·
System for measuring medication
·
System for delivering
medication
·
System for prevention of needle
sticks
Syringes- parts:
Tip- which connects the needle
Barrel- outside part, which contains
measurement calibrations. Acts as receptacle for medication
Plunger- which fits the inside the
barrel and has a rubber tip. Used to pull or push medication into or out of
barrel
(Nursing alert: the
nurse must ensure that the syringe tip, inside of the barrel, shaft &
rubber plunger tip & shaft of the needle are kept sterile).
There are several kinds
of syringes, differing in size, shape, and material.
TYPES OF SYRINGES:
The three most
commonly used types are the standard hypodermic syringe, the insulin syringe,
and the syringe.
Size starts from
0.5 to 60 mL.
1 to 3 ml, adequate
for SIC or injection
Larger sizes for IV
medication
1.
Hypodermic syringe
Comes in 2-, 2.5,
3-, and 5-mL Sizes.
The syringe may
have two scales marked on it: minim and the milliliter. The milliliter scale is
the one normally used; the minim scale is used for very small dosages.
2.
Insulin syringe
An insulin syringe
is similar to a hypodermic syringe, but the scale is specially designed for
insulin: a 100-unit calibrated scale intended for use with U- 100 insulin.
This is the only
syringe that should be used to administer insulin
These syringes
frequently have a non-removable needle.
The correct choice
of syringe is based on the amount of insulin required.
3. Tuberculin syringe
The tuberculin
syringe was designed to administer tuberculin solution.
It is a narrow
syringe, calibrated in tenths and hundredths of a milliliter (up to 1 mL) on
one scale
Should be used for
doses of 0.5ml or less
Also classified as:
Luer-Lok and Non-Luer-Lok.
A Luer-Lok syringe
has a tip that requires the needle to be twisted onto it to avoid accidental
removal of the needle
The non-Luer-Lok
syringe has a smooth graduated tip, and needle are slipped onto it.
Pre-filled
single-dose syringes (Pre-filled unit-dose systems)
These are available
as:
·
prefilled syringes ready for
use or
·
Prefilled sterile cartridges and
needles that require the attachment of a reusable bolder before use.
Needles:
Are made of
stainless steel, and most are disposable.
Reusable needles
(e.g., for special procedures) need to be sharpened periodically before
resterilization because the points dull.
A dull or damaged
needle should never be used.
Needles are
available in different gauges — the smaller the number, the larger the gauge
(inside diameter)
Length - long enough to penetrate the
appropriate layers of tissue, needle has three parts, the hub, the shaft, and
the bevel,
The hub is at one end
of the needle and is the part that attaches to the syringe.
The shaft is the
long slender stem of the needle that is beveled at one end to form a point,
Bevel- is the
slanted pan at the tip of the shaft
The hollow bore of
the needle shaft is known as the lumen.
Needle Size-is
designated by LENGTH AND GAUGE
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 1/2 inch to 3 inches; some special
use needless are even longer.
The appropriate
needle length is chosen according to the client's muscle development, weight
and the type of injection.
The gauge of a
needle, used to designate the size of the lumen, ranges from 28 (the finest) to
18 (the largest).
For an adult
requiring a subcutaneous injection, it is appropriate to use a needle of #24 to
#26 gauge and 3/8 to 5/8 inch long,
Obese clients may
require a 1-inch needle. For intramuscular injections, a longer needle (e.g., 1
to 1 1/2 inches) with a largest gauge (e,g; to #22 gauges) is used.
Factors to be considered in the selection of syringes and needles:
·
The route ordered
·
Viscosity of the medication
solution
·
Amount of medication to be
administered
·
Body size and the amount of fat
·
The bevel should be sharp
without any hooks
·
Needle should fit tightly to
the syringe, so that the pressure of the liquid will not blow off the
·
needle
·
Length and size of the needle
should be appropriate to the site and the person
Needle less system:
Needle less devices
or protected needles reduces the chance of accidental needle stick injuries and
exposure to blood borne pathogens. It uses pressure to inject the medic on
through the skin and is relatively pain- free.
Pre-filled
cartridges: provides a single dose of medication, E.g. carpuject
Pre-filled
syringes: syringes filled with medication, which can be used for more than one
time.
E.g., lovenox
Cannula:
Cannula is a tube
that can be inserted into the small peripheral vein therapeutic purpose of
medications, fluids and/or blood products,
Parts:
·
Scalp veins (Hollow-Needle Catheter)
·
Designed to provide rapid venous
access, for patient comfort during infusion.
·
Butterfly wings facilitate for
better and easy fixation.
·
Super smooth, kink resistant
tube.
·
Color coded butterfly wings by size
for easy identification.
·
Sterile and Disposable
Intra-arterial catheters: designed to
insert into arteries. E.g: radial artery
Central venous catheter: designed for
central veins. E.g: Subclavian catheter
Infusion Sets:
Macrodrip:
15-20 gtts = 1 mL,
for giving large amounts of fluid
Microdrip set:
60 gtts = 1 mL, for
restricting amounts of fluid
Blood tubing:
·
To administer blood and blood
components
·
Has a filter to prevent clots
from blood products from entering the body
·
Approximately 20 drops — 1 ml
·
With 200 micron filters and 18
G needle
·
Kink resistant.
Volume control
administration set (Buretrol)
·
Delivers specific volumes of
fluids
·
It has got 150 ml containers that
are attached below the infusion bag
·
It is filled for prescribed
amount prior to infusion
Electromechanical
pump tubing which is specific for each pump.
COMMENTS