ADDITIONAL WORK / EXTRA PAGES: Injection Case Study Assignment

Parenteral Medication Packaging
What is the difference between ampules and vials?
What special equipment do you need to withdraw medication from an ampule?

Syringes
What is the difference between slip tip and luer-lok?
Why is it important to choose the right size syringe for medication administration?

Intradermal Injections

What is an intradermal injection?
Where is this injection administered?
What angle do you administer?
If properly administered what should you see?
What size needle and gauze would you use?
What is a common medication used for intradermal injection?

Intramuscular Injection
What is an intramuscular injection?
What locations/landmarks for IM injection administration?
What is the maximum amount of medication that can be administered?
What needle size and gauze?
What special considerations do you need to consider?
What angle of administration?
What are some common side effects of IM injections?
What is the Z-track method and why is it important?

Subcutaneous Injection (SQ)
What is a subcutaneous injection?
What are the common locations to administer SQ injections?
What size needle and gauze do you use?
What angle do you administer?
What are some considerations to think about when administering a SQ injection?
What are some common side effects of SQ injections.

Insulin

Insulin is often given subcutaneous to treat Type 1 Diabetes. It is important to understand how insulin works.
What is the onset?
What is the duration?
What is the peak?
What signs and symptoms do you want to monitor?
Explain what order you inject air into vials and withdraw insulin.
Insulin can only be measured and given in an insulin syringe true or false?

Sliding Scale

Mr. Jones blood sugar was checked and his blood glucose was 257. He is being treated on the moderate scale. How many units of insulin would you administer?

Sensitivity/Ratio Scale

A patient has an insulin sensitivity factor of 1:13. The nurse administers 2 units of insulin. How many mg/dl will the patient’s blood sugar drop?

Insulin to Carb Ratio
1 unit insulin: 15 grams CHO
Mr. Smith had 1 cup of OJ (30g), 2 slices of toast (30g), ½ cup of cream of wheat (15g), 1 egg, 1 tsp of sugar free jelly, and 1 cup of coffee.
Calculate the total CHO:
Calculate the total insulin to be administered.

Case Study:
Mr. Jones is a 70 year old man with uncontrolled diabetes. His current BS is 301. He was admitted to get his blood sugar under control. He needs a Flu vaccine administered IM and insulin administered SQ. He has NKDA and is 167lbs. His vital signs are stable and assessment is unremarkable.

You have orders to administer:
Fulzone (Influenza Vaccine) 0.5ml at 0900
NPH 17 units at 0900
Regular insulin 12 units at 0900

What would you communicate to this patient upon entering the room?
Discuss the 6 safety rights how you would follow them.
What education would you provide the patient regarding these two medications?
Describe the process of administrating these medications.
Discuss any contraindications for administering these medications.
What would you want to monitor after administration of these medications?