NCM104 Finals Lec&lab
NCM104 Finals Lec&lab
NCM104 Finals Lec&lab
(LEC)
TRANSTRACHEAL CATHETER
PAIN
o Subjective – symptom
It only becomes OBJECTIVE if the pain
scale is measured over time, determining the
increase and decrease of the pain.
o Also referred to as the 5th vital sign
o Unpleasant sensory and emotional experience
associated with actual or potential tissue
damage
o Previous pain experience alters pain sensitivity
Hollow tube inserted within the trachea to deliver o HOW DO YOU ASSESS FOR PAIN?
oxygen.
a. Numeric Rating Scale (NRS) – 1 being the
Transtracheal Catheter is used with the aid
lowest, 10 being the highest
of Tracheostomy Tube.
TRACHEOSTOMY
MAIN COMPONENTS:
a. Outer Cannula – it has a cuff that will be inflated
when injected an air by a syringe which will keep the
tube in its place, similar with ET Tube.
b. Inner Cannula – needs to be replaced by a new one
and clean the used.
c. Obturator
TRACHEOSTOMY CARE:
Inner Cannula Cleaning: Hydrogen Peroxide and
sterile water or Normal Saline depends on
Hospital.
Trache Tie:
1. Velcro Collar
Measurement in people who cannot verbalize
(late-stage dementia)
More on observing the patient
can also be used for adults who cannot
verbalize their experienced pain properly
non-verbal cues and facial expressions are
2. Tie Tape – use a square knot needed to be observed and rated it
Physiological Changes – VS can be altered
due to extreme pain felt by the patient
Physical Changes – physical injuries
connect to pain.
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
Skin tears does not easily associate with Intravascular Space (fluid within the
extreme pain, other interpretations should blood vessels) – blood is found in IVS
still be observed. arteries, veins, capillaries
PCA PUMP NURSING INTERVENTION Transcellular Space (epithelial lined
space)
Ex. #1: Heart – there is a
lining. The epicardium is the
outer most layer, surrounds
epicardium is pericardial fluid
which is enclosed in the
pericardial sac/pericardium.
In between the epicardium
and pericardium contains
PCA – Patient Control Analgesia pericardial fluid – an example
Analgesia – pain reliever of TRANSCELLULAR
The patient can add a dose of analgesic if the SPACE.
pain he experiences worsens. He will just press Ex.: #2: Fluids in Abdomen &
the top of the IV drip for the dose to be added. Peritoneal Cavity – very little
Patient has still a high chance of overdosing in Moreover, fluids that are not
this PCA Pump, so the pain nurse’s/ICU nurse’s found inside and in between
responsibility is to adjust the PCA Pump as per the cells are called
doctor’s order. (Max. dose the patient can add TRANSCELLULAR SPACE.
per 15 mins.) Additional Examples of
The medication is sometimes given TRANSCELLULAR SPACE:
subcutaneously, instead of through IV. a. Fluids inside ureters that
Assess for level of sedation and pain are going through the
Coordination with pain service and pain nurse bladder can be considered
Standby Naloxone (Narcan) – an antidote; TCS.)
Morphine – if a high dosage of this was given to the b. Sweat
patient, he may experience respiratory depression. c. Saliva
To prevent that from happening, Naloxone is given. d. Seminal Fluids
Disadvantage: Shortly after Naloxone was Interstitial Fluid (fluid that surrounds
given, the patient will feel body pain again the cell) – found in between the cells
because narcotic analgesics will be in no
effect.
HOW TO KNOW IF THE PATIENT HAS
RESPIRATORY DEPRESSION?
Assess VS, RR less than 8 might indicate
that the patient has respiratory depression.
FLUIDS & ELECTROLYTES
HYDROSTATIC PRESSURE
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
SPACING TYPES
1. First Spacing
Normal fluid distribution (ICF & ECF)
2. Second Spacing
Abnormal accumulation of Interstitial
Fluid (edema)
dehydration
3. Third Spacing
Abnormal fluid accumulation in
Transcellular Space
Abnormal accumulation of fluid
in a non-functional space or
Concentration of solutes in a solution compartment, outside of the
HYPERTONIC SOLUTION: intracellular fluid (ICF) and
extracellular fluid (ECF)
compartments
Ex.: Pleural Cavity (around the
lungs), the peritoneal cavity
(around the abdominal organs),
and the pericardial cavity
(around the heart)
CENTRAL VENOUS PRESSURE (CVP)
MEASUREMENT
Venipuncture – process of collecting or
“drawing” blood from a vein and the most
common way to collect blood specimens for
laboratory testing.
VENIPUNCTURE MATERIALS:
Vacutainer Needle/Venipuncture Needle
Alcohol Swab
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
through an incision (cut) made on the
outside of the abdomen.
starts from the mouth
enteral nutrition is applicable for patients who
cannot digest food due to:
a. obstruction in esophagus
b. failure in continuity of peristaltic movement
1. Nasogastric/Nasointestinal/Nasoenteric Tube
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
if not, explain to the relative. 1. Gather the equipment and bring them to the
also to teach the relatives on what bedside.
are the stuffs to check for the bring stethoscope, clean gloves, formula
patient in the use of NGT. 2. Prepare feeding container and formula:
3. Provide patient privacy. a. Check expiration date of formula and
close the door or curtain integrity of container.
4. Performs hand hygiene and apply clean gloves. b. Have tube feeding at room temperature.
IMPLEMENTATION: c. Shake formula well.
1. Place the patient in High Fowler’s position or 3. Explain the procedure to patient.
elevate head of bed preferably 45 degrees for tell the patient that this is a nutritional
some patients. requirement for him/her
2. Prepare the tube: 4. Provide patient privacy.
a. SMALL BORE TUBE – ensure stylet or close the door or curtain
guidewire is secured in a position. 5. Performs hand hygiene and apply clean gloves.
b. LARGE BORE TUBE – Place in a basin to IMPLEMENTATION:
become more pliable and flexible 1. Place the patient in High Fowler’s position or
3. Determine how far to insert the tube. elevate head of bed preferably 45 degrees for
o Measurement length: TIP OF CLIENT’S some patients.
NOSE-TIP OF EARLOBE-TIP XIPHOID 45º - 90º - depending on the patient’s
PERFORMANCE: capability to stay on that position while
Lubricate the tip of the tube well with water- performing the procedure
soluble lubricant. 2. Verify tube placement:
o RATIONALE: If the nasogastric tube is o Nasogastric tube:
not properly lubricated, it will have a a. Attach syringe and aspirate 1mL of
difficult time curving with the body's gastric contents.
anatomy and may not make it to its b. Observe the appearance of aspirate and
destination without a great deal of internal note pH (if available).
damage to the patient. 3. Check for gastric residual volume (GRV) before
Insert the tube with its natural curve downward, each feeding – for bolus and intermittent
into the selected nostrils. feedings every 4 to 6 hours in non- critically ill
Ask the client to hyperextend the neck and patients.
gently advance the tube towards the a. Connect asepto syringe to the end of
nasopharynx. feeding tube. Remove bulb and flush tube
with air (negative pressure). Put down slowly
Direct the tube along the floor of the nostrils and
to aspirate total amount of gastric contents
toward the midline.
and measure.
Slight pressure and a twisting motion are
b. If 100 ml (or more than the last feeding) is
sometimes required to pass the tube into the
withdrawn refer to agency policy before
nasopharynx.
proceeding. (at some agencies a feeding is
If the tube meets resistance, withdraw it. delayed when the specified amount or more
Relubricate it and insert in the other nostrils. formula remains in the stomach).
Once the tube reaches the oropharynx , the c. Re-instill the gastric contents into the
client will feel the tube in the throat and may stomach if this is the agency policy.
gag. Ask the client to tilt the head forward. 4. Auscultate for gurgling sounds.
If the client gags, stop passing the tube 5. Initiate feeding:
momentarily. o Syringe for Intermittent Feeding
In cooperation with the client, pass the tube 5 to a. Pinch proximal end of feeding tube
10cm with each swallow until the indicated b. Remove plunger from syringe and
length is inserted. attach tip of syringe to end of tube.
o swallow or introduce water c. Fill syringe with measured amount
o every swallow = move the tube of formula.
Ascertain the correct placement of the tube. d. Release tube, elevate syringe to no
Check the pH – 1 to 5. more than 45 cm(18inches) above
extract secretions insertion site, and allow it to empty
DOCUMENT & EVALUATE: gradually by gravity.
a. Client’s tolerance of the NGT 6. Flush with 30ml water every 4 hours before and
b. Correct placement after an intermittent feeding.
c. Client’s understanding of restrictions, color, and AFTER CARE & EVALUATION:
amount of gastric contents After Care –
SKILL: FEEDING THROUGH NGT – PT. 2 Keep patient in Fowler's position for 30 minutes.
ASSESSMENT: Secure tubing to patients’ gown.
Washes equipment used and store in the
Verify Doctor's order for formula, rate, route and
designed area.
frequency.
Evaluation –
Identify patient using two identifiers.
Perform a follow-up examination of the following:
full name a. tolerance of feeding
birthdate
b. bowel sounds
Assess patient for food allergies or intolerances. c. regurgitation and feelings of fullness after
Perform physical assessment of abdomen. feedings
PLANNING: DOCUMENTATION:
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
a. Record amount and type of feeding instilled, b. have the concepts of computation
patient’s response to tube feeding, patency of (tab, vial, ampule)
tube, condition of naris and any side effects. COMMON SITES FOR INTRAMUSCULAR
b. Document your evaluation of patient learning. INJECTION: deltoid, gluteus maximus,
gluteus minimus
o dangerous site: g. maximus and
SKILL: REMOVAL OF NGT – PT. 3 minimus because sciatic nerve is
Removing – there and the client may be
1. Verify health care provider's order for removal. paralyzed kapag natamaan.
2. Gather equipment, explain procedure to patient. o safest site: ventrogluteal
3. Perform hand hygiene, apply gloves. SCIENTIFIC KNOWLEDGE – BASED
4. Position patient in high-Fowler's if possible. To safely and accurately administer medications,
5. Place towel on patient's chest. you need knowledge related to:
6. Disconnect tube from administration set if Legal aspects of health care – NCLEX-
appropriate. based; safe and effective
7. Remove tape partially. Pharmacology
8. Coil end of tubing until the nose. Pharmacokinetics – action of medication
9. Instruct patient to take deep breath and hold it. Physiology – normal function of the body
Pull tube out smoothly. Dispose tube properly by Pathophysiology – altered normal function
wrapping the coiled tubing with gloves. of the body
10. Offer tissue to patient to blow nose. Clean naris, Human anatomy
provide oral care. Mathematics
11. Perform hand hygiene.
Evaluation – MEDICATION LEGISLATION & STANDARDS
a. Inspect naris and oropharynx for irritation. Federal Regulations
b. Ask if patient is comfortable. o Pure Food and Drug Act – all medicines
c. Observe patient for difficulty breathing, should be free from impurities
coughing, or gagging. o Food and Drug Administration (FDA) –
MEDICATION ADMINISTRATION to ensure all medicines have undergone
o A medication is a substance used in the vigorous testing before being released in the
diagnosis, treatment, cure, relief, or prevention market
of health problems. BFAD – PH setting of FDA
medication administration is done in all cosmetics and supplements
settings “No therapeutic claim” – not yet
this is an independent nursing intervention BFAD approved
by a nurse but based on a doctor’s order Medicines should be FDA
medication administration is also a way to approved
prevent health problems: o MedWatch program – nurses will report
a. vaccines medication errors
prophylaxis – live virus; o State and Local Regulations – there is a
these are non-continuated specific policy per hospital
vaccines (Pfizer); In US, Intracardiac is only for
regarded by the T-cells doctor’s intervention.
and acts as non-foreign In PH, gluteus minimus site of
body. injection is only for doctor’s
dead virus – tetanus intervention.
b. antibiotics Healthcare institutions and medication laws
pseudomonas – caused by o Generic Act – not prescribing medicines
nosocomial/hospital without generic
infection; patients are Medication regulations and nursing practice
asked to drink antibiotics (Nurse Practice Acts)
before being exposed to a o REQUIREMENT FOR NURSES: PRC
patient/surrounding with license for nursing practice; ANSAP card
suspected pseudomonas; for IV Therapy
there is no prophylaxis o STRICTLY “NO LICENSE, NO
for COVID-19. ADMINISTRATION”!
for relief – analgesia as PHARMACOLOGICAL CONCEPTS
pain reliever; anti-
hypertensive.
cure – antibiotic,
antibacterial, antivirus.
diagnosis – helps in
ruling out the alteration
of body function (Varium
– chemical administered
through rectum to check
GI organs in ultrasound)
the nurse will have to:
a. prepare the medicine, administer it,
and evaluate the client’s response Medical Names:
after administering the procedure
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
o chemical – exact description of Toxic effect: Accumulation of medication
medication’s composition. in the bloodstream
prepared by pharmacists in the bloodstream, iron toxicity
acetaminophen – tyenol, advil, that were not excreted in urine will
panadol corrode the blood vessel
paracetamol – tempra, biogesic Idiosyncratic reaction: Overreaction or
o generic – the manufacturer who first underreaction or different reaction from
develops the drug assigns the name, normal
and it is then listed in the U.S. Inflames a body part or either no
Pharmacopeia. reaction at all
o trade – brand/proprietary name. This is C. Allergic Reaction – unpredictable response to a
the name under which a manufacturer medication
markets the medication. Skin Test – testing for allergies through
Classification intradermal administration
o Effect of medication on body system D. Medication Interactions – when one medication
diuretics – for urination modifies the action of another
laxatives – for increasing bowel food and medicine combination
movements ORANGE JUICE & Ferrous
o Symptoms the medication relieves Sulfate combination
o Medication’s desired effect DRUG STUDY
Examples: to lower body
temperature, blood pressure,
sugar, etc.
Medication Forms – solid, liquid, other oral
forms; topical, parenteral; forms for instillation
into body cavities
o solid – tablets, capsules
o liquid – syrup, suspension (more viscous),
inhalers
o topical – ointment, jellies
o parenteral – through syringes
o instillation – through eyes, nose, ears,
rectum, vagina
PHARMACOKINETICS AS THE BASIS OF
MEDICATION ACTIONS ROUTES OF ADMINISTRATION
The study of how medications: A. Oral Routes – oral medications have slower onset
Enter the body (Absorption) action but a more prolonged effect
are absorbed and distributed into cells,
tissues, or organs (distribution)
Reach their site of action
Alter physiological functions
Are metabolized (metabolism)
Exit the body (excretion)
REMEMBER:
absorption – medication enters body
sublingual – dissolves easily
sublingual administration – under the
EMERGENCY SITUATION for Hypertensive
tongue; instruct patient not to swallow/drink
patient: NIFEDIPINE sublingually administered
while the medicine is being administered
and placed through Wharton Ducts or submaxillary
buccal administration – between the gum
ducts.
and the cheek
Half Life – medicines are considered half-life so the
B. Parenteral Routes
patient needs to take meds again to sustain the
Four Major Sites of Injection
function of it to the body.
intradermal – dermis, located
o Example: PARACETAMOL has low half-
between the epidermis and
life that is why it is given every 4hours. hypodermis
Metabolized: alters metabolism of the drug if the subcutaneous – below dermis
patient has liver disease intramuscular – muscle
Excretion: kidney failure – toxic effect cannot be intravenous – vein
excreted Other Routes
TYPES OF MEDICATION ACTION epidural – for painless birth
A. Therapeutic Effect – expected or predicted intraosseous – directly into the
physiological response bone
B. Adverse Effect – unintended, undesirable, often intraperitoneal – into the
unpredictable peritoneum (body cavity)
Side effect: Predictable, unavoidable intrapleural – needle passes
secondary effect through intercostal muscles and
S/Sx during the testing of the parietal pleura on its way to the
medicine should appear pleural space
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
intraarterial – joint injection;
symptomatic relief for
osteoarthritis
Routes Usually Limited to Physicians
ONLY:
intracardiac – injections given
directly into the heart muscles or
ventricles; used in emergency
intraarticular – treatment for oEXCESS: 0.6 ml should be stored in a
inflammatory joint conditions like refrigerator, for consumption within 24hrs.
gout, tendinitis, carpal tunnel after 24hrs, dispose.
syndrome, rheumatoid arthritis,
and osteoarthritis HEALTH CARE PROVIDER’S ROLE
C. Topical Administration
Prescriber can be physician, nurse practitioner,
skin or physician’s assistant.
mucous membranes Orders can be written (hand or electronic),
D. Inhalation Route verbal, or given by telephone.
for asthmatic patients; local & systemic Telephone Orders for medication should be
effect signed within 24hrs.
E. Intraocular Route The use of abbreviations can cause errors; use
medications for eyes like contact lenses caution.
SYSTEMS OF MEDICATION MEASUREMENT MEDICATION ABBREVIATIONS:
Require the ability to compute medication doses Abb. Meaning Abb. Meaning
SL sublingually PR per rectum
accurately and measure medications correctly
ORAL by mouth PV per vagina
Metric system SC/SUBCUT subcutaneous PRN as necessary
Most logically organized 1 mg not 1.0 mg IM intramuscular OD once a
o Meter, liter, gram day/once daily
IV intravenous BID twice a day
Household system
ID intradermal TID thrice a day
o Most familiar to individuals – 1 tbsp., 1 NG nasogastric QID four times a
tsp. day
o Disadvantage: inaccuracy HS hours of sleep OD right eye
use measuring cup instead PC after meal OS left eye
AC before meal OU both eyes
Solution
ANST after negative AD right ear
REMEMBER: FOR PEDIATRIC DOSES, DOCTOR’S ORDER skin test
ARE NEEDED TO BE FOLLOWED. AS left ear ATC around the
clock
DOSE CALCULATION METHODS AU each ear/both RTC round the
Verify medication calculations with another ear clock
nurse to ensure accuracy. gtts drops Rx to take
The ratio and proportion method REMEMBER:
o Example: 1:2 = 4:8 OD (once daily) – same time of the day
Formula Method: [Mon 8am = Tues 8am]
BID (twice a day) – same time of the day
[8am & 6pm]
QID (four times a day) – same time of the day
Easier Formula Method:
[6am = 12pm = 6pm = 12mn]
HS (hours of sleep) – laxatives; sleep
enhancers; usually given at 10pm
ANST (after negative skin test)
Where:
D – desired/doctor’s order Distinction between OD: once a day & right eye
S – stock/availability of medicine
Q – quantity
SAMPLE PROBLEMS:
Cotrimoxazole: 500mg = 1 tablet q12 = Stock Distinction between PRN & RTC:
1000mg/tablet
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
b. right dose
c. right patient
d. right route
e. right time
f. right documentation
MAINTAINING PATIENT’S RIGHTS:
a patient has the right:
o To be informed about a medication
o To refuse a medication
o To have a medication history
o To be properly advised about
experimental nature of medication
o To receive labeled medications safely
TYPES OF ORDERS IN ACUTE CARE o To receive appropriate supportive
AGENCIES therapy
o To not receive unnecessary medications
o To be informed if medications are part of
a research study
ADMINISTRATION APPLICATION ON
DIFFERENT ROUTES
ORAL ADMINISTRATION:
REMEMBER:
Single (Ex: deworm)
Easiest and most desirable route.
Take anti-histamine first to tame the
Food sometimes affects absorption.
parasites. If parasites were not tamed, it will
Aspiration precautions.
go out to different routes of the body.
Enteral or small-bore feedings:
STAT (more important than now) Verify that the tube location is
If order was given at 10:10, the medication compatible with medication absorption.
should be administered by 10:11. Use liquids when possible.
Now – ranges from 1 ½ hours up to 3 hours; within If medication is to be given on an empty
90 minutes given. stomach, allow at least 30 minutes
before or after feeding.
MEDICATION ADMINISTRATION – ROLES &
Risk of drug-drug interactions is higher.
SYSTEMS
TOPICAL MEDICATION:
A. Pharmacist’s Role – Prepares and distributes
medication
B. Nurse’s role
o determining medications ordered are
correct, assessing patient’s ability to
self-administer, determining whether
patient should receive medications at a
given time, administering medications
Skin application
correctly, and closely monitoring effects Use gloves and applicators; clean skin
o cannot be delegated first.
o Includes patient teaching Use sterile technique if the patient has
C. Distribution Systems an open wound.
o unit dose systems Follow directions for each type of
o automatic medication dispensing system medication.
(AMDS) Transdermal patches:
MEDICATION ERRORS a. Remove old patch before
applying new.
Report all medication errors.
b. Document the location of the
Patient safety is top priority when an error
new patch.
occurs. c. Ask about patches during the
Documentation is required. medication history.
The nurse is responsible for preparing a written d. Apply a label to the patch if it is
occurrence or incident report: an accurate, difficult to see.
factual description of what occurred and what e. Document removal of the patch
was done. as well.
Nurses play an essential role in medication NASAL INSTILLATION:
reconciliation.
CRITICAL THINKING
6 Rights:
a. right medication
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
ADMINISTERING MEDICATIONS BY
INHALATION
spray
drops
tampons
EYE INSTILLATION:
syringes
a. Luer – Lok
b. Non – Luer – Lok
Needles
RECTAL INSTILLATION:
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
VASTUS LATERALIS –
hub
shaft
bevel
PREPARING AN INJECTION FROM AN AMPULE:
Used for adults and children
Snap off ampule neck
Use middle third of muscle for injection
Aspirate medication into syringe using filter
Often used for infants, toddlers, and children
needle receiving biologicals
Replace filter needle with an appropriate size DELTOID –
needle or needless device
Administer injection
PREPARING AN INJECTION FROM A VIAL:
If dry, use solvent or diluent as needed
Inject air into vial
Label multidose vials after mixing
Refrigerate remaining doses if needed
MINIMIZING PATIENT DISCOMFORT:
Use a sharp-beveled needle in the smallest USE OF THE Z – TRACK METHOD INJECTIONS –
suitable length and gauge; position patient
comfortably.
Select the proper injection site.
Apply a vapocoolant spray or topical anesthetic.
Divert the patient’s attention from the injection.
Insert the needle quickly and smoothly.
Hold the syringe steady while the needle
remains in tissues. Zigzag path seals needle track
Inject the medication slowly and steadily. Medication cannot escape from the muscle
SUBCUTANEOUS INJECTIONS – tissue
INTRADERMAL INJECTIONS –
Used for skin testing (tuberculosis [TB],
allergies)
Slow absorption from dermis
Skin testing requires the nurse to be able to
clearly see the injection site for changes
Use a tuberculin or small hypodermic syringe for
skin testing
Angle of insertion is 5 to 15 degrees with bevel
up
oMedications placed into loose connective tissue A small bleb will form
under dermis SAFETY IN ADMINISTERING MEDICATIONS BY
INTRAMUSCULAR INJECTIONS – INJECTION
Faster absorption than subcutaneous route
No interruption policy
Many risks, so verify the injection is justified
Handwashing
Angle of administration: 90 degrees
Clean Gloves
Body mass index (BMI) and adipose tissue
influence needle size selection Draping (sites)
Amounts: Return to the room after 15-30 minutes
Adults: 2 to 5 mL (4 to 5 mL unlikely to (ID/SQ/IM)
be absorbed properly) Tuberculosis Test (48-72hours)
Children, older adults, thin patients: up Aspirate (5-10s)
to 2 mL 10 seconds before withdrew
Small children and older infants: up to 1 Do not massage
mL Teach-Back
Smaller infants: up to 0.5 mL Needless Devices
VENTROGLUTEAL –
Gluteus medius
Deep and away from major nerves and blood
vessels
Preferred and safest site for all adults, children,
and infants
Recommended for volumes greater than 2 mL
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier
o Most needlestick injuries are
preventable
o Needlestick Safety and Prevention Act
o Safety syringes
Dispose of sharps in marked containers
TRANSES BY: ALCANTARA, Princess June P. (1 BSN C) SOURCES: PPT Presentations & Discussions of Prof. Cabale, Manlangit, &
Javier