8-1 © 2012 the mcgraw-hill companies, inc. all rights reserved. chapter 8equipment for dosage...
TRANSCRIPT
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8-1
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 8 Equipment for Dosage Measurement
PowerPoint® Presentation to accompany:
Math and Dosage Calculations for Healthcare Professionals
Fourth Edition
Booth, Whaley, Sienkiewicz, and Palmunen
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8-2
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Learning Outcomes
8-1 Recognize medication dosage volumes in different enteral equipment.
8-2 Recognize medication dosage volumes in different parenteral equipment.
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Key Terms Ampule
Calibrated spoons
Calibrations
Cartridges
Eccentric
Enteral
Hypodermic syringes
Jejunostomy tube
Leading ring
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8-4
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Key Terms Meniscus
Nasogastric
Parenteral
PEG tube
Trailing ring
Transdermal
Vial
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Introduction
To prepare the correct dosage, it is important to be familiar with and use equipment properly.
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Enteral Administration
Measuring devices are calibrated at varying intervals. Calibrations – measure the amount of liquid
in the container
Should match physician’s order units
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Enteral Administration (cont.)
Equipment
Medicine cups
Droppers
Calibrated spoons
Oral syringes
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Enteral Administration (cont)
Medicine cups may show measurements from all three systems.
Metric Household Apothecary
A meniscus is a curve in the surface of the liquid.
Measure quantity at the bottom of the curve.
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Oral Administration (cont.)
Rule 8-1Rule 8-1
Do not use medicine cups for doses less than 5 mL.
To ensure accuracy use a dropper; calibrated spoon; or oral syringe.
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Droppers
Droppers measure and administer small amounts of liquid medication. They deliver medication to the eyes, ears,
and nose. They are used for oral pediatric doses.
Units of measurement vary with dropper.
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Calibrated Spoons
Used with pediatric and elderly patients
Administer medication directly into the mouth or into a food or beverage
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Patient Education
Instructions for proper use Medicine cup
Locate appropriate calibration.
Place cup on flat surface while pouring liquid medicine.
Check measurement with cup at eye level.
Make measurement at lowest level of meniscus.
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Patient Education (cont.)
Instructions for proper use Dropper
Measure proper amount before
delivery.
Hold dropper vertically.
Count slowly and allow drops to
fully form.
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Patient Education (cont.)
Instructions for proper use Calibrated spoons
are for medications measured by teaspoons, tablespoons, or milliliters;
should not be replaced with household spoons.
Check medication for expiration date and changes in clarity, color,or consistency.
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Oral Syringes
Used for quantities less than 5 mL
Safety features Eccentric tips Tips of different shape
or size Tinted
Not sterile
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Oral Syringes
Rule 8–2 Rule 8–2 1. Never attach a needle to an oral syringe.
2. Never inject an oral dose.
3. In emergencies, you may use a hypodermic syringe without a needle to measure and administer liquid oral doses.
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Other Equipment for Enteral Medications
When a patient cannot take medication orally, medications can be administered through a tube.
Types of tubes Nasogastric tube Nasal-small bowel tube PEG tube Jejunostomy tube
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Error Alert! Utensil used must provide the
calibration needed to accurately measure the dose.
ExampleExample
Which would you select to administer ½ tsp of a liquid medication?
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Practice
True or False
1. A hypodermic syringe with a needle can be used to measure liquid for oral administration.
2. Oral and hypodermic syringes are identical in appearance.
3. Measuring spoons used for baking are acceptable for measuring liquid medications.
False
False
True
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Practice
4. Oral medication comes in a bottle labeled 200 mg/5 mL. The dose to be administered is 600 mg. Which of the following is the correct dose?
a) 1 tspb) 2 tspc) 1 tbspd) 2 tbsp
= 15 mL
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Parenteral Medication Administration Devices
Parenteral administration Topical and transdermal medications
Inhalers
Sublingual medications
Injections
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Parenteral Medication Administration Devices (cont.)
Administer medications by injection Intravenous (IV)
Intramuscular (IM)
Intradermal (ID)
Subcutaneous (Subcut)
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Standard Syringes Calibrated in milliliters (mL)
Allow for measurement of small doses
Are usually 3-mL
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Standard Syringes (cont.)
Zero calibration – edge of barrel near needle
Leading ring - tip of plunger closest to needle
Trailing ring – ring farthest from needle
Click to view syringe
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Hypodermic Syringe
Plunger
Needle
Barrel
Trailing Ring Leading Ring
Syringe hub
Needlestick prevention safety device
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Safety Syringes
Have same components as standard syringes
Include a safety mechanism
Reduce the chance of needlestick injury
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Prefilled Syringes Prefilled syringes contain a single,
standard dose of medication.
When using a prefilled syringe, measure
the dose carefully.
Discard any excess medication in a
prefilled syringe prior to injection.
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Prefilled Syringes
Rule 8-3Rule 8-3When using a prefilled syringe, 1. examine the markings to determine
whether the syringe is calibrated in milliliters or milligrams;
2. calculate the dose accordingly.
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Insulin Syringes
Insulin syringes are used only to measure and administer insulin. U-100 insulin most common form
They are calibrated in units.
U-100 insulin syringes are available in 50 and 100 unit capacities.
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Insulin Syringes (cont.)
100 Unit Insulin Syringe
50 Unit Insulin Syringe
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Insulin Syringes (cont.)
50 unitsyringe
100 unitsyringe
Comparison of insulin syringes:
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Rule 8-4Rule 8-4Never use any type of syringe other than an insulin syringe to measure and administer insulin.
Insulin Syringes (cont.)
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Tuberculin Syringes
Uses Subcutaneous
injections Intradermal
injections Doses less than 1
mL
Examples: PPD skin test Vaccines Heparin Pediatric
medicines Allergen extracts
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Tuberculin Syringes (cont.)
Calibrated in hundredths of a mL
Require careful measurement Calibrations are close together. Carefully align leading ring with correct
calibration.
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Tuberculin Syringes (cont.)
1 mL Tuberculin Syringe
0.5 mL Tuberculin Syringe
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Tuberculin Syringes (cont.)
Comparison of tuberculin syringes:
0.5 mL syringe
1 mL syringe
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Syringes for Established IV Lines
Used to administer medication and fluids directly into a patient’s vein
Use the injection port of an IV line
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Syringes for Established IV Lines
Advantages eliminate repeated punctures decrease risk of needlestick injuries allow compatible drugs to be administered
together enable periodic drug delivery enable dilution of the medication
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Large-Capacity Syringes
Syringes with 5 mL, 6 mL, 12 mL Volume is measured in milliliters but
calibrations may vary.
Look carefully at the marks to measure an accurate amount of medication.
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Large-Capacity Syringes (cont.)
10 mL syringe
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Error Alert!
Pay close attention to the calibration of any syringe you use.
Check the marks carefully.
Always align the leading ring with the calibration.
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Ampules, Vials, and Cartridges
Cartridge Vial
Ampule
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Cartridges Prefilled container shaped like a syringe
barrel
One dose of medication
Fits a reusable syringe
Examples Tubex®
Carpuject®
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Ampule
An ampule is a sealed container holding one dose of medication.
It snaps open.
Use a standard syringe to withdraw the medication.
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Vials
Container covered with a rubber stopper
Contains one or more doses of medication
May contain either liquid or powder medication
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Preparing the Syringe
Rule 8-5Rule 8-5 In most circumstances, the person who prepares a syringe for injection should deliver the injection.
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Preparing the Syringe
Rule 8-5 Rule 8-5 Exceptions include:1. pharmacy technicians who pre-fill
syringes;
2. nurses or medical assistants preparing a syringe for a physician;
3. healthcare workers teaching a patient to administer his or her own medication.
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Needle Gauge and Length Choose appropriate needle for injection.
Gauge The gauge is the interior diameter.
Smaller gauges correspond to larger diameters.
Length is determined by the injection site.
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Needle Gauge and Length (cont.)
Type of Injection Needle GaugeAvailable Lengths
(inches)
Intradermal 25 – 26
Subcutaneous 23 – 27
Intramuscular 18 – 23
85
83
43
21
21
85 1
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Practice
Plunger
Needle
Barrel
Trailing Ring Leading Ring
D.
E. F.
A. B.
G.
C.
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Practice
Syringe hub
Plunger
Needle
Barrel
Trailing Ring Leading Ring
D.
E. F.
A. B.
C.
Needlestick prevention safety device
G.
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Practice
You have an order to administer 1.5 mL of a medication. It comes in a 3 mL prefilled syringe. What should you do?
ANSWER: Carefully check the calibration and discard the excess medication prior to giving the injection. In this case, you would discard 1.5 mL medication. You should NEVER attempt to inject the correct dose without removing the excess medication first.
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In Summary
In this chapter you learned about
enteral medication administration devices.
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In Summary (cont.)
parenteral medication administration devices.
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Apply Your Knowledge
Which type of delivery device is used to administer medication to the eyes and ears?
ANSWER: Dropper
What kind of syringe is used to deliver vaccinations?
ANSWER: Tuberculin
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Apply your Knowledge
How many mL are indicated on this syringe?
ANSWER: 1.6 mL
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End of Chapter 8
Nothing will work unless you do.
~Maya Angelou