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NSE 211 Final Exam Latest Update
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NSE 211 Final Exam Latest UpdateNeedle Sizes - Answer - Vary in length from 0.6-7.6 cm
- Length accord. to pts size, weight, & type of tissue
- Longer (2.5-3.8cm): IM injections
- Shorter (1-1.6cm): SC injections
Ampules - Answer - Single dose of med. in a liquid; 1ml to 10ml
- Aspiration of med. syringe, sometimes use filter needle
-- Change to approp. needle for actual injection
Vials - Answer - Liquid or dry forms of meds.
-- Label specifies which diluent to use (NaCl,...)
- Air must be injected
- Use filter needle when preparing
Powder Vials - Answer - Draw up diluent or solvent
- Inject diluent into vial
- Gently roll b/w hands
- Reinsert needle & draw up correct amount of med.
- Make label for vial
Vastus Lateralis Muscle - Answer - Lacks major nerves & blood vessels
- Rapid drug absorption
- Freq. in infants for immunizations (or older children & toddlers)
Ventrogluteal Muscle - Answer - Deep site, away from major nerves and blood vessels
- Less chance of contamination in incon. pts & infants
- Identified easily by prominent bony landmarks
- Preferred site for meds. larger in vol., more viscous, & irritating for adults
Deltoid Muscle - Answer - Easily accessible, not well developed in most pts
- Small amounts of meds.
,- Not used in infants or children w/ underdeveloped muscles
- Potential for injury to brachial artery & radial & ulnar nerves
- May be used in immunizations of toddlers, older children, & adults
- Recc. site for Hep. B vaccine & rabies injections
Deltoid Muscle Landmarks - Answer - Z track
- Lower edge of acromial process & point on lateral arm in line w/ axilla
- Insert needle 1" to 2" below acromial process
- 2 or 3 fingerbreadths at 90 deg. angle
- May be used for immunization; only 1mL or less
Vastus Lateralis Landmark - Answer - Lateral muscle of quad. group, from handbreadth
below greater trochanter to handbreadth above knee
- Insert needle parallel to surface client lying
- May grasp muscle for insertion for thin adults
Ventrogluteal Muscle Landmark - Answer - Greater trochanter of femur w/ heel of hand
- Spread index & middle fingers fro anterior superior iliac spine to as far along iliac crest
- Insert needle b/w fingers at 90 deg. angle
- Vol.: Up to 3mL
- Preferred site
Angles of Injection - Answer - IM: 90 deg.
- SC: 45-90 deg.
- Intradermal: 15 deg.
Diabetes Management - Answer - Insulin
- Aim is to have pos. pt outcomes w/o incr. risk of hypoglycemia (most common adverse
effect)
- Risk of hypoglycemia for all pt who take antihypergycemic meds. must be anticipated
& monitored for hypoglycemia
S&S of Hypoglycemia - Answer - Trembling, palpitations, sweating
- Anxiety, hunger, nausea
, - Tingling, hard to concentrate, confusion
- Weakness, drowsiness, vision changes
- Diff. speaking, H/A, dizzness
Hypoglycemia Protocol - Answer - Give 150mL of juice or soda
- OR give 15mg of sucrose tablets
- Recheck BG in 15 min increments
- Notify HCP if BG below 4 mmol/L
Short Acting Insulin - Answer - Aspart (NovoRapid), glulisine (Apidra), lispro (Humalog),
regular (Humulin-R)
- Admin: At mealtimes as bolus
- Insulin in basal-bolus regimen of multiple daily injections (MDI)
Intermediate Insulin - Answer - NPH (2 kinds)
- Used as basal insulin in basal-bolus regimen, recc. to give at bedtime to help prevent
nocturnal hypoglycemia
Long Acting Insulin - Answer - Insulin detemir (Levemir) & glargine (Lantus)
- Usually given at bedtime
- Should not be mixed w/ any other insulin
- No peak time; have duration of action of up to 30 hours
Lipohypertrophy - Answer - Thickened rubbery area of fat tissue
- Fibrous poor vascularized lesions that can grow & develop in SC fat (where insulin
given)
- Rotate sites
- Look for puffiness, raised areas, & redness
- Feel for hardness or lumpiness
FIT Technique - Answer - Sites: Abdomen, thighs, butt
-- Rotate sites; 2 inch away from umbilicus
- Insulin best absorbed in SC; 4.5-6mm needles suitable
- If extremely lean, perform skin lift
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