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Parenteral:

  ID  sites
  • lightly pigmented
  • thinly keratinized
  • hairless
  • ventral midforearm
  • clavicular area of chest
  • scapular area of back
Parenteral:

  ID equipment
  • 25-27 gauge. 3/8-5/8" long needle
  • 1ml calibrated in 0.01 ml increments
Parenteral:

  Subq actions
  • systemic effect
  • sustained effect: absorbed through capillaries
Parenteral:

  ID Actions
  • Local Effect
  • samll amount injected so that volume doesnt interfere with wheal formation or cause a systemic reation
  • Used for observation of an allergic reaction to foreign proteins
  • ex. tuberculin test
Parenteral:
  Subq Sites
  • Adequate fat pad size
  • abdomen
  • upper hips
  • upper back
  • lateral upper arms
  • lateral thighs
  • Should be rotated - insulin/heparin
Parenteral:

  Subq Equipment
  • 25-27 gauge, 1/2-5/8" needle
  • 1-3 ml syringe
  • insulin syringe in units
Parenteral:

 IM Technique 
  • Cleanse the area
  • Hold the skin taut
  • insert needle bevel up; should be able to see the needle under the skin
  • Inject slowly to form wheal (blister)
  • Remove needle slowly
  • do not massage area
  • Mark area with pen
  • Assess for allergic reaction in 24-72 hours
Parenteral:

  Subq Technique
  • Cleanse area
  • Pinch skin
  • Insert needle at an angle apprpriate to body size
  • release skin
  • aspirate
  • inject
  • Remove needle quickly
  • gently massage area
  • apply gentle pressure to site
  • apply bandage, if needed
Parenteral:

  IM Action
  • Systemic effect
  • More rapid effect than subq
  • used for irritating drugs, aqueous suspensions, solutions in oils
Parenteral:
  IM Sites
  • chosen for adequate muscle size and minimal major nerves and vessels
  • ventrogluteal
  • dorsogluteal
  • deltoid
  • vastus lateralis (peds)
Parenteral:

  IM Equipment
  • 20-23 gauge; 18 gauge for blood products; 1-1 1/2 " long needle
 
Parenteral:

  IM Technique
  • Same as for Subq; except flatten skin using thumb and index finger and inject between them, insert needle at 90 degree angle
  • Syringe 1-3 ml
Parenteral:

  IV Action
  • Systemic effect
  • More rapid than IM or subq
Parenteral:

  IV Sites
  • Accessible peripheral veins
Parenteral:

  IV Equipment
  • Needle: 20-21 gauge (adults), 24 gauge 1" (newborn), 22 gauge 1" (peds)
Parenteral:

  IV Technique
  • Apply a tourniquet
  • Cleanse area (aseptic technique)
  • Insert butterfly/catheter and feed up into vein until blood returns
  • Remove touniquet
  • stabilize needle and apply dressing to site
  • monitor flow rate, distal pulses, skin color, and temp, and isertion site
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