Part Three
- Method of giving treatment
Giving the treatment via intramuscular, subcutaneous, and intravenous injections
And allergy testing
The Definition :
These are medications that are given by intramuscular, intravenous, or subcutaneous injection (such as vials, ampoules, and diabetes treatment 'insulin').
The Reasons :
Treating the patient's signs and symptoms.
The person in charge:
Nursing team.
Tools :
Medicines - syringes - cotton - alcohol - solutions - intravenous devices - cannulas of different sizes - medical adhesive - tourniquet.
It is important to follow the correct ten times before giving the medicine
(ten (10) Rights):-
1. The correct patient
2. The correct medication
3. The correct dose
4. The right way
5. The right time
6. Healthy repetition
7. Correct registration
8. Required effectiveness.
9. The right to education.
10. Right of refusal
Steps:
1. Washing hands.
2. Verifying the patient (full name and medical number)
3. Explain the procedure that will be performed to the patient.
4. Maintain patient privacy.
Preparing treatment for intramuscular injection:
1. If it is a single ampoule, withdraw the treatment using a sterile syringe and expel the air from the syringe.
2. If the treatment needs to be analyzed, the water ampoule is withdrawn using a sterile syringe, then it is injected into the ampoule containing the powder, the bottle is shaken, then the specified dose is withdrawn using the syringe, then the air is expelled.
3. The site of intramuscular injection is determined.
4. Clean the site designated for the injection with a piece of cotton moistened with 70% alcohol in a circular manner and in one direction from the inside out without going back again.
5. Insert the tip of the syringe perpendicular to the injection site, then pull the syringe plunger out to confirm the injection site (if blood is drawn, the site is considered wrong and is changed, and if nothing is drawn, the site is correct and the treatment is injected).
Preparing treatment for a patient through intravenous injection:
1. Determine the location of the intravenous injection.
2. The place to be injected is tied with a tourniquet.
3. Feel the vein with the tip of the index finger.
4. Clean the site designated for the injection with a piece of cotton moistened with 70% alcohol in a circular manner and in one direction from the inside out without going back again.
5. The tip of the syringe is inserted at an angle slightly raised along a parallel line from the surface of the skin at the site of feeling the vein.
6. The syringe plunger is pulled out to confirm the location (blood flows into the syringe).
7. Loosen the tourniquet and inject the treatment slowly.
8. Press the injection site with a piece of cotton soaked in alcohol until the blood stops at the injection site.
9. Place a small piece of gauze at the injection site and secure it with adhesive tape.
10. Dispose of injection waste in a waste disposal bag.
11. Registration in the treatment description and implementation form.
Preparing treatment for a patient by subcutaneous injection:
1. Stabilize the skin at the injection site and, with a quick pricking motion, insert the needle at an angle of 90 degrees if the skin is thick and 45 degrees if the skin is thin.
2. Injecting the treatment to be given.
3. Remove the needle and press a piece of cotton soaked in alcohol on the injection site.
4. Dispose of all waste in accordance with infection control policy.
5. Recording the administration of treatment in the treatment description and implementation form.
Drug allergy test:
1. Perform the subcutaneous injection steps at a 45 degree angle in the case of a 3 cm syringe and a flat site in the case of an insulin syringe.
2. When injecting, inject only one ml of the drug to be tested.
3. Mark the injection site.
4. Observe the injection site for 10 minutes after the injection.
5. Notify the doctor if any reaction occurs (redness of the skin, visible swelling, tendency to scratch).
6. You record this on the patient’s ticket and allergy card.
7. The syringe containing the medication to be administered is prepared and the patient is injected if no reaction occurs.
8. The remaining steps are completed as usual for subcutaneous injection.
Note: When following these steps, infection control policies for administering treatment should be taken into account.
Transfusion
The Definition :
Giving a quantity of blood or its derivatives (plasma, platelets, red blood cells) to a patient according to the doctor’s instructions.
The Reasons :
Compensating blood loss from the patient's body and treating defects in blood components.
The person performing the work: the nursing team.
Tools: A bag of blood or its derivatives (usable) - a holder for solutions - a blood transfusion device - a spongy cotton with alcohol - medical tape - a large cannula.
Steps:
1. Hand washing (routine).
2. Verifying the patient (full name and medical number)
3. Measure the patient’s vital signs to ensure that they are within normal levels.
4. Explain the procedure that will be performed to the patient.
5. Maintain patient privacy.
6. Review the patient’s full name - blood types - and match the bag number with the delivery form number.
7. Preparing medications for recovery and incompatibility next to the patient.
8. Wash your hands (sanitary) immediately before installation.
9. Open the blood transfusion device, connect it to a bottle of saline solution, and fill it (to test the efficiency of its work).
10. Connect the device to the blood bag and transfer it to the patient very slowly for the first 15 minutes.
11. Measure the patient’s vital signs every 5 minutes for the first 15 minutes.
12. Note the presence of any symptoms of blood incompatibility with the patient’s body (such as: tremors, back pain, headache, vomiting, rapid pulse, low blood pressure, rapid breathing, skin rash).
13. Increase the drip in the absence of signs indicating incompatibility according to the doctor’s instructions on the ticket.
14. Dispose of the empty blood bag after completing the administration of the required amount, connect the blood transfusion device to the salt solution, pass the solution through the device until the blood disappears from it, and dispose of it in hazardous waste.
15. Measuring vital signs after a blood transfusion.