Download Fractions

Chapter 23
Mathematics Review and
Medication Administration
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Fractions
• Definitions
Numerator: Top number of a fraction
Denominator: Bottom number of a fraction
• Types of Fractions
Proper fractions: Numerator is less than the
denominator
Improper fractions: Numerator is larger than the
denominator
Mixed fractions: Consist of a whole number plus a
fraction
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Slide 2
Fractions
• Changing an Improper Fraction to a Whole or Mixed
Number
Divide the denominator into the numerator.
• Changing a Mixed Number to an Improper Fraction
Multiply the denominator into the whole number.
Add the numerator to the product; the sum is now the
new number.
• Reducing Fractions to the Lowest Term
Find a number that will evenly divide into the
numerator and the denominator.
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Slide 3
Fractions
• Determining Which Fraction Is Larger
If the denominators are the same, the fraction with the
larger numerator is the larger fraction.
If the denominators are different, you must find a
“common denominator.”
• Finding a common denominator means to find a
number into which both denominators can be divided.
After the common denominator is found, an equivalent
numerator for each fraction must be found. (Divide the
first denominator into the equivalent denominator;
multiply the answer by the first numerator.)
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Slide 4
Fractions
• Adding Fractions That Have the Same Denominator
Add the numerators and place the sum of the
numerators over the denominator.
• Adding Fractions That Have Different Denominators
Find common denominators for all fractions in the
problem.
Find the equivalent numerators.
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Slide 5
Fractions
• Adding Mixed Numbers
Add the fractions of the mixed number. Then add the
sum of the fractions to the whole number.
• Subtracting Fractions with the Same Denominator
Subtract the numerator and place it over the
denominator.
• Subtracting Fractions with Different Denominators
Find a common denominator, and then subtract.
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Slide 6
Fractions
• Subtracting Mixed Numbers
When the numerator of the top fraction is smaller than
that of the bottom fraction, borrow one whole number
from the whole number of the mixed fraction and
express it as a fraction.
• Multiplying Fractions
Multiply the numerators; multiply the denominators.
• Multiplying Fractions and Mixed Numbers
Change the mixed number to an improper fraction.
Multiply.
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Slide 7
Fractions
• Dividing Fractions
Write the problem down correctly; invert the second
fraction.
Multiply.
• Dividing Fractions and Whole Numbers
Change the whole number to a fraction
Divide.
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Slide 8
Decimal Fractions
• The decimal fraction is a type of fraction that uses a
decimal to indicate the denominator of the fraction.
• The placement or position of the decimal point
determines whether the denominator is 10, a
multiple of 10, or a division of 10.
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Slide 9
Decimal Fractions
• Names of Decimal Places
.00001
.0001
.001
.01
.1
1.
10
100
1000
10,000
100,000
One hundred thousandths
Ten thousandths
Thousandths
Hundredths
Tenths
Unit (whole number)
Tens
Hundreds
Thousands
Ten thousands
One hundred thousands
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Slide 10
Decimal Fractions
• Names of Decimal Places (continued)
A decimal point found left of a whole number means
that the number is a fraction of a whole number.
A decimal point found after a number means that it is
a whole number.
A number without a decimal point is understood to
have an “invisible” decimal point behind it.
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Slide 11
Decimal Fractions
• Adding Decimals
Align the decimal point of each decimal fraction in a
column.
Add.
• Subtracting Decimals
Align the decimal point of each decimal fraction in a
column.
Subtract.
• Rounding a Number
A number found after the decimal point that is 5 or
larger can increase the number before it by one whole
number.
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Slide 12
Decimal Fractions
• Multiplying Decimals
Multiply. Decimal points in the problem do not have to
be aligned.
The decimal place in the answer is determined by
how many numbers are found to the right of the
decimal points in the numbers multiplied.
• Dividing Decimals
Change a decimal fraction in the divisor to a whole
number by moving the decimal point all the way to the
right.
Move the decimal point in the dividend the same
number of places moved in the divisor.
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Slide 13
Decimal Fractions
• Dividing Decimals (continued)
Place the decimal point in the answer directly over the
decimal point in the dividend after moving the decimal
point in the dividend.
If a decimal point is in the divisor, but not in the
dividend, move it the same number of places as the
divisor. Remember, there is an unexpressed decimal
point at the end of all whole numbers. Add zeros after
the decimal point in the dividend as needed.
If the dividend contains a decimal fraction and the
divisor does not, leave the divisor as it is.
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Slide 14
Decimal Fractions
• Changing Fractions to Decimals
Divide the numerator by the denominator.
• Changing a Decimal Fraction to a Common Fraction
To change a decimal fraction to a common fraction,
give the decimal fraction a denominator according to
the position of the decimal point in the decimal
fraction.
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Slide 15
Percents
• The word “percent” and its symbol, %, mean
“hundredths.”
• A hundredth is a fraction of a whole number;
therefore, a number followed by percent sign (%) is
a fraction.
• The denominator of the fraction is understood to
be 100.
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Slide 16
Percents
• Changing a Percent to a Decimal Fraction
Remove %; move the decimal point two places to the
left to indicate “hundredths.”
• Changing a Fraction to a Percent
Change a fraction to a percent by dividing the
numerator by the denominator.
Multiply the answer by 100.
Label the answer with the percent symbol, %.
• Multiplying by Percent
Change the percent to a decimal.
Multiply.
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Slide 17
Ratios
• Ratios show the relationship of one number or
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quantity to another number or quantity.
Numbers of a ratio are separated by a colon.
A ratio is also a fraction.
The value of a ratio is not changed if both terms are
multiplied or divided by the same number.
When numbers are written in ratio, they must all be
expressed in the same units.
A fraction may be written as a ratio.
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Slide 18
Proportions
• Proportion shows that the relationship between
two ratios has equal value.
• Definitions
Means: inner terms of the proportion
Extremes: outer terms of the proportion
• Set up the left side of the proportion as the “known”
side using information that is known or given.
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Slide 19
Proportions
• Set up the known side.
• Set up the unknown side. Use x for what you are
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trying to find.
Set up the units in the same position on each side of
the problem.
Multiply the means.
Multiply the extremes
Solve for x (divide the number with the x into the
number on the opposite side of the problem).
Label the answer with the unit of measurement that
accompanies the x in the problem.
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Slide 20
Proportions
• Review of Proportion Method
Set up problems in the same order on both sides.
Multiply the means; multiply the extremes.
The number multiplied with the x is always that
number with the x to the right of it.
Divide the number with the x into the number on the
other side of the problem.
Label the problem by looking to see what unit of
measurement the x is with the proportion.
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Slide 21
The Metric System
• The metric system is based on the decimal system.
• The decimal system uses the divisions and multiples
of a unit, which is always in ratios of tens.
• The metric system uses the following units:
liter (L) = volume (amount) of fluids
gram (g) = weight of solids
meter (m) = measure of length
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Slide 22
The Metric System
• Smaller units of the system are designated by the
following prefixes:
deci = 0.1 of the unit (liter, gram, meter); tenths
centi = 0.01 of the unit; hundredths
milli = 0.001 of the unit; thousandths
• Larger units of the system are designated by the
following prefixes:
deka = 10 times the unit (liter, gram, meter)
hecto = 100 times the unit
kilo = 1000 times the unit
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Slide 23
The Metric System
• Units of Weight
1 gram (g)
0.001 gram (g)
1 kilogram (kg)
0.001 kilogram (kg)
=
=
=
=
1000 milligrams (mg)
1 milligram (mg)
1000 grams (g)
1 gram (g)
• Units of Volume
1 liter (L)
0.001 liter (L)
1 milliliter (mL)
= 1000 milliliters (mL)
= 1 milliliter (mL)
= 1 cubic centimeter (cc)
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Slide 24
The Metric System
• Approximate Equivalents of the Metric System and
the Apothecary System
Volume
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•
1 milliliter (mL)
4 or 5 milliliters (mL)
30 milliliters (mL)
500 milliliters (mL)
1000 milliliters (mL)
=
=
=
=
=
15 or 16 minims
1 fluid dram
1 fluid ounce
1 pint
1 quart
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Slide 25
The Metric System
• Approximate Equivalents of the Metric System and
the Apothecary System (continued)
Weight
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60 milligrams (mg)
1000 milligrams (mg)
4 grams (g or gm)
30 grams (g)
0.45 kilogram (kg)
1 kilogram (kg)
= 1 grain (gr)
= 15 grains
= 1 dram
= 1 ounce
= 1 pound (lb.)
= 2.2 pounds (lbs.)
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Slide 26
The Metric System
• Metric Measurements of Length
The basic unit of length is the meter.
The meter is equal to 39.37 inches.
0.001 meter
= 1 millimeter (mm)
0.01 meter
= 1 centimeter (cm)
0.1 meter
= 1 decimeter (dm)
10 meters
= 1 decameter (dam)
100 meters
= 1 hectometer (hm)
1000 meters
= 1 kilometer (km)
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Slide 27
The Metric System
• Metric Measurements of Length
Most frequently used equivalents
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1 meter (m)
0.001 meter (m)
1 meter (m)
1 centimeter (cm)
1 millimeter (mm)
= 1000 millimeters (mm)
= 1 millimeter (mm)
= 100 centimeters (cm)
= 10 millimeters (mm)
= 0.1 centimeter (cm)
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Slide 28
Pediatric Considerations
• Young’s Rule
A method for the calculation of the appropriate dose of
a drug for a child 2 years of age or older; applies to
children up to the age of 12
Age of child
_
× Average adult dose = Child’s dose
(Age of child + 12)
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Slide 29
Pediatric Considerations
• Clark’s Rule
A method of calculating the approximate pediatric
dosage of a drug for a child
Weight of child (lbs.) × Average adult dose
150
= Child’s dose
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Slide 30
Pediatric Considerations
• Fried’s Rule
This rule is used for infants younger than 2 years of
age.
Age in months × Average adult dose = Child’s dose
150
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Slide 31
Pediatric Considerations
• Estimating Body Surface Area in Children
Body surface area is defined as the total area
exposed to the outside environment.
Use body surface area scale to find the correct
surface area (SA).
SA (m2) × Adult dose = Child’s dose
1.73 m2
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Slide 32
Pharmacology
• This is the study of drugs and their action on the
living body.
• Substances derived from plants and animals, from
vitamins and minerals, and from synthetic sources
can be used as drugs in the treatment and
prevention of disease.
• The action of any drug on the body is a complicated
process.
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Slide 33
Pharmacology
• Pharmaceutical Phase
The making of the drug until absorption of the drug
takes place in the patient’s body
• Pharmacokinetic Phase
The movement of the drug’s active ingredients from
the body fluids into the entire system and to the site
where the intended action of the drug takes place
• Pharmacodynamic Phase
Interaction of the drug’s active ingredient with the
intended body tissues; the body’s cells respond to the
action of the drug and change as the drug is
metabolized
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Slide 34
Pharmacology
• Drug Dosage
The dosage is the amount of a drug prescribed for the
patient by the physician.
A dose of medicine refers to a single prescribed
amount of drug given at one time.
Nurses must become familiar with therapeutic
dosages of frequently used drugs to confidently
administer dosages of medication to each patient.
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Slide 35
Pharmacology
• Drug Actions and Interactions
Two general types
• Local: Affect only the area where the drug is placed
• Systemic: Affect the entire body
Drug interaction: One drug alters another drug
Potentiation: One drug increases the action or effect
of another drug
Incompatibility: Drugs that do not combine chemically
with other drugs
Antagonist: Drug that will block the action of another
drug
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Slide 36
Pharmacology
• An idiosyncratic response to a drug is an
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individual’s unique hypersensitivity to a particular
drug.
A reduced response to a drug is called tolerance.
An adverse drug reaction is a harmful, unintended
reaction to a drug administered at a normal dosage.
Contraindications are conditions under which the
drug should not be given.
Interactions are modifications of the effect of a drug
when administered with another drug.
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Slide 37
Pharmacology
• Factors that may affect how patients respond to
medication:
Age
Weight
Physical health
Psychological status
Environmental temperature
Gender
Amount of food in the stomach
Dosage forms
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Slide 38
Medication Orders
• The nurse is ethically and legally responsible for
ensuring that the patient receives the correct
medication ordered by the physician.
• Medication orders should include the following:
Patient's name
Date and time of the order
Name of the drug
Dosage of the drug
Route of administration
Time or frequency drug is given
Signature of the physician
Any special instructions
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Slide 39
Medication Orders
• Controlled Substances
Opioids, barbiturates, and other controlled drugs that
have a high possibility for abuse or addiction are
double-locked.
“Narcotic keys” are kept by designated nurses per
shift.
Each controlled drug used is logged into the narcotic
log book.
At the end of each shift, controlled drugs are carefully
counted by a nurse from the outgoing shift and a
nurse from the incoming shift.
Always have a witness to the “wasting” of a controlled
substance.
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Slide 40
Medication Orders
• Types of Orders
Standing orders
• Already written by a physician for all patients on a
particular unit or area
• Carried out without having to call the physician
Verbal orders
• May be given in the presence of an LPN/LVN or an RN
directly or over the telephone
• Should be written on the chart and signed by the
physician as soon as possible
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Slide 41
Medication Administration
• Six Rights
Right medication
Right dose
Right time
Right route
Right patient
Right documentation
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Slide 42
Medication Orders
• Important Considerations of Medication
Administration
If you did not pour it, do not give it.
If you gave it, chart it.
Do not chart for someone else or have someone else
chart for you.
Do not transport or accept a container that is not
labeled.
Do not put down an unlabeled syringe.
If given a verbal order, repeat it to the physician.
If you make an error, report it immediately.
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Slide 43
Medication Orders
• Important Considerations of Medication
Administration (continued)
Never leave a medication with a patient or family
member. Watch the patient take it and swallow it.
Always return to assess the patient’s response.
Chart as soon as possible after giving medication.
If a patient refuses medication, do not force it; chart
“Refused medication because of. . . .”
If you elect to omit a dose based on your nursing
judgment, let another nurse help make the decision. If
medication is not given, document “Dose omitted
because. . . .” Report to the physician.
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Slide 44
Routes of Administration
• Enteral
Via the GI tract
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Powders
Pills
Tablets
Liquids or suspensions
Suppositories
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Slide 45
Routes of Administration
• Percutaneous
Through the skin or mucous membranes
• Topical
• Instillation
• Inhalation
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Slide 46
Routes of Administration
• Parenteral
Methods other than the GI tract; needle route
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Ampules
Vials
Intramuscular
Subcutaneous
Intradermal
Intravenous
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Slide 47
Enteral Administration
• Preparation of Tablets, Pills, and Capsules
These preparations enter the GI tract and are
absorbed more slowly into the blood stream than via
any other route.
The slow absorption rate makes the PO (by mouth)
route relatively safe.
Some PO medications are irritating to the patient’s GI
tract, and larger tablets may be difficult for some
patients to swallow.
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Slide 48
Skill 23-1: Step 5
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Administering tablets, pills, and capsules.
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Slide 49
Enteral Administration
• Preparation of Liquid Medications
Liquid medications are often given to children; to
patients who cannot swallow tablets, pills, or
capsules; and to geriatric patients.
Medications may be given PO or via a nasogastric,
gastrostomy, or jejunostomy tube.
Liquids must not be given to unconscious patients
because of the possibility of aspirating.
Some liquid medications are not to be followed by
water, and some may stain the teeth.
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Slide 50
Skill 23-2: Step 13
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Administering liquid medications.
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Slide 51
Enteral Administration
• Tubal Medications
Nasogastric (NG) tubes are used to administer liquid
medications to unconscious patients, dysphagic
patients, and those who are too ill to eat.
Many medications come in liquid form; if they do not,
solid tablets may be pulverized in a mortar and pestle,
and capsules can be opened.
Not all tablets are safe to use when crushed, and not
all capsules are safe to use when opened.
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Slide 52
Skill 23-3: Step 13a
Administering tubal medications.
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Slide 53
Skill 23-3: Step 16
Administering tubal medications.
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Slide 54
Enteral Administration
• Suppositories
Cone-shaped, egg-shaped, or spindle-shaped
medication made for insertion into the rectum or
vagina
Dissolves at body temperature and absorbed directly
into the bloodstream
Useful for infants, patients who cannot take oral
preparations, and patients with nausea and vomiting
Stored in cool place so they do not melt
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Slide 55
Percutaneous Administration
• With these routes, medications are absorbed
through the skin or the mucous membranes.
• Most produce a local action, but some produce a
systemic action.
• Drugs include topical applications, instillations, and
inhalations and ointments, creams, powders, lotions,
and transdermal patches.
• Absorption is rapid but of short duration.
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Slide 56
Percutaneous Administration
• Ointments
An oil-based semisolid medication; may be applied to
the skin or a mucous membrane
• Creams
Semisolid, nongreasy emulsions that contain
medication for external application
• Lotions
Aqueous preparations that are used as soothing
agents that relieve pruritus, protect the skin, cleanse
the skin, or act as astringents
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Slide 57
Percutaneous Administration
• Transdermal Patches (Topical Disk)
Adhesive-backed medicated patches applied to the
skin provide sustained, continuous release of
medication over several hours or days.
• Eyedrops and Eye Ointments
Care should be taken to keep all ophthalmic
preparations sterile by not touching the dropper or the
tube to the eye.
• Eardrops
Containers of solutions to be used as eardrops will be
labeled “otic.” They must be at room temperature
when applied.
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Slide 58
Figure 23-4
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
A variety of medications are available as transdermal patches.
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Slide 59
Percutaneous Administration
• Nosedrops
Nosedrops are for individual use only.
• Nasal Sprays
Sprays absorbed quickly; less medication is used and
wasted when administered in this manner.
• Inhalation
Drugs may be absorbed through the mucous
membranes of the respiratory tract.
Inhalation produces a relatively limited effect or a
systemic effect.
This method is actively used by respiratory therapy
and anesthesiologists.
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Slide 60
Percutaneous Administration
• Sublingual Administration
Drug is administered by placing it beneath the tongue
until it dissolves.
Drug may be a tablet or liquid squeezed out of a
capsule.
It is rapidly absorbed into the bloodstream.
• Buccal Administration
A tablet is placed between the cheek and teeth, or
between the cheek and the gums.
Absorption into the capillaries of the mucous
membranes of the cheek gives rapid onset of the
drug’s active ingredient.
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Slide 61
Parenteral Administration
• Equipment
Syringes
• Syringe consists of a barrel, a plunger, and a tip.
• Outside of the barrel is calibrated in milliliters, minims,
insulin units, and heparin units.
• Types
Tuberculin syringe
Insulin syringe
Three-milliliter syringe
Safety-Lok syringes
Disposable injection units
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Slide 62
Figure 23-5
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Parts of a syringe.
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Slide 63
Figure 23-6
(From Clayton, B.D., Stock, Y.N. [2004]. Basic pharmacology for nurses. [13th ed.]. St. Louis: Mosby.)
Tuberculin syringe calibration.
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Slide 64
Figure 23-7
(From Clayton, B.D., Stock, Y.N. [2004]. Basic pharmacology for nurses. [13th ed.]. St. Louis: Mosby.)
Calibration of U100 insulin syringe.
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Slide 65
Figure 23-8
Reading the calibrations of a 3-mL syringe.
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Slide 66
Figure 23-10
Safety-Glide syringe.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 67
Figure 23-12
(From Clayton, B.D., Stock, Y.N. [2004]. Basic pharmacology for nurses. [13th ed.]. St. Louis: Mosby.)
Parts of a needle.
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Slide 68
Percutaneous Administration
• Equipment (continued)
Needles
• Parts are the hub, shaft, and beveled tip.
• Opening at the needle’s beveled tip is the lumen.
• Size of the diameter of the inside of the needle’s shaft
determines the gauge of the needle; the smaller the
gauge, the larger the diameter.
• Needle gauge selection is based on the viscosity of the
medication.
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Slide 69
Percutaneous Administration
• Equipment (continued)
Needle length
• Selected based on the depth of the tissue into which the
medication is to be injected
• Intradermal: 3/8 to 5/8 inch
• Subcutaneous: 5/8 to 1/2 inch
• Intramuscular: 1 to 1 1/2 inch
Intravenous needles
• Butterfly (scalp needle)
• Over-the-needle catheter (Angiocath, Jelco)
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Slide 70
Figure 23-13
(From Clayton, B.D., Stock, Y.N. [2004]. Basic pharmacology for nurses. [13th ed.]. St. Louis: Mosby.)
Needle length and gauge.
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Slide 71
Percutaneous Administration
• Equipment
Needleless devices
• Devices are designed with a sheath or guard that
covers the needle after it is withdrawn from the skin.
• Intravenous catheters have been designed with
blunt-edged cannulas, valves, or needle guards to
minimize injuries.
• IV tubing with recessed and shielded needle connectors
has been designed, further reducing needlesticks.
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Slide 72
Percutaneous Administration
• Intramuscular Injections
Involves inserting a needle into the muscle tissue to
administer medication
Site selection
•
•
•
•
Gluteal sites
Vastus lateralis muscle
Rectus femoris muscle
Deltoid muscle
Z-track method
• Used to inject medications that are irritating to the
tissues
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Slide 73
Figure 23-15, C
(C, from Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Locating IM injection for ventrogluteal site.
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Slide 74
Figure 23-16, C
(C, from Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Giving IM injection in vastus lateralis site on adult.
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Slide 75
Figure 23-17
(From Clayton, B.D., Stock, Y.N. [2004]. Basic pharmacology for nurses. [13th ed.]. St. Louis: Mosby.)
Rectus femoris muscle. A, Child/infant. B, Adult.
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Slide 76
Figure 23-18, C
(C, from Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Giving IM injection in deltoid site.
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Slide 77
Figure 23-19
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
A, Z-track method. B, Using an air lock. C, Administering IM injection
by airlock technique.
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Slide 78
Percutaneous Administration
• Intradermal Injections
Introduction of a hypodermic needle into the dermis
for the purpose of instilling a substance such as a
serum, vaccine, or skin test agent
Not aspirated
Small volumes (0.1 mL) injected to form a small
bubblelike wheal just under the skin
Used for allergy sensitivity tests, TB screening, and
local anesthetics
A tuberculin syringe used with a 25-gauge, 3/8- to
5/8-inch needle
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Slide 79
Figure 23-20
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Angles of insertion for intramuscular (90°), subcutaneous (45°), and
intradermal (15°).
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Slide 80
Percutaneous Administration
• Subcutaneous Injections
Injections made into the loose connective tissue
between the dermis and the muscle layer
Drug absorption slower than with IM injections
Given at a 45-degree angle if the patient is thin or at a
90-degree angle if the patient has ample
subcutaneous tissue
Usual needle length is 1/2 to 5/8 inch and 25 gauge
Used to administer insulin and heparin
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Slide 81
Figure 23-21
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Subcutaneous injection. Angle and needle length depend on the
thickness of skinfold.
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Slide 82
Percutaneous Administration
• Intravenous Therapy
Provide fluid and electrolyte maintenance, restoration,
and replacement
Administer medication and nutritional feedings
Administer blood and blood products
Administer chemotherapy to cancer patients
Administer patient-controlled analgesics
Keep a vein open for quick access
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Slide 83
Percutaneous Administration
• Methods of Intravenous Administration
IV push
Intermittent venous access device
Intermittent infusion (or piggyback)
Continuous infusion
Electronic pumps and controllers
Patient-controlled analgesia
Volumetric chambers
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Slide 84
Figure 23-23
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
PCA infusion pump.
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Slide 85
Figure 23-24
Volumetric chamber.
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Slide 86
Percutaneous Administration
• Nursing Responsibility
The nurse must ensure that fluid of the ordered type
and amount is started and that the fluid is regulated to
infuse over the period ordered.
To find the drops per minute (the drip rate), you must
know which type of IV tubing will be used with the
infusion and obtain the drip factor for the tubing to be
used.
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Slide 87
Percutaneous Administration
• Nursing Responsibility (continued)
Monitor intravenous therapy
• Check the infusion and the IV needle site at least every
hour.
Flow of fluid
IV site: erythema, wetness, and edema
Phlebitis: inflamed vein
Infiltration: fluid passes into the tissues
• Assess for chills, fever, headache, nausea, vomiting,
anxiousness, and dyspnea.
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Slide 88
Percutaneous Administration
• Nursing Responsibility (continued)
Assess for anaphylactic shock
•
•
•
•
•
Respiratory distress
Skin reactions
Signs of circulatory collapse
GI signs and symptoms
Change in mental status
Requires immediate intervention.
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Slide 89
Nursing Process
• Nursing Diagnoses
Anxiety
Health-seeking behaviors
Injury, risk for
Knowledge deficient
Mobility, impaired
Noncompliance: drug regimen
Sensory/perception, disturbed
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Slide 90