4 Identifying Labels, Syringes, and Intravenous Bags

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47 N urses and allied health professionals who administer medications must be able to identify the information on medication labels, syringes, and intrave- nous solution bags accurately and precisely. To ensure the safety of clients, this is an important skill to master before administering medication. This chapter reviews the techniques necessary to read labels, syringes, and intravenous bags competently. Specifically, it is designed to assist you in learning how to: Read medication labels to obtain pertinent information and identify various intravenous solutions. Read a syringe. Select the correct size needle and syringe. Reconstitute powdered medications. Add medication to an intravenous bag of fluid. Draw up two types of insulin in the same syringe. This chapter also presents examples of medication labels and intravenous labels, as well as types and sizes of syringes and needles. 4 Identifying Labels, Syringes, and Intravenous Bags Introduction Reading Medication Labels T he brand name of a medication (also known as the trade or proprietary name) is usually written in big letters on the medication label. The brand name is typically assigned by the manufacturer of the medication and has a registered mark (®) attached to it. The generic name of a medication may be written in smaller letters, placed in parentheses, or written in italics. The generic name must be included on the label to enable the filling pharmacist to dispense the generic versions as substitutes for the brand-name drugs. A brand medication is often filled with generic substitutions unless the ordering physician checks off or writes “dispense as written.” See Figure 4-1. FIGURE 4-1 Locating the brand name and generic name on a drug label. Source: Courtesy of Merck & Co., Inc. © Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION.

Transcript of 4 Identifying Labels, Syringes, and Intravenous Bags

  • 47

    Nurses and allied health professionals who administer medications must be able to identify the information on medication labels, syringes, and intrave-nous solution bags accurately and precisely. To ensure the safety of clients, this is an important skill to master before administering medication.

    This chapter reviews the techniques necessary to read labels, syringes, and intravenous bags competently. Specifically, it is designed to assist you in learning how to:

    Read medication labels to obtain pertinent information and identify various intravenous solutions.

    Read a syringe.

    Select the correct size needle and syringe.

    Reconstitute powdered medications.

    Add medication to an intravenous bag of fluid.

    Draw up two types of insulin in the same syringe.

    This chapter also presents examples of medication labels and intravenous labels, as well as types and sizes of syringes and needles.

    4 Identifying Labels, Syringes, and Intravenous Bags

    Introduction

    Reading Medication Labels

    The brand name of a medication (also known as the trade or proprietary name) is usually written in big letters on the medication label. The brand name is typically assigned by the manufacturer of the medication and has a registered mark () attached to it. The generic name of a medication may be written in smaller letters, placed in parentheses, or written in italics. The generic name must be included on the label to enable the filling pharmacist to dispense the generic versions as substitutes for the brand-name drugs. A brand medication is often filled with generic substitutions unless the ordering physician checks off or writes dispense as written. See Figure 4-1.

    Figure 4-1 Locating the brand name and generic name on a drug label.

    Source: Courtesy of Merck & Co., Inc.

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  • 48 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Varicella virus vaccine live (Varivax) is a live attenuated virus used to produce active immunity to the varicella virus, which causes chicken pox.

    M edication Administration Tip

    Ciprodex (ciprofloxacin) is an antibacterial agent used to treat infections caused by susceptible gram-negative bacteria.

    M edication Administration Tip

    Pataday/Patanol (olopatadine hydrochloride) is an antihistamine used to relieve itching caused by conjunctivitis.

    M edication Administration Tip

    Travatan (travoprost) is an ophthalmic solution used in the treatment of glau-coma and ocular hypertension.

    M edication Administration Tip

    Figure 4-1 (Continued)

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Alcon Laboratories, Inc. Used with permission.

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  • Reading Medication Labels 49

    Also on the medication label are (see Figure 4-2):

    The dosage strength, always included, indicating how much drug is provided in the medication container.

    The drug form, such as tablets, capsules, powders, milliliters, drops, ounces, and so on.

    The amount of the drug in the bottle or the container volume, such as the num-ber of tablets or milliliters.

    Figure 4-2 Locating the drug strength, drug form, and amount of the drug on a label.

    Source: Courtesy of Merck & Co., Inc.

    Whitehouse Station, NJ 08889, USA

    Dist. by:

    90 Tablets

    Manufactured by:MERCK SHARP & DOHME LTD.Cramlington, Northumberland, UK NE23 3JUMade in UK

    Store between5 - 30C (41- 86F).

    USUAL ADULT DOSAGE:See accompanying circular.

    Rx only

    NDC 0006-0543-54

    543

    Lot 9639

    000

    90

    No.

    6577

    Zocor 80 mg(Simvastatin)

    8080 mgmg

    9090 TTaaTTTT bbletslets

    Source: Courtesy of Merck & Co., Inc.

    120 Capsules

    USUAL ADULT DOSAGE:See accompanying circular.

    NDC 0006-0568-40Store at 20-25C (68-77F), excursions permitted between 15-30C (59-86F). [See USP Controlled Room Temperature.]

    Manuf. for:

    Whitehouse Station, NJ 08889, USAManuf. by:Patheon, Inc.Mississauga, Ontario, Canada L5N 7K9Formulated in Canada

    100mg

    Direct contact of the powder in ZOLINZA capsules with the skin or mucous membranes should be avoided. (See accompanying circular.)

    Each capsule contains 100 mg vorinostat.

    Rx only

    97

    23

    10

    21

    20

    No

    .38

    83

    Lot30006-0568-40

    4

    100 m

    g56

    8

    ZolinzaTM(vorinostat) capsules

    110000mmgg120120 CapsulesCapsules

    Source: Courtesy of Merck & Co., Inc.

    98

    63

    00

    09

    0

    No

    .37

    93

    Lot

    Hyzaar 100-25(Losartan Potassium-Hydrochlorothiazide Tablets)

    90 Tablets

    USUAL ADULT DOSAGE: See accompanying circular.

    Rx onlyHYZAAR is a registered trademark ofE.I. du Pont de Nemours and Company,Wilmington, DE

    NDC 0006-0747-54

    Each tablet contains 100 mg losartan potassium and25 mg hydrochlorothiazide.Store at 25C (77F); excursions permitted to15-30C (59-86F) [see USP Controlled RoomTemperature]. Keep containertightly closed. Protect fromlight.

    9090 TTaaTTTT bbletslets

    100-25 100-25H dH d

    Source: Pfizer Inc. Used with permission.

    Source: Courtesy of Merck & Co., Inc.

    93

    28

    10

    23

    0

    No

    .66

    42

    Lot

    30 Tablets www.propecia.com

    Whitehouse Station, NJ 08889, USA

    Each tablet contains 1 mg finasteride.

    Warning: PROPECIA (finasteride) should not be used by women or children. Women who are or may potentially be pregnant must not use PROPECIA. They should also nothandle crushed or broken tablets of PROPECIA. (See accompanying circular). Store at room temperature 15-30

    C

    (59-86 F). Keep container closed and protect from moisture.Keep this and all drugs out of the reach of children.USUAL ADULT DOSAGE:1 mg once a day.

    NDC 0006-0071-31

    Rx onlyFinasteride (active ingred.)

    Made in UKFormulated in USA

    1 m1 mmg mg

    30 Tablets30 Tablets

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  • 50 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Then look for (see Figure 4-3):

    The supply dosage, which is the number of units per specified quantity.

    Whether the container is a single or unit dose or includes multiple dosages.

    The route of administration or method of delivering the medication, such as oral, IV, IM, sublingual, topical, etc.

    Specific directions, such as the protocol for reconstituting powder, which are clearly written.

    Figure 4-3 Locating the supply dosage, the number of doses, the route of medication administration, and specific instructions on a drug label.Source: Pfizer Inc. Used with permission.

    Nitrostat (Nitroglycerin) is an antianginal agent used in the treatment of acute angina.

    M edication Administration Tip

    Hyzaar (losartan potassium-hydrochlorothiazide) is an antihypertensive used in the treatment of elevated blood pressure.

    M edication Administration Tip

    Propecia (finasteride) is an androgen hormone inhibitor used in the treatment of symptomatic benign prostatic hyperplasia (BPH).

    M edication Administration Tip

    Zolinza (vorinostat) is a histone deacetylase (HDAC) inhibitor used in the treat-ment of T-cell lymphoma.

    M edication Administration Tip

    Zocor (simvastatin) is an antihyperlipidemic used in the treatment of elevated total cholesterol.

    M edication Administration Tip

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  • Reading Medication Labels 51

    Estring (estradiol vaginal ring) is a hormone (estrogen) used in the treatment of atrophic vaginitis and the prevention of postmenopausal osteoporosis.

    M edication Administration Tip

    Glucagon for Injection (rDNA origin) is a glucose-elevating agent used in the treatment of hypoglycemia.

    M edication Administration Tip

    Cleocin Vaginal Ovules (clindamycin phosphate) is an antibiotic used in the treat-ment of bacterial vaginosis.

    M edication Administration Tip

    Source: Pfizer Inc. Used with permission.

    Figure 4-3 (Continued)

    Source: Eli Lilly and Company. Used with permission.

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  • 52 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Humalog Mix 75/25 is an antidiabetic agent (hormone insulin) used in the treat-ment of diabetes mellitus type 1.

    M edication Administration Tip

    Humulin 50/50 is an antidiabetic agent (hormone insulin) used in the treatment of diabetes mellitus type 1.

    M edication Administration Tip

    Other important information found on medication labels is (see Figure 4-4):

    The drugs expiration date.

    Warnings and alerts associated with the drug, such as allergies, storage instructions, whether to shake well or do not shake, and whether to expose the medication to sunlight.

    The manufacturers name with control or lot numbers (used mostly for drug recalls).

    The manufacturers bar code (very important for unit dosing). The bar code, once scanned at the clients bedside before the medication is given to a client, is a check that the drug and dose are correct and documentation of that fact. See Figure 4-5.

    Figure 4-4 Locating the expiration date, a warning or alert, storage instructions, the manufacturers name, the lot number, and a bar code on a drug label.

    Source: Pfizer Inc. Used with permission.

    1234

    5

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

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  • Reading Medication Labels 53

    Accupril (quinapril HCL) is an antihypertensive agent used in the treatment of hypertension.

    M edication Administration Tip

    Antivert (meclizine HCL) is an antiemetic/anti-motion sickness agent used in the prevention and treatment of nausea, vomiting, and motion sickness.

    M edication Administration Tip

    Xanax (alprazolam) is an antianxiety drug used in the treatment and manage-ment of anxiety disorders.

    M edication Administration Tip

    Vibramycin (doxycycline hyclate) is an antibiotic used in the treatment of sensi-tive bacteria, particularly when Penicillin is contraindicated.

    M edication Administration Tip

    Humalog Mix 75/25 Pen is an antidiabetic agent (hormone insulin) in pen/unit dosing form, used in the treatment of diabetes mellitus type 1.

    M edication Administration Tip

    12/20/2015

    Source: Eli Lilly and Company. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Figure 4-4 (Continued)

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  • 54 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Practice Questions for Reading Medication LabelsCircle the following on the labels provided.

    1. Brand name of the medication

    Vistaril (hydroxyzine pamoate) is an antianxiety/antihistamine/antiemetic used in the treatment of anxiety/pruritis/nausea and vomiting.

    M edication Administration Tip

    Figure 4-5 Scanning the bar code on medication ensures that the drug and dose are correct.

    Source: Simon Jarratt/Corbis/age fotostock

    Source: Pfizer Inc. Used with permission.

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  • Reading Medication Labels 55

    2. Trade name of the medication

    3. Generic name of the medication

    Norvasc (amlodipine besylate) is an antianginal/antihypertensive used in the treatment of anxiety and hypertension.

    M edication Administration Tip

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

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  • 56 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    6. Drug amount

    4. Drug strength

    5. Drug form

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

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  • Reading Medication Labels 57

    Allegra-D 12 Hour (fexofenadine HCL and pseudoephedrine HCL) is a deconges-tant and antihistamine used in the treatment of symptomatic allergies.

    M edication Administration Tip

    Ambien CR (zolpidem) is a sedative/hypnotic used in the treatment of short-term insomnia.

    M edication Administration Tip

    7. Supply dosage

    8. Number of dosages

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

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  • 58 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    9. Route of medication

    10. Expiration date

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    11/15/2014Source: Eli Lilly and Company. Used with permission.

    1/31/2015

    Source: Alcon Laboratories, Inc. Used with permission.

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  • Reading Medication Labels 59

    11. Drug warning, alert, allergy

    12. Storage instructions

    13. Manufacturers name

    Source: sanofi-aventis US. Used with permission.

    93

    28

    10

    23

    0

    No

    . 66

    42

    Lot

    30 Tablets www.propecia.com

    Whitehouse Station, NJ 08889, USA

    Each tablet contains 1 mg finasteride.

    Warning: PROPECIA (finasteride) should not be used by women or children. Women who are or may potentially be pregnant must not use PROPECIA. They should also nothandle crushed or broken tablets of PROPECIA. (See accompanying circular). Store at room temperature 15-30

    C

    (59-86 F). Keep container closed and protect from moisture.Keep this and all drugs out of the reach of children.USUAL ADULT DOSAGE:1 mg once a day.

    NDC 0006-0071-31

    Rx onlyFinasteride (active ingred.)

    Made in UKFormulated in USA

    Source: Courtesy of Merck & Co., Inc.

    Source: Courtesy of Merck & Co., Inc.

    Source: Alcon Laboratories, Inc. Used with permission.

    Whitehouse Station, NJ 08889, USA

    Dist. by:

    90 Tablets

    Manufactured by:MERCK SHARP & DOHME LTD.Cramlington, Northumberland, UK NE23 3JUMade in UK

    Store between5 - 30C (41- 86F).

    USUAL ADULT DOSAGE:See accompanying circular.

    Rx only

    NDC 0006-0543-54

    543

    Lot 9639

    000

    90

    No.

    6577

    Zocor 80 mg(Simvastatin)

    Source: Courtesy of Merck & Co., Inc.

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  • 60 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    14. Lot number

    Demerol (meperidine hydrochloride) is an opioid agonist analgesic used in the treatment of moderate-to-severe acute pain.

    M edication Administration Tip

    Lasix (furosemide) is a loop diuretic used in the treatment of edema and hypertension.

    M edication Administration Tip

    15. Bar code

    Source: Pfizer Inc. Used with permission.

    77550

    Source: sanofi-aventis US. Used with permission.

    9797

    4

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

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  • Reading Injection Syringes 61

    Source: sanofi-aventis US. Used with permission.

    Reading Injection Syringes

    Reading injection syringes is relatively simple once you know what to look for. The following illustrations are examples of injection syringes with their vari-ous parts labeled. See Figure 4-6.

    The plunger is inside the barrel and is used to push the medication out of the syringe into tissue.

    The barrel is what holds the solution.

    The tip is where the needle attaches.

    Insulin syringes are typically standardized to measure units. The customary cali-bration is 100 units (U) per 1 milliliter (ml). In other words, 1 milliliter equates to 100 units of insulin. The syringe in Figure 4-7 is a U100 insulin syringe.

    Figure 4-6 Three different sizes of injection syringes with parts labeled.

    Source: jkitan/Shutterstock, Inc.

    Source: AbleStock

    Source: Photodisc

    Figure 4-7 A U100 insulin syringe.

    Source: Elena Kalistratova/Shutterstock, Inc.

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  • 62 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Remember that a minim is a measurement of weight that is equivalent to a drop and is abbreviated as m. The meter is a measurement of length that is equal to 39.37 inches and abbreviated as m or M.

    M edication Administration Tip

    A tuberculin syringe is calibrated in minims (m) and milliliters. Remember that 16 minims are equal to 1 milliliter of fluid. See Figure 4-8.

    .2 .3 .4 .5 .6 .7 .8 .9 1.0

    2 4 6 8 10 12 14 16

    Figure 4-8 A tuberculin syringe.

    Standard syringes are calibrated in milliliters on one side and in minims on the other side. Standard syringes generally come in 3-, 5-, and 10-milliliter sizes. See Figure 4-9.

    Source: ajt/Shutterstock, Inc.

    Source: Michael G. Smith/Shutterstock, Inc. Source: Tatiana Popova/Shutterstock, Inc.

    Practice Questions for Reading Injection SyringesQuestions 13: Identify the number of units shaded in the insulin syringe:

    1. ____________ units

    USE U-100 ONLY

    105 15 20 25 30 35 40 45 50U

    NIT

    Figure 4-9 Standard syringes in 3-, 5-, and 10-milliliter sizes.

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  • Reading Injection Syringes 63

    2. ____________ units

    USE U-100 ONLY

    105 15 20 25 30 35 40 45 50 UNIT

    3. ____________ units

    USE U-100 ONLY

    105 15 20 25 30 35 40 45 50 UNIT

    Questions 46: Shade the number of units in the insulin syringe:

    4. 23 units

    USE U-100 ONLY5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    5. 70 units

    USE U-100 ONLY

    5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    6. 5 units

    USE U-100 ONLY

    5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    Questions 79: Identify the number of minims shaded in the following tuberculin syringe:

    7. ____________ minims

    2 4 6 8 10 12 14 16

    8. ____________ minims

    2 4 6 8 10 12 14 16

    9. ____________ minims

    2 4 6 8 10 12 14 16

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  • 64 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Questions 1012: Shade the number of minims in the tuberculin syringe:

    10. 12 minims

    2 4 6 8 10 12 14 16

    11. 5 minims

    2 4 6 8 10 12 14 16

    12. 2 minims

    2 4 6 8 10 12 14 16

    Questions 1316: Identify the number of milliliters shaded in the standard syringe:

    13. ____________ milliliters

    1 1 122 12

    12

    2

    3m

    l

    14. ____________ milliliters

    1 1 122 12

    12

    2

    3m

    l

    15. ____________ milliliters

    3 245 ml

    1

    16. ____________ milliliters

    3 2456

    ml

    178910

    Questions 1720: Shade in the number of milliliters in the standard syringe:

    17. 1 milliliter

    1 1 122 12

    12

    2

    3m

    l

    18. 1.2 ml

    1 1 122 12

    12

    2

    3m

    l

    19. 2.4 ml

    3 245 ml

    1

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  • Selecting the Correct Size Needle and Syringe 65

    20. 6.4 ml

    3 2456

    ml

    178910

    Selecting the Correct Size Needle and Syringe

    Use the smallest syringe possible when giving injections. Adequate sizes are1-milliliter syringes for subcutaneous injections.

    3-milliliter syringes for intramuscular injections.

    The ventrogluteal site is the preferred site for most injections for the adult client. The vastus lateralis is commonly used in small children and infants. The deltoid muscle is easily accessible but can be underdeveloped in many adults and is seldom used in pediatrics (Potter & Perry, 2005, p. 888). See Figure 4-10.

    M edication Administration Tip

    Clavicle

    Acromion process Scapula

    Axilla

    Humerus

    Brachial artery

    Radialnerve

    Site of injection(deltoid)

    Anteriorsuperioriliac spine

    Posterioriliac crest

    Greater trochanterof femur

    Femoral artery

    Sciatic nerve

    Rectusfemoris

    Site of injection(Vastus lateralis)

    Site of injection(Gluteus medius)

    Palm overgreatertrochanter

    Deltoid site

    Vastus lateralis siteVentrogluteal siteFigure 4-10 Intramuscular injection sites: ventrogluteal, vastus lateralis, and deltoid.

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  • 66 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    In addition to choosing the appropriate needle size, correctly identifying the parts of a needle is very important when administering an injection. See Figure 4-11.

    3 245 ml

    1

    barrel

    hub

    shaft

    bevel

    Figure 4-11 Identifying the parts of a needle.

    Source: Courtesy and Becton, Dickinson and Company.

    Figure 4-12 Different sizes and gauges of needles: (a) 27 gauge (diameter) 1/2 inch; (b) 30 gauge 1/2 inch; (c) 26 gauge 1/2 inch; (d) 29 gauge 1/2 inch; (e) 25 gauge 1/2 inch.

    A

    B

    C

    D

    E

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  • Reconstituting Powdered Medication 67

    Sometimes the nurse has to reconstitute a powdered medication for intramus-cular or intravenous administration. In such cases, always follow the label directions to achieve the correct dosage-to-solute ratio. See Figure 4-14.

    Injectable syringes have many new safety features such as the safety sheath, which allows the nurse to cover the used needle safely and not run the risk of a fingerstick. Safety syringes come in most sizes. See Figure 4-13.

    Never recap used nonsafety syringes. Always discard the used syringes in appro-priate disposal containers.

    M edication Administration Tip

    Reconstituting Powdered Medication

    When reconstituting a powdered medication, add the exact amount of diluting solution according to the label and then mix the solution by rolling the vial in the palms of the hands.

    M edication Administration Tip

    Figure 4-13 Safety syringes have a sheath, which allows the nurse to cover the used needle safely to avoid a fingerstick.

    Source: Courtesy and Becton, Dickinson and Company.

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  • 68 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    Figure 4-14 Powdered medication (A) before, and (B) after it has been reconstituted.

    AB

    Adding Medications to Intravenous Solution Bags

    Adding medications to intravenous solution bags must be done correctly and under sterile conditions. Review the following steps to learn how to safely add medications to intravenous solution bags:

    1. Locate the injection port on the intravenous bag. Clean off the port using an antiseptic swab.

    IVPB100 mL

    Regular IV1,000 mL

    Injection port

    IV solution bag

    Drip chamber

    Roller clamp

    Source: George Allen Penton/ShutterStock, Inc. Source: Robert Byron/Dreamstime.com

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  • Drawing Up Two Types of Insulin in the Same Syringe 69

    Also, when mixing two insulin solutions, follow these steps in the order shown:

    1. Inject air into the air space in a vial of long-acting insulin.

    2. Inject air into the air space of a vial of short-acting insulin.

    2. Insert needle into the center of the injection port and inject medication. Remove needle and dispose of properly. Rotate the intravenous bag gently to mix medication and affix completed medication label.

    Drawing Up Two Types of Insulin in the Same Syringe

    Insulin is a very fragile medication and can be easily destroyed with rough han-dling. So it is recommended that (see Figure 4-15):When you are warming cool insulin, gently roll the vial in the palms of the hands; do not shake it.

    When placing air into an insulin vial, inject the air into air, not into the solution.

    Figure 4-15 Roll the vial gently between the hands to warm the solution.

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  • 70 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    3. Draw up the short-acting insulin.

    4. Draw up the long-acting insulin.

    The reason for this safety practice is to avoid harmful spillage of insulin from one vial to the other. If a minute amount of short-acting insulin happens to spill into the long-acting insulin, the action of the long-acting insulin remains relatively unchanged. Conversely, if a minute amount of long-acting insulin spills into the short-acting insulin, the action of the short-acting insulin could be dangerously altered.

    Posttest Remember to show all work and to proof all answers.Questions 110: Circle the following on the medication labels.

    1. Generic name of the drug

    2. Supply dosage

    3. Expiration date

    5/1/

    2012

    Source: sanofi-aventis US. Used with permission.

    Source: Eli Lilly and Company. Used with permission.

    Source: Courtesy of Merck & Co., Inc.

    DIDONA_CH04.indd 70 2/19/2009 11:38:12 PM

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  • Drawing Up Two Types of Insulin in the Same Syringe 71

    Source: Eli Lilly and Company. Used with permission.

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    4. Bar code

    5. Storage instructions

    6. Route of drug

    7. Number of dosages

    DIDONA_CH04.indd 71 2/19/2009 11:38:13 PM

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  • 72 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    8. Drug form

    9. Warning or alert

    10. Drug strength

    Questions 1115: Shade the syringe with the correct dosage.

    11. 18 units

    USE U-100 ONLY

    5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Depo-subQ Provera (medroxyprogesterone acetate) is a hormone/antineoplas-tic used in the treatment of reducing endometrial hyperplasia and long-acting contraception.

    M edication Administration Tip

    DIDONA_CH04.indd 72 2/19/2009 11:38:13 PM

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  • Drawing Up Two Types of Insulin in the Same Syringe 73

    16. What size syringe and needle would the healthcare provider select to admin-ister the Demerol?

    a. 3 ml, 21 gauge, 1 inch

    b. 1 ml, 18 gauge, 1/2 inch

    c. 5 ml, 25 gauge, 5/8 inch

    d. 10 ml, 26 gauge, 1/2 inch

    17. How many milliliters would the healthcare provider add to the Eloxatin vial to reconstitute the powered mixture?

    Answer: ____________ ml

    12. 10 minims

    2 4 6 8 10 12 14 16

    13. 1.8 milliliters

    1 1 122 12

    12

    2

    3m

    l

    14. 3.25 milliliters.

    3 245 ml

    1

    15. 6.7 milliliters

    3 2456

    ml

    178910

    Questions 1620: Answer the questions based on the clinical scenario provided.

    Clinical ScenarioA client diagnosed with advanced cancer of the colon comes to the clinic with

    acute rectal bleeding with bowel movements. He is complaining of abdominal pain, he is afebrile, and slightly dehydrated. The clinic doctor orders 500 ml D5W with 1 ampule of multivitamin to infuse over the next 3 hours for rehydration, Eloxatin 100 mg IVPB as a one-time dose, and Demerol 50 mg IM Q4H PRN for pain.

    Eloxatin (oxaliplatin) is an antineoplastic agent used in the treatment of meta-static colon and rectal cancer.

    M edication Administration Tip

    Source: sanofi-aventis US. Used with permission.

    DIDONA_CH04.indd 73 2/19/2009 11:38:14 PM

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  • 74 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    18. How many milliliters would the healthcare provider draw up to correctly administer the ordered amount of Eloxatin?

    Answer: ____________ ml

    19. How would the healthcare provider add the multivitamin to the empty intra-venous bag of D5NS solution? Number the steps in the correct order.

    a. _____ Rotate the bag.

    b. _____ Inject the medication.

    c. _____ Draw up the medication.

    d. _____ Swab the IV bag port.

    e. _____ Label the bag containing the multivitamin.

    20. How would the healthcare provider draw up the clients morning insulin for administration? Ordered: 10 units of regular insulin and 15 units of NPH insulin. Number the steps in the correct order.

    a. _____ Inject air into regular insulin.

    b. _____ Inject air into NPH insulin.

    c. _____ Draw up NPH insulin.

    d. _____ Draw up regular insulin.

    Answers Answers to Practice Questions for Reading Medication Labels

    1.

    Source: sanofi-aventis US. Used with permission.

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 74 2/19/2009 11:38:15 PM

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  • Answers 75

    2.

    3.

    4.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 75 2/19/2009 11:38:17 PM

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  • 76 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    5.

    6.

    7.

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 76 2/19/2009 11:38:20 PM

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  • Answers 77

    8.

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    9.

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Eli Lilly and Company. Used with permission.

    10.

    11/15/201411/15/201411/15/2014

    1/31/20151/31/20151/31/2015

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 77 2/19/2009 11:38:23 PM

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  • 78 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    11.

    Source: sanofi-aventis US. Used with permission.

    93

    28

    10

    23

    0

    No

    .66

    42

    Lot

    30 Tablets www.propecia.com

    Whitehouse Station, NJ 08889, USA

    Each tablet contains 1 mg finasteride.

    Warning: PROPECIA (finasteride) should not be used by women or children. Women who are or may potentially be pregnant must not use PROPECIA. They should also nothandle crushed or broken tablets of PROPECIA. (See accompanying circular). Store at room temperature 15-30

    C

    (59-86 F). Keep container closed and protect from moisture.Keep this and all drugs out of the reach of children.USUAL ADULT DOSAGE:1 mg once a day.

    NDC 0006-0071-31

    Rx onlyFinasteride (active ingred.)

    Made in UKFormulated in USA

    Warning: PROPECIAWarning: PROPECIA (finasteride) (finasteride)should should not be used by women ornot be used by women orchildren. Women who are or may children. Women who are or may potentially be pregnant must not potentially be pregnant must not use PROPECIA. They should also notuse PROPECIA. They should also nothandle crushed or broken tabletshandle crushed or broken tabletsof PROPECIA. of PROPECIA.

    Source: Courtesy of Merck & Co., Inc.

    Source: Courtesy of Merck & Co., Inc.

    Source: Courtesy of Merck & Co., Inc.

    12.

    13.

    Whitehouse Station, NJ 08889, USA

    Dist. by:

    90 Tablets

    Manufactured by:MERCK SHARP & DOHME LTD.Cramlington, Northumberland, UK NE23 3JUMade in UK

    Store between5 - 30C (41- 86F).

    USUAL ADULT DOSAGE:See accompanying circular.

    Rx only

    NDC 0006-0543-54

    543

    Lot 9639

    000

    90

    No.

    6577

    Zocor 80 mg(Simvastatin)

    MaMannuuffacturedactured bby:y:MERCKMERCK SHARPSHARP && DOHMEDOHME LLTTLLLL DD..

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 78 2/19/2009 11:38:27 PM

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  • Answers 79

    14.

    15.

    9797

    497

    974

    9797

    4

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    Source: sanofi-aventis US. Used with permission.

    Answers to Practice Questions for Reading Injection Syringes

    1. 17 units

    2. 3 units

    3. 10 units

    4.

    USE U-100 ONLY

    5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    DIDONA_CH04.indd 79 2/19/2009 11:38:29 PM

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  • 80 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    5.

    USE U-100 ONLY

    5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    6.

    USE U-100 ONLY

    5 15 25 35 45 (Oxylate Side)55 65 75 85 95

    20 30 40 50 60 70 80 90 100

    UN

    IT

    10

    7. 16 minims

    8. 8 minims

    9. 3 minims

    10. 2 4 6 8 10 14 1612

    11. 2 4 6 8 10 14 1612

    12. 2 4 6 8 10 14 1612

    13. 0.6 milliliters

    14. 1.7 milliliters

    15. 3.8 milliliters

    16. 7.5 milliliters

    17. 1 1

    122 12

    12

    2

    3m

    l

    18.

    1 1 122 12

    12

    2

    3m

    l

    19.

    3 245 ml

    1

    20. 3 24

    56

    ml

    178910

    DIDONA_CH04.indd 80 2/19/2009 11:38:32 PM

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  • Answers 81

    Answers to Posttest

    1.

    2.

    3.

    5/1/20

    12

    4.

    5.

    Source: sanofi-aventis US. Used with permission.

    Source: Eli Lilly and Company. Used with permission.

    Source: Eli Lilly and Company. Used with permission.

    Source: Alcon Laboratories, Inc. Used with permission.

    Source: Courtesy of Merck & Co., Inc.

    DIDONA_CH04.indd 81 2/19/2009 11:38:34 PM

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  • 82 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    6.

    7.

    8.

    9.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 82 2/19/2009 11:38:36 PM

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  • Answers 83

    10.

    11.

    USE U-100 ONLY105 15 20 25 30 35 40 45 50 UN

    IT

    12.

    2 4 6 8 10 12 14 16

    13.

    1 1 122 12

    12

    2

    3m

    l

    14.

    3 245 ml

    1

    15.

    3 2456

    ml

    178910

    Source: Pfizer Inc. Used with permission.

    DIDONA_CH04.indd 83 2/19/2009 11:38:40 PM

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  • 84 Chapter 4 n Identifying Labels, Syringes, and Intravenous Bags

    16. a

    17. 20 ml

    18. 20 ml

    19. c, d, a, b, and e.

    20. b, a, d, and c.

    Reference Potter, A. P., & Perry, A. G. (2005). Fundamentals of nursing. Philadelphia: Mosby.

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