Math and Dosage Calculations for Medical Careers PowerPoint® to accompany Math and Dosage Calculations for Medical Careers Second Edition Booth • Whaley Chapter 4 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Chapter 4 Equipment for Dosage Measurement

Learning Objectives Identify equipment used to administer medication. When you have completed Chapter 4, you will be able to: Identify equipment used to administer medication. Indicate the appropriate equipment for delivering various types of medicine. Chapter 4

Learning Objectives (con’t) Measure medications using the calibrations on the equipment. Describe the method of administration appropriate for each piece of measuring equipment. Chapter 4

Introduction In order to prepare the correct dosage of medications, you must know how to use equipment properly. Oral Parenteral – bypassing the digestive tract IM, IV, ID , Sub-Q Topical Transdermal Drops, sprays, & mists Vaginal & Rectal Chapter 4

Oral Medication Administration Measuring devices have a series of calibrations or marks numbered at varying intervals. Calibrations enable you to measure the amount of liquid in the container. Compare the calibration with the desired dose of medication. Be sure that they match the order. Chapter 4

Oral Medication Administration (con’t) Medicine cups Droppers Calibrated spoons Oral syringes Chapter 4

Medicine Cups Meniscus – the bottom of the curved surface of a liquid in a cup or container. Chapter 4

Medicine Cups (con’t) Rule 4 - 1 Do not use medicine cups for doses less than 5 mL, even if the cup has calibrations smaller than 5 mL. Instead, use a dropper a calibrated spoon an oral syringe Chapter 4

Droppers Used to measure and administer small amounts of oral liquid medication Used to deliver medication to the eyes, ears, and nose Chapter 4

Calibrated Spoons Often used with pediatric and elderly patients Can administer medication directly into the mouth or into food or a beverage Chapter 4

Oral Syringes Used especially for quantities less than 5 mL Usually tinted Not sterile Chapter 4

Oral and Hypodermic Syringes Oral syringes off-center tips tinted in color non-sterile Hypodermic syringes centered tips clear in color sterile Chapter 4

Oral Syringes (con’t) Rule 4 - 2 Never attach a hypodermic needle to an oral syringe. Never inject an oral dose. In emergencies, you may use a hypodermic syringe without a needle to measure and administer liquid oral doses, but never while its needle is attached. Chapter 4

Other Equipment for Oral Medications If the patient cannot take medication orally, medications can be administered through a tube to the stomach. Types Nasogastric tube PEG tube Jejunostomy tube Chapter 4

Error Alert! Equipment used to administer medication must be measured accurately using the equipment’s calibrations. Chapter 4

Review and Practice Determine if the statements below are true. You may us a hypodermic syringe with a needle to measure liquid for oral administration. False Oral and hypodermic syringes are identical in appearance. False Excellent! Chapter 4

Review and Practice Excellent! Measuring spoons used for baking are acceptable for measuring liquid medications. True Oral medication comes in a bottle labeled 200 mg/5 cc. The dose to be administered is 600 mg. Which of the following is the correct dose? a. 1 tsp b. 2 tsp c. 1 tbs d. 2 tbs c . 1 tbs = 15 mL Excellent! Chapter 4

Hypodermic Syringes Plunger Barrel Syringe hub Needle Leading Ring Chapter 4

Hypodermic Syringes (con’t) Parenteral administration Usually used to deliver medications by injection intravenous (IV) intramuscular (IM) intradermal (ID) subcutaneous (Sub-Q) Chapter 4

Hypodermic Syringes (con’t) Common standard syringe Have scales calibrated in cubic centimeters (cc) Allowing for measurement of small doses Usually uses the metric system May also use the minim scale from the apothecary system Chapter 4

Types of Syringes 3 mL syringe Prefilled syringes Insulin syringes Tuberculin syringes Safety syringes Syringes to establish intravenous lines Large-capacity syringes Chapter 4

Standard 3 mL (cc) Syringe Calibrated in cubic centimeters (cc) or milliliters (mL) May have divisions of tenths, two-tenths, or hundredths of a cubic centimeter May also use minims Click to View Syringe Chapter 4

Prefilled Syringes Prefilled with a single, standard dose of medication Use once and discard Usually marked in tenths of a mL Measure the dose carefully; discard any excess medication Chapter 4

Prefilled Syringes (con’t) Rule 4 - 3 When using a prefilled syringe, always examine the markings to determine whether the syringe is calibrated in milliliters or milligrams and calculate the dose accordingly. Chapter 4

Insulin Syringes Used only to measure and administer insulin Insulin syringes are unique Measured in units Available in 50 and 100 Units Chapter 4

Insulin Syringes (con’t) Rule 4 - 4 Never use any type of syringe other than an insulin syringe to measure and administer insulin. Chapter 4

Insulin Syringes (con’t) 100-Unit Insulin Syringe 50-Unit Insulin Syringe Chapter 4

Tuberculin Syringes Used for doses less than 1 mL Examples: PPD skin test Vaccines Heparin Pediatric medicines Allergen extracts Chapter 4

Tuberculin Syringes (con’t) Calibrated in hundredths of a mL 1mL tuberculin syringe 0.5 mL tuberculin syringe Chapter 4

Safety Syringes Needles are protected by plastic shields to help prevent needle sticks. 100-unit insulin safety syringe Chapter 4

Syringes for Established Intravenous Lines Used to administer medication through already established intravenous lines (lines that deliver medications and fluids directly into a patient’s vein) Use the injection port Enables you to deliver drugs on a periodic basis and to dilute the medication Chapter 4

Syringes for Established Intravenous Lines (con’t) Needleless syringe Plastic injection tip Chapter 4

Large-Capacity Syringes Not all medication can be delivered in doses of 3 mL or less Syringes with 5 mL, 6 mL, 12 mL are available Look carefully at the marks to measure an accurate amount of medication Chapter 4

Large-Capacity Syringes (con’t) 5 mL, 6 mL, 10 mL, 12 mL or more 10 mL syringe Chapter 4

Error Alert! Pay close attention to the calibration of any syringe you use. Check the marks carefully. Chapter 4

Ampules, Vials, and Cartridges Chapter 4

Ampule Glass container Usually holds one dose of medication Snaps open Use a standard syringe to withdraw the medication Chapter 4

Vial Container covered with a rubber stopper May contain more than a single dose of medication Either liquid or powder form of medication Chapter 4

Cartridge Prefilled container shaped like a syringe barrel Usually holds one dose of medication Fits a reusable syringe Examples: Tubex Carpuject Chapter 4

Preparing an Injection Rule 4 - 5 In most circumstances, the person who prepares a syringe for injection should deliver the injection. Exceptions include: Pharmacy technicians who prefill syringes for nurses, medical assistants, or patients Nurses or medical assistants preparing a syringe for a physician Health-care workers teaching a patient to administer his or her own medication Chapter 4

Needle Gauge and Length You must choose a needle with an appropriate gauge Gauge Interior diameter Smaller gauges correspond to larger diameters An 18-gauge needle is wider than a 22-gauge needle More viscous drugs and deeper injections require needles with smaller gauges or larger needle diameters Chapter 4

Needle Gauge and Length (con’t) The injection site determines length. Length must be long enough to reach the desired area of tissue. Length must not be so long that it penetrates beyond the desired area. Chapter 4

Needle Gauge and Length (con’t) Type of Injection Needle Gauge Length for Adults (inches) Intradermal 25 – 26 Subcutaneous 23 – 27 Intramuscular 18 – 23 1 – 2 Chapter 4

Review and Practice Determine if the statements below are true. You can use an insulin syringe to measure 6 mL of medication. False A patient is punctured each time a syringe is used with an established intravenous line. False Excellent! Chapter 4

Topical Medications Gels, creams, ointments, and pastes They are applied directly to the skin Use a glove, tongue blade, or cotton-tipped applicator Avoid letting any of the medication contact your own skin Chapter 4

Transdermal Medications These often use a self-adhesive patch Maintains a consistent level of medication in the blood Place the medication on clean, dry, hairless skin with no rash or irritation and with good circulation Rotate placement sites Remove older patches and dispose of them Mark each new patch with your initials, the date, and the time Chapter 4

Transdermal Medications (con’t) Examples cardiovascular drugs hormones allergy medications pain medications Chapter 4

Drops Deliver medications to the nose, eyes, and ears Also called instillations Use the equipment that comes with the drug to administer the medication Droppers and plastic squeeze bottles are used Chapter 4

Sprays These are used to deliver medication to the nose and throat. Squeeze bottles and atomizers are used. Chapter 4

Mists Vaporizers, or steam inhalers, use boiling water to create a mist that the patient inhales. Nebulizers and metered dose inhalers (MDI) are also used to deliver medication to the patient. Chapter 4

Vaginal and Rectal Medications Suppositories Tablets Douches for liquid forms of medication Creams and foams Rectal Suppositories Enemas for liquid forms of medication Creams and foams Chapter 4

Apply your Knowledge What kind of utensil is often used to deliver medication to the eyes and ears? Answer: Dropper Chapter 4

Apply your Knowledge What kind of syringe is used to deliver vaccinations? Answer: Tuberculin Chapter 4

Apply your Knowledge How many mL are indicated on this syringe? Answer: 1.6 mL Chapter 4

Equipment for Dosage Measurement Nothing will work unless you do. --Maya Angelou THE END Chapter 4