1. Parenteral Dosages Chapter 12
Copyright © 2020 by Mosby, an imprint of Elsevier Inc. All rights reserved.

2. Route of administration other than gastrointestinal
Parenteral Route
Route of administration other than gastrointestinal
Intramuscular (IM)
Subcutaneous (subcut)
Intradermal (ID)
Intravenous (IV)

3. May be diluted and administered by themselves
Parenteral Dosages
Review Figure 12-1 to view intramuscular, subcutaneous, and intradermal injections, with comparison of the angles of insertion
May be diluted and administered by themselves
May be administered in conjunction with existing IV fluids
May be administered in addition to IV fluids
Ask these questions:
What are parenteral dosages, and why are some medications given parenterally?
How are parenteral medications administered?
How can parenteral medications be administered intravenously?
Copyright © 2020 by Mosby, an imprint of Elsevier Inc. All rights reserved.

4. Copyright © 2020 by Mosby, an imprint of Elsevier Inc
Copyright © 2020 by Mosby, an imprint of Elsevier Inc. All rights reserved.

5. Parenteral Dosages Packaging of parenteral medications: Ampules Vials
Mix-O-Vials
Pre-filled Syringes
An ampule is a single-dose container that must be broken at the neck to withdraw the drug.
A vial is a glass or plastic container that is sealed with a rubber stopper. Vials generally contain more than one dose of medication.
A Mix-O-Vial is used to package unstable drugs and allows the components to be combined just before administration. Pressure is applied to the top of the vial to release the stopper between the compartments and allow the drug to be mixed.
A prefilled disposable syringe can be used to supply parenteral medications.

6. Guidelines for Syringe Selection
Standard doses more than 1 mL
Round to tenths and measure in 3 mL syringe
3 mL syringe is calibrated in 0.1 mL increments
1.53 mL is rounded to 1.5 mL
Drawn up in a 3 mL syringe

7. Guidelines for Syringe Selection (Continued)
Small (less than 1 mL), critical care, or children’s doses
Round to hundredths and measure in 1 mL syringe
1 mL syringe is calibrated in 0.01 mL increments
0.257 mL is rounded to 0.26 mL
Drawn up in a 1 mL syringe

8. Guidelines for Syringe Selection (Continued)
Amounts of 0.5 to 1 mL calculated in tenths
Can be accurately measured in either a 1 mL or 3 mL syringe

9. Remember
Dosages measured in hundredths (such as mL) and all amounts less than 0.5 mL should be prepared in a 1 mL syringe, which is calibrated in hundredths
However, if the route is intramuscular (IM), you may need to change needles to achieve a more appropriate length

10. Tip Syringes Barrel Plunger Hypodermic Tuberculin Insulin
Parts of a syringe
Tip
Barrel
Plunger
Types of syringes
Hypodermic
Tuberculin
Insulin
Syringes
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11. Intramuscular maximum dosage
Injectable Solutions
Intramuscular maximum dosage
Average 150 lb adult = 3 mL
Maximum for deltoid site is 2 mL
Children age 6-12 years = 2 mL
Children birth to age 5 years = 1 mL

12. Parenteral Injections
Examples of parenteral dosage calculations
Collecting data about the drug
Selecting supplied dosage
Calculating the amount to give
Measuring the dose with appropriate equipment for medication administration

13. To protect both patient and nurse
Needleless System
Why does Occupational Safety and Health Administration recommend the administration of parenteral medications with a needleless system?
To protect both patient and nurse
Because the system provides a shield to cover device
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14. Calculation of Parenteral Drug Dosages
For example:
The order states Kantrex 200 mg IM q6 h. Kantrex is supplied 0.5 g/2 mL. How many milliliters will the nurse administer?
Copyright © 2020 by Mosby, an imprint of Elsevier Inc. All rights reserved.

15. Converting All Measures to Equivalents Measures
For example:
A physician orders atropine gr 0.01 IM stat. Atropine 0.4 mg/mL is available. Convert the physician’s order to milligrams.
The physician’s order and the available drug must be in the same system of measurement before you can write a proportion for the actual amount of medication to be administered.
Convert measures into the same system before writing the proportion problem.
1 gr = 60 mg
1 gr : 60 mg :: 0.01 gr : x mg
x = 0.6 mg
Copyright © 2020 by Mosby, an imprint of Elsevier Inc. All rights reserved.

16. Parenteral Drug Dose Calculation: Alternative Formula Method
For example:
The physician orders morphine 30 mg IM q4 h prn for pain. Morphine gr i/5 mL is available. How many milliliters will the nurse administer?
Copyright © 2020 by Mosby, an imprint of Elsevier Inc. All rights reserved.