Chapter 7. Parenteral Medication Administration
7.1 Introduction
Parenteral medications are medications administered directly into body tissue or the circulatory system (according to Merriam-Webster, “parenteral” is a term taken from Greek meaning “to avoid the intestines”). They are synonymous with “injectables,” as syringes and needles are used to administer these medications by subcutaneous, intradermal, intramuscular, and intravenous routes. Injections are a direct and reliable way to deliver medication for fast absorption. However, parenteral medications pose a greater risk of harm and adverse reactions than nonparenteral medications. Parenteral medications require special equipment and a specific skill set to ensure that the medication is prepared correctly to have the right therapeutic effect, and to avoid complications (Perry et al., 2018).
Learning Outcomes
- Describe the advantages and disadvantages of administering medications by each parenteral route (ID, SC, IM, IV).
- Identify two strategies to reduce risk of needle-stick injuries.
- Accurately read a variety of syringes.
- Identify three strategies to prevent infection associated with parenteral medication administration.
- Demonstrate preparing meds from vials and ampules following principles of asepsis.
- Describe three strategies to help minimize patient discomfort during an injection.
- Landmark IM injection sites: deltoid, vastus lateralis, ventrogluteal.
- Identify rational for choice of an IM injection site.
- Discuss factors related to needle and syringe selection associated with subcutaneous and intramuscular route of medication administration.
- Discuss the aspirate versus don’t aspirate debate in relation to IM injections.
- Demonstrate safe subcutaneous and intramuscular injections.
- Describe three nursing considerations associated with the use of an indwelling subcutaneous device.
- Demonstrate safe administration of medication given IV direct via a PVAD short saline lock.
- Demonstrate safe administration of medication given IV direct into an infusing PVAD short with both compatible and incompatible solutions.
- Demonstrate safe administration of IV medication through a minibag and secondary IV set.
- Describe how to manage adverse reactions to IV medications.
- Explain three complications associated with intravenous medications.
- Summarize how to manage and report medication errors in the health care setting.