Mixing Medications If two medications are compatible they can be mixed together

Mixing medications if two medications are compatible

This preview shows page 55 - 62 out of 86 pages.

Mixing Medications If two medications are compatible, they can be mixed together in  the same syringe Give client 1 shot instead of 2 Check drug compatibility in drug handbook,  compatibility chart,  or call pharmacy If using multidose vials, do not contaminate one medication with  another If using a multidose and a single dose vial, draw from the  multidose first   Why?
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Practice – Order for 50mg Demerol &  25mg Vistaril IM Check Dr. order & compatibility.  Wash hands. Check concentration in vials, Check expiration Demerol is in single dose vial 50mg/ml Vistaril is in multidose vial 50mg/ml. (Date & time vial) How much would you draw up? Clean top of vials with alcohol Inject 1ml air into Demerol vial, then inject 1/2ml air into Vistaril vial & draw 1/2ml  Vistaril.   Put needle into Demerol & draw up additional 1 ml, so you have  1.5 ml total in  syringe.  Change needle. Label syringe or write drugs & dose on syringe package
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Insulin Administration
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Types of Insulin Classified according to rate of action. Rapid – Novalog or Humalog  Designed for faster onset & shorter duration Give within 15 minutes of meal  Short acting  - Regular (Humulin R, Novalin R) Used for intermittent sliding scale or combined with intermediate Intermediate  – NPH  (Humulin N, Novalin N) or  Lente (rarely used) Usually given once or twice a day Premixed combinations with Regular or Rapid are available (e.g.  70/30, 75/25) Long Acting  – Lantus (glargine) OR  Levemir (detemir)
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Insulin Type Onset Peak Duration Rapid *Humalog insulin lispro  *NovoLog insulin aspart 15 min 30-90min 1-3 h 3-5 h Short-Acting *Regular (Humulin R, Novolin R) ½ -1h 2-4h 5-7h Intermediate – may be mixed with rapid or short Lente (suspension) 1-3 8-12 18-28 *NPH (suspension) 3-4 6-12 18-24 Long Acting – Do not mix Levemir (detemir) New 4-6 ?slt.  24 hours *Lantus (glargine)  (clear)  given 1x day at hs 1.1h NONE 24 Ultralente (susp) 4-6 18-24 36
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Managing Blood Glucose Action:  Insulin lowers blood glucose by increasing its transport  into cells and increasing conversion to glycogen If BG (blood glucose) is high between scheduled intermediate or  long-lasting insulin doses, a  sliding scale  of rapid or short- acting insulin is used for insulin coverage as ordered by physician Often ordered when pt. takes Lantus or Levemir insulin to  cover glucose peaks from meals Insulin may need to be held or dosage adjusted if patient is NPO  for surgery or testing. Check with MD for orders
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Sliding Scale  Physician orders specific amount of insulin coverage based on blood glucose  levels
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  • Spring '12
  • smith
  • Hypodermic needle, Syringe, needle

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