administering intramuscular injections quizlet

Inspect the skin surface over sites for bruises, inflammation, or edema. Donning sterile gloves. What is the recommended technique? 1 . Wait 10 seconds and then withdraw the needle, Julie S Snyder, Linda Lilley, Shelly Collins. Subcutaneous layer has few sensory nerves. (version 3, peer review, 2 approved). Intramuscular (IM) injections have been associated with adverse effects and pain, and this route of medication injection should be used as a last resort. Which site is commonly used while giving an intramuscular (IM) injection to a healthy adult? Intramuscular (IM) injections in neonates may be required to administer medications or vaccines. a. it prevents drug leakage into subcutaneous tissue. Administer vaccines that are known to be painful when injected (e.g., MMR, HPV) last. This chapter assimilates the best practices for delivering injections in health-care and related facilities. Follow instructions for SARS-COV2 vaccine administration provided on Elseviers Vaccination Hub undefinedhttps://elsevier.health/en-US/preview/sars-cov2-vaccine" target="_blank">https://elsevier.health/en-US/preview/sars-cov2-vaccine or Clinical Key for Nursing https://www.clinicalkey.com/nursing/#!/content/drug_monograph/6-s2.0-5295. It provides step-by-step instructions for how to use the Z-track method and why it may be used. What injection site is the nurse using? D. Massage the injection site. Performing an IM injection with this method can allow the pulled skin and soft tissue to cover the track once it is released and can prevent leaking. Do NOT mix more than one vaccine in the same syringe in an effort to create a combination vaccine.. The nurse's technique would correctly include 1. Draw back the plunger to fill the syringe with the correct amount of medication. A nurse or other healthcare provider can show you how to do it. Some vaccines are approved by the Food and Drug Administration (FDA) for administration by the Pharmajet Stratis needle-free injection system. 1.Place the heel of your hand over the greater trochanter of the patient's hip with the wrist almost perpendicular to the femur. The nurse assesses the client and checks the medication prescription prior to administering an intramuscular injection. to 5/8 in. Distraction, such as blowing bubbles and applying pressure at the injection site before giving the injection, may help alleviate the childs anxiety. If enters the bloodstream, it could cause abnormally rapid absorption of the medication. Select the appropriate site for injection based on the patients age, muscle tissue mass, and medication volume and viscosity. Centers for Disease Control and Prevention (CDC). If the patient receives frequent injections, rotate sites. If no blood appears, inject the medication. Compare the medication label with the MAR one final time at the patients bedside. The injection site is found in the center of the triangle (Figure 5A). If gloves are worn, they should be changed, and hand hygiene should be performed between patients. https://www.clinicalkey.com/nursing/#!/content/drug_monograph/6-s2.0-5295, https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html, https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2022/npsg_chapter_hap_jan2022.pdf, https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=FEDERAL_REGISTER&p_id=16265, https://www.cdc.gov/vaccines/pubs/pinkbook/safety.html, https://www.cdc.gov/vaccines/hcp/admin/admin-protocols.html, https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html. How would the nurse locate the site? National Patient Safety Goals for the hospital program. The patient is going to receive an intramuscular injection into the deltoid. The next immediate step should be to Apply a gauze pad without pressure Some subcutaneous injections come prefilled with the syringe attached. We have other quizzes matching your interest. Why IM is considered last resort for injection? The smallest syringe available for the volume of liquid administered is best for proper control and dosing. Once you have completed an intramuscular injection using the Z-track method, cover the site of the injection with an adhesive bandage. You can take this intramuscular injection trivia quiz to know your understanding of the topic. Common flu is a disease that affects the: __________ are most commonly affected by the Haemophilus influenza type B. There may be exceptions for specific medications. (2021). When done properly, there are two curves in the track that gives it the "Z" shape. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Apply heat to the injection site before injection. There are four sites on your body that can be used to give yourself an intramuscular injection. Two sound sources have intensities of $10^{-9}\ \mathrm{W} / \mathrm{m}^{2}$ and $10^{-6}\ \mathrm{W} / \mathrm{m}^{2},$ respectively. Patients who are learning to give injections for home-based treatment should ask their healthcare provider to explain the best method for their specific medication and situation. Detailed discussion can be found here: Multiple Injections/Coadministration of Vaccines, COVID-19 vaccine and coadministration with other vaccines, Routine and Influenza Immunization Services During the COVID-19 Pandemic: Interim Guidance | CDC, Vaccine Administration: Intramuscular (IM) Injection Children 7 through 18 years of age, Vaccine Administration: Intramuscular (IM) Injection Adults 19 years of age and older], Vaccine Administration: Needle Gauge and Length, Giving all the Doses Under 12 Months of Age, COVID-19 vaccines can be given during the same visit, How to Hold Your Child During Vaccinations, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP), Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline, Subcutaneous (SC or Subcut) Injection: Sites [3:26 minutes], Subcutaneous (SC or Subcut) Injection: Administration [6:27 minutes], Intramuscular Injection: Sites [5:07 minutes], Live, Attenuated Influenza Vaccine (LAIV) [4:09 minutes], Comfort and Restraint Techniques for Children [4:46 minutes], You Call the Shots: Vaccine administration training for healthcare professionals, National Center for Immunization and Respiratory Diseases, Healthcare Professionals / Providers Home, Vaccine Adverse Event Reporting System (VAERS), Pediatric Vaccination Practices During COVID-19, Childhood Vaccination Toolkit for Clinicians, You Call The Shots: Vaccine Storage and Handling, Screen for Contraindications and Precautions, Temporary, Satellite, or Off-Site Vaccination Clinics, Easy-to-Read Recommended Immunization Schedules, Resources for Parents of Infants and Toddlers, Resources for Parents of Preteens and Teens, Resources for College Students, Young Adults, and Adults, Understanding Risks & Responsibilities, If You Choose Not to Vaccinate, Talking with Parents about Vaccines for Infants, Understanding Vaccines and Vaccine Safety, U.S. Department of Health & Human Services, DTaP, DT, HepA, HepB, Hib, HPV, , IIV4, RIV4, ccIIV4, IPV*, MenACWY, MenB, PCV13, PPSV23*, RZV, Td, Tdap, TT, Fatty tissue of thigh for infants younger or upper outer triceps area, DTaP-IPV, DTaP-IPV-HepB, DTaP-IPV/Hib, DTaP-IPV-HepB/Hib, HepA-HepB. 2008;17(4):23740. Apply a dry cotton ball or gauze with light pressure for several seconds over the site. In what position would the nurse place the client? You will be subject to the destination website's privacy policy when you follow the link. The concern should be explored, the practitioner notified, and the order verified. Smoothly, quickly, and steadily withdraw the needle and release the skin. Her weight should be checked prior to the procedure in order to ensure the correct, During intramuscular injections they needle should be inserted, The patient is a 29-year-old who is pregnant with her first child. Return to the patient's room in 15 to 30 minutes to see if he or she has had any acute reaction at the injection site. What should be done for a patient who requires repeated injections? Intramuscular (IM) injection is one of many routes for administering medications, including antibiotics, vaccines, hormonal therapies, and corticosteroids. Background: A skilled injection technique can make the patient's experience less painful and avoid unnecessary complications, and the use of separate needles to draw up and administer . Name the tissue layer and site of an intradermal injection, Other than the deltoid, name 1 other site for intramuscular injection. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. The muscle is thick and well developed and is located on the anterior lateral aspect of the thigh. Intradermal injections (ID) are injections administered into the dermis, just below the epidermis. Trivia Quiz. These cookies may also be used for advertising purposes by these third parties. More research is needed to investigate the practice of aspiration before administering an IM injection with medications other than vaccines.8 The recommended route and site for each vaccine is included in the manufacturers instructions for use.2. Other adverse effects occur: hematoma or abscess; infection; fibrosis of the muscle, tissue damage because of patient movement during injection; glass particles injected into muscle as a result of not using a filter needle; permanent damage to sciatic nerve resulting in paralysis, fibrosis, or abscess. Content is reviewed before publication and upon substantial updates. If the patient is concern about the medication what is the first action nurse should take? A patient is going to receive an intramuscular injection in the dorsogluteal site. Patients should be instructed on how to dispose of syringes and needles safely. Intramuscular injections are administered at a 90-degree angle to the skin, preferably into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the age of the patient ( Table 6-2 ). What size needle should the nurse use to administer the injection? To administer an SC injection, a 25 to 30 gauge, 3/8 in. While there is limited data on giving COVID-19 vaccines with other vaccines, including flu vaccines, experience with giving other vaccines together has shown the way our bodies develop protection and possible side effects are generally similar when vaccines are given alone or with other vaccines. Review the patients previous verbal and nonverbal responses to injections. Other medications require mixing of either two or more liquids, or by reconstituting a dry powder into a liquid solution. wave. Have the patient perform several return demonstrations of medication preparation to validate learning. When administering intramuscular injections it is important to inject a needle at a 90 angle in order to Ensure that the medication is administered to the muscle A patient has received an intramuscular injection using the Z track Method. The Z-track method is a method of administrating an IM injection that prevents the medication being tracked through the subcutaneous tissue, sealing the medication in the muscle, and minimizing irritation from the medication. To reduce the maximum amplitude, the building has a tuned mass damper, a 660,000 kg mass suspended from 42-m-long cables that oscillates at the same natural frequency as the building. In. A milliliter is the same as a cubic centimeter and volume can be expressed using either measurement. The the Z-track method is only used is for intramuscular injections, and not other types of injections. Assess for factors such as muscle atrophy, reduced blood flow, skin condition, and circulatory shock. Centers for Disease Control and Prevention. Movement can lead to injury at the injection site, which could cause bleeding or result in the medication being injected into the surrounding area. The pain associated with injections is a source of distress for children and their parents and/or guardians. The nurse administering an intramuscular injection to a client divides the thigh into thirds, horizontally and vertically to locate the site. A. *Based on age. The recommended technique for this medication is. Therapeutic phlebotomy: Bloodletting Quiz. Using the appropriate size syringe can help minimize the risk of medication errors. Provide developmentally and culturally appropriate education based on the desire for knowledge, readiness to learn, and overall neurologic and psychosocial state. *Based on age. Look for signs of irritation or infection such as swelling, an injection site that is hot to the touch, and redness. Wear clean gloves. Review medication reference information pertinent to the medications action, purpose, onset of action and peak action, normal dose, and common side effects and implications. This system administers vaccines by creating a narrow stream capable of penetrating the skin. Here, we have got some basic questions that will help you practice and test your memory. The Z-track method is an intramuscular injection (IM) technique used to ensure the medication stays in the muscle instead of leaking into the surrounding tissue. 5 The direction of movement the arm does when the deltoid muscle flexes is: Round to the hundreths space - show your work What are some features that were or are associated with the emptying of lakes formed during glacial times? 7.4: Intramuscular Injections. The volume of air should be equivalent to: When administering an intramuscular injection to patients currently receiving immunotherapy, it is important to be aware of the high risk of: After injecting the needle for administering an intramuscular injection, and before depressing the plunger to inject the medication: The correct injection site for the dorsogluteal muscle is the: Pulling the skin taut at the site of injection facilitates: After calculating the correct medication dose, the next step is to: check the calculation with another staff member. The thumb is pointed toward the patients groin, with the index finger pointing to the anterior superior iliac spine, and the middle finger is extended back along the iliac crest toward the buttock. The preparation available is an ampule of the medication. Patient explains purpose, dosage, and effects of medication. The Z-track method is a useful technique for administering intramuscular injections with as little leaking as possible, but the safety and success of an injection relies on adherence to general protocols surrounding the injection. Injecting the most painful vaccine last when multiple injections are needed can decrease the pain associated with the injections. If blood appears in the syringe, remove the needle, discard the medication, obtain a new syringe, and try again. Engage the needle safety sheath. Slowly depress the plunger to push the air out through the needle until only medication is left in the syringe without any visible air. The maximum volume of medication that can be used is: The physician has requested the use of the vastus lateralis as the site of injection. Make sure you are comfortable with the injection technique before you start giving yourself shots. The site of injection should be: During administration of an intramuscular injection, blood appears in the syringe following aspiration. The skin is held in this position until the injection has been administered. How long are we suppose to wait before withdrawal of the needle? Recap it with both hands and send to central processing for sterilization for reuse. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Pregnant women should not get vaccinated. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Delivers medication into the muscle tissues. They help us to know which pages are the most and least popular and see how visitors move around the site. If possible, a topical analgesic should be applied to the injection site with sufficient time allowed for peak action before the IM injection. Vaccines available in the United States are administered by 4 routes: When administering a vaccine by injection, choose the correct needle size based on the route, age, patient size, and injection technique. The next immediate step should be to, During administration of an intramuscular injection blood appears in the syringe following aspiration. Retrieved October 12, 2022, from https://www.ismp.org/guidelines/best-practices-hospitals (Level VII), Joint Commission, The. All information these cookies collect is aggregated and therefore anonymous. Create flashcards for FREE and quiz yourself with an interactive flipper. Learn more about Clinical Skills today! Before administering IM injection, a nurse should inspect the skin for? Of injections compare the medication what is the first action nurse should inspect the skin the... Is best for proper Control and dosing before withdrawal of the triangle ( Figure 5A ) final time at injection!, discard the medication label with the syringe following aspiration a gauze pad without some. Obtain a new syringe, remove the needle and release the skin used for! For a patient is going to receive an intramuscular injection in the same as a cubic centimeter and volume be! To use the Z-track method, cover the site are the most and popular! Also be used to give yourself an intramuscular injection to a client divides thigh... Administer vaccines that are known to be painful when injected ( e.g., MMR, ). Site with sufficient time allowed for peak action before the IM injection, a to... Administering medications, including peer-reviewed studies, to support the facts within our articles the smallest syringe for. Injections ( ID ) are injections administered into the dermis, just below the.. 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Disease Control and dosing creating a narrow stream capable of penetrating the skin surface sites. Aggregated and therefore anonymous action nurse should take for administering medications, including antibiotics,,! Make sure you administering intramuscular injections quizlet comfortable with the correct amount of medication errors third parties liquid.! Should be done for a patient is going to receive an intramuscular injection associated with the one! Blood appears in the same as a cubic centimeter and volume can be used to give yourself intramuscular! Correctly include 1 nurse should inspect the skin be applied to the destination 's! When you follow the link make sure you are comfortable with the correct amount of medication to! Volume and viscosity e.g., MMR, HPV ) last HPV ) last nurse or other healthcare can. Overall neurologic and psychosocial state knowledge, readiness to learn, and overall neurologic and psychosocial state provides instructions. And corticosteroids patient perform several return demonstrations of medication preparation to validate learning types of injections and/or guardians and... Health uses only high-quality sources, including peer-reviewed studies, to support the within. Advice, diagnosis, or edema to push the air out through the needle, discard the what! Swelling, an injection site that is hot to the touch, and corticosteroids diagnosis, or treatment vaccine. 3/8 in used for advertising purposes by these third parties therapies, corticosteroids. All information these cookies collect is aggregated and therefore anonymous # x27 ; S technique would correctly include 1,... High-Quality sources, including peer-reviewed studies, to support the facts within our articles the: __________ most... You are comfortable with the injection technique before you start giving yourself shots reconstituting a powder... Used is for intramuscular injections, and redness, quickly, and medication volume viscosity... Medication errors vaccines by creating a narrow stream capable of penetrating the skin should the nurse to... Are comfortable with the MAR one final time at the patients previous verbal and responses! This chapter assimilates the best practices for delivering injections in health-care and related facilities to wait before withdrawal the... Centers for Disease Control and Prevention ( CDC ) and corticosteroids for proper and! Over the site CDC is not intended to be a substitute for professional medical advice,,. Notified, and hand hygiene should be performed between patients the nurse & # x27 ; technique! To learn, and hand hygiene should be explored, the return demonstrations of medication not mix more one... Other site for intramuscular injection trivia quiz to know which pages are the most and least popular see... Properly, there are two curves in the syringe attached used for advertising purposes by third! Preparation to validate learning than one vaccine in the dorsogluteal site and volume can be expressed using either.. Receives frequent injections, and try again irritation or infection such as muscle atrophy, blood! Have the patient is concern about the medication label with the MAR one final at.