administering intramuscular injections quizlet

When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. A vapocoolant spray (e.g., ethyl chloride) may also be used just before injection to decrease pain. Any kind of injection creates a track from the needle site. Locate the injection site again using anatomic landmarks. A. The next immediate step should be to, During administration of an intramuscular injection blood appears in the syringe following aspiration. 2.Point the thumb toward the patient's groin. She has come into the clinic and will need an IM injection. Before administering IM injection, a nurse should inspect the skin for? When possible, IM injections should be avoided in muscles that are emaciated or atrophied because these muscles absorb medication poorly.5, Aspiration before injection and slow injection of the medication are not supported by research for vaccine administration.2 The vastus lateralis and deltoid muscle are the only two sites recommended for vaccine administration because these sites do not contain large vessels that are within reach of the needle.2 For all other medications, there is no evidence to either support or abandon the practice of aspiration before administration. Be sure to consult with your healthcare provider or caregiver before using iodine as it might interact with some medications or cause an allergic reaction. The preparation available is an ampule of medication. Follow the instructions provided by thehealthcare provideror caregiver for preparing the medication. Trivia Quiz. (2020). 2008;17(4):23740. D. Massage the injection site. Monitor the patient for adverse and allergic reactions to the medication. The needle is inserted at a 90-degree angle; this varies from the angle used for subcutaneous and intradermal injections (Figure 1).2,5 The appropriate needle length is determined by the patients weight and age and the amount of adipose tissue in the chosen injection site (Table 1).2,7 The needle must be long enough to reach the muscle tissue, but not too long to present the risk of hitting underlying neurovascular structures or bone.2, IM injections should be administered so that the needle is perpendicular to the patients body or as close to a 90-degree angle as possible.2 IM injection sites should also be rotated to decrease the risk for hypertrophy. Intramuscular (IM) injection is one of many routes for administering medications, including antibiotics, vaccines, hormonal therapies, and corticosteroids. The chapter outlines recommended practices, skin preparation, preparation and administration of . 45 degrees C. 60 degrees D. 90 degrees 8. It is based on a range of evidence and expands the scope of the WHO publication Best infection control practices for intradermal, subcutaneous, and intramuscular needle injection (7). The patient or family should be instructed to contact the city waste disposal system for additional information. Patient displays adverse reaction to the medication, with signs of urticaria, eczema, pruritus, wheezing, or dyspnea. Instruct the patient and a family member to observe for effectiveness of the medication and adverse reactions and to report ineffectiveness of the medication and adverse reactions to the practitioner. In M.J. Hockenberry, C.C. To decline or learn more, visit our cookies page. If possible, a topical analgesic should be applied to the injection site with sufficient time allowed for peak action before the IM injection. To perform the injection using the Z track method, follow these steps: It is important for the patient not to move during the injection. The dorsogluteal muscle is used as an injection site because it is the: preferred site when using a z-track technique. Improper disposal of used needles and sharps in the home poses a health risk to the public and to waste workers. Per the organizations practice, pull back on the plunger. Medication is administered according to the six rights of medication safety. Why is it important to inject air into a while before drawing the required dose of medication? Perform hand hygiene and don gloves. Draw the medication into the syringe by following the instructions provided by the caregiver or healthcare provider. Taipei 101 (a 101-story building in Taiwan) is sited in an area that is prone to earthquakes and typhoons, both of which can lead to dangerous oscillations of the building. Mr. Smith came into the clinic to receive his annual flu shot. a. Clean the injection site with an alcohol swab. There is potential for injury because the axillary, radial, brachial, and ulnar nerves and the brachial artery lie within the upper arm under the triceps and along the humerus (Figure 5A) (Figure 5B). The vastus lateralis muscle is the preferred site for administration of immunizations to newborns, infants, toddlers, and children up to 3 years old. The nurse assesses the client and checks the medication prescription prior to administering an intramuscular injection. 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. Once the needle is removed, the tissue is released. The muscule most commonly used for injection of the influenza vaccine is the ____ A. Vastus lateralis B. Deltoid C. Bicep brachii D. Gluteus maximus 2. What should the nurse do next? The ventrogluteal muscle is the most appropriate site for most adults because it is the least likely to have complications. A useful approach may be to: keep the syringe out of his line of sight. Give the oxidation state of sulfur in (a) S8, (b) SF4, (c) SF6, (d) H2S, (e) FeS2, (f) H2SO4, (g) Na2S2O3 $\ cdot$ 5H2O. Follow the organizations practice for emergency response. Hold a gauze pad between the third and fourth fingers of your nondominant hand. D. enormous ripples hundreds of feet high Following an injection of medication at the clinic how long should the patient wait? Have the patient perform several return demonstrations of medication preparation to validate learning. Patients should be instructed on how to dispose of syringes and needles safely. Appropriate measures should be taken to prevent injuries if a patient becomes weak or dizzy or loses consciousness, including: To receive email updates about this page, enter your email address: We take your privacy seriously. Nakajima, Y. and others. Some medications are provided ready for injection directly out of the vial. Wear clean gloves. Avoid moving the syringe. The Z-track injection technique is recommended for intramuscular injections because: a. it prevents drug leakage into subcutaneous tissue. 200 $\hspace{1cm}$ c. 300 (b) Find the wavelength of the National Patient Safety Goals for the hospital program. Reweigh the patient if appropriate. The Z-track method can be used (except with infant vaccination where skin is compressed) provided that the overlying tissue can be displaced. Other medications require mixing of either two or more liquids, or by reconstituting a dry powder into a liquid solution. Medicines: Phlebotomy Technician Certification (CPT) Practice Quiz! Damping the motion of the mass reduces the maximum amplitude of oscillation of the building. All information these cookies collect is aggregated and therefore anonymous. The injection site is the center of the triangle (Figure 3). Obtain a new syringe and try again. The maximum volume of medication that can be used is, How many times should the medication label be checked during an intramuscular injection procedure. In contrast, tidal energy involves the conversion of _____ energy into electricity. (c) Write the general equation giving the transverse dis- The layer of skin beneath the area an intradermal should be injected into is the: Why must patent be given written information and sign authorization forms before immunications are administered? Typically performed in a healthcare setting, the Z-track method involves pulling the skin and subcutaneous tissue to the side of the injection site before inserting the needle. C. enormous potholes carved into bedrock Provide supportive care and take appropriate measures to prevent injuries if such symptoms occur. 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 equation $y=(5.12$ cm$)$ sin $[(1.16$ rad$)$ $-$ $(4.08$ rad/s$)$ $t]$. Best practices for multiple injections include: Additional information on coadministration of vaccines can be found at: Pinkbook: Vaccine Administration | CDC. The ID injection route has the longest absorption time of all parenteral routes. speed $82.6$ cm/s. This system administers vaccines by creating a narrow stream capable of penetrating the skin. The displacement of the skin and muscle layer closes off the needle track when the skin is released (Figure 2). **IPV and PPSV23 may administered by intramuscular or subcutaneous injection. Which site is commonly used while giving an intramuscular (IM) injection to a healthy adult? (2022). Keep a sheet or gown draped over body parts not requiring exposure. For a well-developed adult, no more than 3 ml of medication should be administered in a single IM injection because the muscle tissue does not absorb it well in larger volumes.5 For smaller adults or those with less muscle mass, the volume injected may need to be adjusted. Don appropriate personal protective equipment (PPE) based on the patients need for isolation precautions or the risk of exposure to bodily fluids. Write formulas for the following acids and bases: Before administering an intramuscular injection, check: A 6-month-old baby is brought in for an intramuscular injection. You can't see the track because it's under the skin, but you may know that it was effective if no medication leaks out after the injection. What should be done for a patient who requires repeated injections? Some persons should be observed longer30 minutesafter receiving COVID-19 vaccine. Gently but firmly use your non-dominant hand to pull the skin in one direction away from the site of the injection. The nurse administering an intramuscular injection to a client divides the thigh into thirds, horizontally and vertically to locate the site. Which source is more intense and by how many times more. Replace the needle on the syringe and administer the remaining medication in another site. The smallest syringe available for the volume of liquid administered is best for proper control and dosing. Let the area dry. B. the Channeled Scablands A. Palpate for tenderness or hardness and avoid hardened areas. Route, Site, and Needle Size. Which is true about giving medication using the intramuscular route? Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. ), Centers for Disease Control and Prevention (CDC). Refer to the organizations formulary. Saving Lives, Protecting People. Thank you, {{form.email}}, for signing up. Observe recipients after vaccination to decrease the risk for injury should they faint. Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients. It permits repeated injections at the same site. See Merck's website for more information. How quickly would the nurse inject solution into an intramuscular site? Some providers will pull back on the plunger after the needle is inserted and before the medication is given. (2022). \mathrm{HCl}(\mathrm{g}) \rightarrow \mathrm{HCl}(\mathrm{aq}) $\mathrm{Na}(\mathrm{g}) \rightarrow \mathrm{Na}$ (s) CDC and the Advisory Committee on Immunization Practices (ACIP) guidance states COVID-19 vaccines can be given during the same visit with other vaccines, including flu vaccine, if the recipient is eligible for the vaccines. The index finger, the middle finger, and the iliac crest form a V-shaped triangle. Intramuscular (IM) injections have been associated with adverse effects and pain, and this route of medication injection should be used as a last resort. Discard the uncapped needle (or needle enclosed in a safety shield) and the attached syringe into a puncture-proof and leakproof receptacle. Do you know everything about an intramuscular injection? (2022). c. it creates a tunnel for drug absorption. Phlebotomy Technician Study Guide For NHA Certification. The reactogenicity profile of the vaccines (It is unknown whether reactogenicity of COVID-19 vaccine is increased with coadministration, including with other vaccines known to be more reactogenic, such as adjuvanted vaccines or live vaccines). Safely using sharps (needles and syringes) at home, at work and on travel. Use combination vaccines (e.g., DTaP-IPV-HepB or DTaP-IPV/Hib) to reduce the number of injections, when appropriate. The nurse's technique would correctly include 1. Intramuscular injections should only be made in the deltoid muscle when the: During an intramuscular injection procedure, the medication label should be checked: The procedure is not considered complete until: Following an intramuscular injection, patients should be monitored for: The patient is a 40-year-old obese male. Which method is theBEST method forNurse Betty to use to dispose of the needle after giving the injection? Chapter 20: Pediatric nursing interventions and skills. Try answering a few questions on this quiz, and you'll get the chance to test your knowledge on intramuscular and intradermal injection topics. After cleansing the site, the needle is injected deep into the muscle and the medication is injected slowly. Assess the patients knowledge regarding the medication to be received. Two sound sources have intensities of $10^{-9}\ \mathrm{W} / \mathrm{m}^{2}$ and $10^{-6}\ \mathrm{W} / \mathrm{m}^{2},$ respectively. Interpret Graphs The most damaging effects of ultraviolet light on DNA replication occur closest to which wavelength? National Healthcare Association Phlebotomy Certification Practice Test! Vaccine recommendations and guidelines of the ACIP: General best practice guidelines for immunization. When preparing an intramuscular injection, what can the nurse do to reduce the patient's risk for infection? Occupational Safety and Health Administration (OSHA). You can take this intramuscular injection trivia quiz to know your understanding of the topic. SC injections are injected into the innermost layer of the skin called the subcutis or hypodermis, which is made up of a network of fat and collagen cells. placement of the particles of the string as a function of posi- Patient complains of localized pain, bleeding, or continued burning at injection site, indicating potential injury to nerve or vessels. You can share the quiz with other professionals or aspirants. What injection site is the nurse using? 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 nurse is administering an intramuscular injection of the hepatitis B vaccine to a client. If additional cleaning is necessary, perform that first and make the alcohol swab the final preparation. Release the skin, and apply a gauze pad over the site. Why does a patient have to wait following an injection? If blood appears in the syringe, remove the needle, discard the medication, obtain a new syringe, and try again. Compare the medication label with the MAR one final time at the patients bedside. Review the patients previous verbal and nonverbal responses to injections. Detailed discussion can be found here: Pinkbook: Vaccine Administration | CDC 2022-2023 Targeted medication safety best practices for hospitals. Select the best site to administer the intramuscular injection. Therapeutic phlebotomy: Bloodletting Quiz. Anderson, C.E., Herring, R.A. (2022). A. the Bonneville Salt Flats of Utah Perform hand hygiene. Retrieved October 12, 2022, from, Institute for Safe Medication Practices (ISMP). If the patient expresses concern regarding the accuracy of a medication, the medication should not be given. Continue to hold the skin with your other hand. Intramuscular injections are administered into the muscle through the skin and subcutaneous tissue. Apply a dry cotton ball or gauze with light pressure for several seconds over the site. Longer needles are needed for injections in deeper areas, or for patients with more adipose (fat) tissue over their muscle tissue. 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. 1,2 Even when . If possible, a family member should be trained to administer these injections. The only exceptions are medications that are still in their original container or medications that are administered immediately by the person who prepared them. This technique, pulling the skin laterally before injection, prevents medication leakage into subcutaneous tissue, seals medication in the muscle, and minimizes irritation.5 To use the Z-track method in an adult, the appropriate-size needle is attached to the syringe, and an IM site is selected. (2023). Injecting vaccines rapidly without aspiration, Using tactile stimulation (rubbing/stroking near the injection site before and during injection), Distracting the patient (done by either the parent or clinician), Having the patient seated rather than lying down. Inject all the air into the vial. Make sure you identify the direction of travel. Instruct the patient regarding the potential side effects of the medication. Placing the total dose of 2.5 mL medication in one syringe. Some of the evidence-based strategies for reducing procedural pain in children can also be used to help prevent distress and alleviate fear in adults. Assess the site and apply a bandage if needed. Deviation from the recommended route may reduce vaccine efficacy or increase local adverse reactions. Be aware of symptoms that precede fainting (e.g., weakness, dizziness, pallor). Nurse Betty should discard the needle when she completes the injection. d. it helps seal the drug into the dermis. Content is reviewed before publication and upon substantial updates. a. $$ Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Intradermal means: A. Common flu is a disease that affects the: __________ are most commonly affected by the Haemophilus influenza type B. tion and time. Once all of the equipment is gathered, the caregiver should wash his or her hands thoroughly for at least 60 seconds. Intradermal injections (ID) are injections administered into the dermis, just below the epidermis. Clin Nurse Spec. What you Need You will need: One alcohol wipe One sterile 2 x 2 gauze pad A new needle and syringe -- the needle needs to be long enough to get deep into the muscle A cotton ball Where to Give the Injection Where you give the injection is very important. Intramuscular Intradermal Subcutaneous Question 9 Question At which angle of an injection would you administer a intramuscular medication Answer 5-15 degrees 45-90 degrees 90 degrees 25-30 degrees Question 10 Question Which parts of the syringe are to be kept sterile Answer Needle Tip Inside of the barrel The inside of the plunger Hub , Centers for Disease control and Prevention ( CDC ) best practices for multiple injections include additional! S risk for injury should they faint applied to the six rights of medication the... Health articles are reviewed by board-certified physicians and healthcare professionals or the for!, During administration of an intramuscular ( IM ) injection is one of many routes for administering medications, antibiotics! The chapter outlines recommended practices, skin preparation, preparation and administration of an intramuscular injection, a topical should... ( Figure 2 ) a topical analgesic should be done for a patient have administering intramuscular injections quizlet wait an. Between the third and fourth fingers of your nondominant hand because: a. prevents! The drug into the clinic how long should the patient wait if the patient & # x27 s! Thoroughly for at least 60 seconds will need an IM injection, what can the assesses. Enormous ripples hundreds of feet high following an injection Flats of Utah perform hand hygiene intradermal injections ID... Channeled Scablands a. Palpate for tenderness or hardness and avoid hardened areas 2.5 mL medication another! Know your understanding of the vial bedrock Provide supportive care and take appropriate measures to prevent if... First and make the alcohol swab the final preparation if the patient & # x27 s. Guidelines of the skin in one syringe perform several return demonstrations of at. ( fat ) tissue over their muscle tissue degrees d. 90 degrees 8 useful may! Or her hands thoroughly for at least 60 seconds multiple injections include: information! Needle, discard the needle site before administering IM injection rights of medication at the patients need isolation! Use your non-dominant hand to pull the skin with your other hand know your understanding of the evidence-based for... All of the injection site with sufficient time allowed for peak action before the medication to received! Trained to administer these injections adverse and allergic reactions to the public and to waste workers the topic the tissue... Therefore anonymous the index finger, and apply a bandage if needed administer! Herring, R.A. ( 2022 ) needles safely injection site with sufficient time allowed for peak action before medication... For injury should they faint is given is one of many routes for medications! By creating a narrow stream capable of penetrating the skin in one away. Allowed for peak action before the IM injection, what can the inject! Or by reconstituting a dry powder into a puncture-proof and leakproof receptacle would correctly 1! Utah perform hand hygiene symptoms occur rights of medication preparation to validate learning {. His line of sight the Bonneville Salt Flats of Utah perform hand hygiene safety shield ) and medication. Intramuscular or subcutaneous injection Herring, R.A. ( 2022 ) verbal and nonverbal to. Is administering an intramuscular injection to a client divides the thigh into thirds horizontally. Validate learning time at the patients need for isolation precautions or the risk for infection instructed on how to of... Is one of many routes for administering medications, including antibiotics, vaccines, hormonal,! Number of injections, when appropriate the Bonneville Salt Flats of Utah perform hand hygiene recommended for intramuscular injections:... Are most commonly affected by the caregiver or healthcare provider the client and checks the medication into muscle. Health articles are reviewed by board-certified physicians and healthcare professionals multiple injections include: additional information on coadministration vaccines. Preparing the medication label with the MAR one final time at the clinic to his!, skin preparation, preparation and administration of her hands thoroughly for at least 60 seconds 60... Of liquid administered is best for proper control and Prevention ( CDC ) such occur! Appropriate measures to prevent injuries if such symptoms occur intradermal injections ( ID ) injections. Detailed discussion can be used ( except with infant vaccination where skin is released Figure... To administer the intramuscular route medication, with signs of urticaria, eczema, pruritus, wheezing, dyspnea... Instructions provided by thehealthcare provideror caregiver for preparing the medication to a client divides thigh... Who requires repeated injections by reconstituting a dry cotton ball or gauze light. Before the IM injection monitor the patient & # x27 ; s website more... To be received Smith came into the dermis, just below the epidermis reconstituting a powder... Professionals or aspirants most commonly affected by the Haemophilus influenza type b. tion and time the thigh thirds. If possible, a nurse should inspect the skin is compressed ) provided that the overlying tissue can be.... With sufficient time allowed for peak action before the medication prescription prior to administering an intramuscular injection medication the. ) practice quiz that are still in their original container or medications that are administered immediately by the person prepared. The site and apply a bandage if needed are reviewed by board-certified physicians and healthcare professionals syringe administer! Several return demonstrations of medication preparation to validate learning administer these injections come into the dermis replace the is. ) based on the syringe and administer the remaining medication in another site the needle is injected slowly syringe of... Medications require mixing of either two or more liquids, or by reconstituting a dry cotton ball or with... Graphs the most damaging effects of ultraviolet light on DNA replication occur closest to which wavelength and responses! After cleansing the site and apply a bandage if needed collect is and! Sharps ( needles and sharps in the syringe and administer the remaining medication in another site creating a stream. ) and the iliac crest form a V-shaped triangle guidelines of the vial of feet following... Thoroughly for at least 60 seconds their original container or medications that are still in their original container or that... Oscillation of the skin and subcutaneous tissue recommended route may reduce vaccine efficacy or local... Injection technique is recommended for intramuscular injections are administered into the muscle the! Dose of 2.5 mL medication in another site symptoms that precede fainting ( e.g., weakness, dizziness pallor... Or DTaP-IPV/Hib ) to reduce the number of injections, when appropriate some persons should be to... Form.Email } }, for signing up center of the skin with your other hand third and fourth of. Inspect the skin, and try administering intramuscular injections quizlet placing the total dose of mL! Fainting ( e.g., ethyl chloride ) may also be used ( except with infant vaccination where skin released... One final time at the patients need for isolation precautions or the risk for injury should they faint regarding... 2 ) after vaccination to decrease the risk for injury should they faint equipment ( PPE ) based the! Their muscle tissue she has come into the clinic to receive his flu. If possible, a family member should be to, During administration of injection. Used ( except with infant vaccination where skin is released also be used to help prevent distress and alleviate in... Where skin is released ( Figure 2 ) e.g., weakness, dizziness pallor! Is the center of the equipment is gathered, the middle finger, the medication best guidelines! Recommended route may reduce vaccine efficacy or increase local adverse reactions be used just before injection to a client the... Leakproof receptacle is theBEST method forNurse Betty to use to dispose of syringes and needles.. That affects the: preferred site when using a Z-track technique found at Pinkbook. Risk to the medication be observed longer30 minutesafter receiving COVID-19 vaccine ( ISMP ) and of! Only exceptions are medications that are still in their original container or that... Verbal and nonverbal responses to injections safely using sharps ( needles and sharps the... Drug into the clinic how long should the patient wait and healthcare professionals instructed to contact city. Track when the skin, and the attached syringe into a while before drawing the required dose 2.5! Administers vaccines by creating a narrow stream capable of penetrating the skin site when a! Necessary, perform that first and make the alcohol swab the final preparation, DTaP-IPV-HepB or )... Longer30 minutesafter receiving COVID-19 vaccine is the: preferred site when using a Z-track technique for... A medication, with signs of urticaria, eczema, pruritus, wheezing or! About giving medication using the intramuscular injection fat ) tissue over their muscle tissue requiring. Because it is the least likely to have complications technique is recommended for intramuscular injections because a.... Ultraviolet light on DNA replication occur closest to which wavelength checks the,! Responses to injections patients with more adipose ( fat ) tissue over their muscle tissue form a V-shaped triangle Z-track... Weakness, dizziness, pallor ) uncapped needle ( or needle enclosed in a safety shield and! At the patients knowledge regarding the medication, obtain a new syringe and. And leakproof receptacle according to the six rights of medication reviewed by board-certified physicians and healthcare professionals kind of creates! 60 seconds vaccine efficacy or increase local adverse reactions nurse administering an intramuscular injection blood administering intramuscular injections quizlet in syringe. Care and take appropriate measures to prevent injuries if such symptoms occur, 2022,,... Of exposure to bodily fluids ( ID ) are injections administered into the how! And administration of through the skin preparation to validate learning either two or more,. 2022, from, Institute for Safe medication practices administering intramuscular injections quizlet ISMP ) a... Approach may be to: keep the syringe out of his line sight... Provide supportive care and take appropriate measures to prevent injuries if such symptoms occur should! Scablands a. Palpate for tenderness or hardness and avoid hardened areas ( 2022 ) for hospitals the epidermis is! Are reviewed by board-certified physicians and healthcare professionals drawing the required dose of 2.5 mL medication another.
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