IM Injections

Question 1

Step 1

Answer 1

Gather equipment. Check each medication order against the original order in the health record according to facility policy. Check the patient’s health record for allergies.

Question 2

Step 2

Answer 2

Know the actions, special nursing considerations, safe dose ranges, purpose of adminstration, and adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient.

Question 3

Step 3

Answer 3

Perfom hand hygiene

Question 4

Step 4

Answer 4

Prepare medications for ONE patient at a time.

Question 5

Step 5

Answer 5

Read the MAR and select the proper medication for medication supply system of the patient’s medication drawer.

Question 6

Step 6

Answer 6

Compare the label with the MAR. Check expiration dates and perform calculations, if necessary. Scan the bar code on the package, if required.

Question 7

Step 7

Answer 7

If necessary, withdraw medication from an ampule or vial without contamination of needle

a. Cleanse vial using alcohol swab for 15 seconds.
b. inject air equivalent to amount of medication
c. withdraw amount of medication as appropriate

Question 8

Step 8

Answer 8

Transport medications to the patient’s beside carefully, and keep the medications in sight at all times.

Question 9

Step 9

Answer 9

Ensure that the patient receives the medications at the corrent time

Question 10

Step 10

Answer 10

Perform hand hygiene and put on PPE, if indicated

Question 11

Step 11

Answer 11

Identify the patient. Compare the information with the MAR. The patient should be identified using at least two methods

Question 12

Step 12

Answer 12

Close the door to the room and pull the bedside curtain

Question 13

Step 13

Answer 13

Complete necessary assessments before adminstering medications. Check the patient’s allergy bracelet or ask the pt about allergies. Explain the purpose and the action of the medication to the patient.

Question 14

Step 14

Answer 14

Scan the patient’s bar code on the identification band, if required.

Question 15

Step 15

Answer 15

Put on clean gloves

Question 16

Step 16

Answer 16

Select an appropriate adminstration site

Question 17

Step 17

Answer 17

Assist the patient to the appropriate position for the site chosen. Drape, as needed, to expose only the site area being used.

Question 18

Step 18

Answer 18

Identify the appropriate landmarks for the site chosen.

Question 19

Step 19

Answer 19

Cleanse the area around the injection site with an alcohol swab. Use a firm, circular motion while moving outward from the injection site. Allow the area to dry.

Question 20

Step 20

Answer 20

Remove the needle cap by pulling it straight off. Hold the syringe in your dominant hand between the thumb and forefinger.

Question 21

Step 21

Answer 21

Hold the skin TAUT for needle insertion. Quickly dart the needle into the tissue so that the needle is perpendicular to the patient’s body, at an angle of 90 degrees.

Question 22

Step 22

Answer 22

Withdraw the needle smoothly and steadily at the same angle at which it was inserted, supporting tissue around the injection site with your nondominant hand. Remove the hand holding the displaced skin and tissue ONLY after removal of the needle.

Question 23

Step 23

Answer 23

Do NOT recap the used needle. Engage the safety sheild or needle guard if present.

Question 24

Step 24

Answer 24

Apply gentle pressure at the site with a dry gauze. Do NOT massage the site.

Question 25

Step 25

Answer 25

Discard the needle and syringe in the appropriate receptacle.

Question 26

Step 26

Answer 26

Assist the patient to a position of comfort

Question 27

Step 27

Answer 27

Remove gloves and additional PPE, if used. Perform hand hygiene

Question 28

Step 28

Answer 28

Document the administration of the medication immediately after administration

Question 29

Step 29

Answer 29

Evaluate the patient’s response to the medication within the appropriate time frame.

Question 30

Intramuscular injections

Answer 30

deliver method through the skin and subcutaneous tissues into certain muscles.

Question 31

Needle length/gauge.

Answer 31

Obese individuals require longer needle, emancipated patients require shorter needle.

20- to 25- gauge needle.
Oil-based solution - 18- to 25- gauge.

Question 32

Needle length per site

Answer 32

Vastus lateralis (thigh) - 5-8 inch to 1 1/4 inch.
Deltoid (children) - 5/8 inch to 1 1/4 inch.
Deltoid (adults) - 1 inch to 1 1/2 inch
Ventrogluteal (adults) - 1 1/2 inch.

Question 33

Patient positioning per injection site.

Answer 33

Deltoid - Adult may sit or stand. Child may be held in adult’s lap.
Ventrogluteal - patient may stand, sit, lie laterally, and lie supine
Vastus lateralis - patient may sit or lie supine. Infants and young children may lie supine or be held in adult’s lap.