IM Injections Flashcards
Step 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.
Step 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.
Step 3
Perfom hand hygiene
Step 4
Prepare medications for ONE patient at a time.
Step 5
Read the MAR and select the proper medication for medication supply system of the patient’s medication drawer.
Step 6
Compare the label with the MAR. Check expiration dates and perform calculations, if necessary. Scan the bar code on the package, if required.
Step 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
Step 8
Transport medications to the patient’s beside carefully, and keep the medications in sight at all times.
Step 9
Ensure that the patient receives the medications at the corrent time
Step 10
Perform hand hygiene and put on PPE, if indicated
Step 11
Identify the patient. Compare the information with the MAR. The patient should be identified using at least two methods
Step 12
Close the door to the room and pull the bedside curtain
Step 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.
Step 14
Scan the patient’s bar code on the identification band, if required.
Step 15
Put on clean gloves
Step 16
Select an appropriate adminstration site
Step 17
Assist the patient to the appropriate position for the site chosen. Drape, as needed, to expose only the site area being used.
Step 18
Identify the appropriate landmarks for the site chosen.
Step 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.
Step 20
Remove the needle cap by pulling it straight off. Hold the syringe in your dominant hand between the thumb and forefinger.
Step 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.
Step 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.
Step 23
Do NOT recap the used needle. Engage the safety sheild or needle guard if present.
Step 24
Apply gentle pressure at the site with a dry gauze. Do NOT massage the site.
Step 25
Discard the needle and syringe in the appropriate receptacle.
Step 26
Assist the patient to a position of comfort
Step 27
Remove gloves and additional PPE, if used. Perform hand hygiene
Step 28
Document the administration of the medication immediately after administration
Step 29
Evaluate the patient’s response to the medication within the appropriate time frame.
Intramuscular injections
deliver method through the skin and subcutaneous tissues into certain muscles.
Needle length/gauge.
Obese individuals require longer needle, emancipated patients require shorter needle.
20- to 25- gauge needle.
Oil-based solution - 18- to 25- gauge.
Needle length per site
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.
Patient positioning per injection site.
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.
