IM injections

Question 1

pre-administration assessment

Answer 1

• medication history
• allergies
• current medication data
• diet history
• perceptual/coordination probs
• current condition
• physical assessment (lab values)

Question 2

whats an ampule?

Answer 2

(little glass bottle with lid)

• use alcohol swab to snap top off
• use filtered needle, then screw new needle on

Question 3

antidote for coumadin?

Answer 3

vit k! (green leafy foods)

Question 4

post administration assessment

Answer 4

is the medication working?

• pain level
• blood value
• vital signs
• side effects / adverse effects

Question 5

administration

Answer 5

• dont aspirate, use right technique and site*
• dont massage*
• draw up injections at med cart but may need original vial for scanning
• open prefilled syringes at bedside
• never leave meds at bedside
• dispose of unused or open meds as agency policy
• ASAP safety all needles & put in sharps container

Question 6

parenteral medications are what?

-and examples

Answer 6

anything given by injection/infusion
-outside of GI
ex/ intradermal: sub Q, IM, IV

Question 7

parenteral medications involve what

Answer 7

• invasive
• aseptic
• sterile procedure
• precise calculation of dosage
• proper site identification
• careful technique

Question 8

mixing meds

Answer 8

• carpuget -> DO NOT NEED TO INJECT AIR
• dont contaminate one med with the other
• maintain aseptic technique

Question 9

ways to minimize discomfort

Answer 9

• smallest needle suitable
• position client comfortably
• select proper site
• stabilize the skin
• hold syringe steady
• insert needle quickly & smoothly
• inject medication slowly

Question 10

angle of insertion for IM

Answer 10

90 angle

Question 11

average gauge & length of IM needle

Answer 11

• 23 gauge

- 1 1/4 long

Question 12

airlock, aspirate, and massage for IM?

Answer 12

• no
• no
• no

Question 13

syringe for IM needles

Answer 13

1-3 ml (depends on how fat the person is)

Question 14

gauge of IM needles

Answer 14

19-25 (usually 23)

Question 15

length of IM needles

Answer 15

usually (1- 1 1/2)

Question 16

intramuscular tissue is

Answer 16

• vascular
• faster medication absorption than subQ
• less sensitive to irritating meds
• multiple nerve pathways

Question 17

if IM administered improperly, damage may occur:

Answer 17

• nerves
• bones
• tissues
• blood vessels

Question 18

IM sites (4)

Answer 18

1) deltoid (arm)
2) ventrogluteal (side of thigh)
3) dorsogluteal (booty, not used very often anymore)
4) vastus lateralis (hand at top of knee, hand at top of thigh)

Question 19

Deltoid

Answer 19

• no more than 1mL
• smallest IM injection site
• where clavicle hits acromium process -> 3 fingers then V

Question 20

Ventrogluteal (side of thigh)

Answer 20

2. 5-3mL

- find top of hip bone (illiac crest)

Question 21

Dorsogluteal (booty)

Answer 21

contraindicated to use b/c easy to hit socratic nerve

Question 22

Vastus Lateralis (hand at top of knee, hand at top of thigh)

Answer 22

-2mL

Question 23

IM injection guidelines

Answer 23

• rotate sites
• avoid tender / bruised skin
• z track with highly irritating solutions**

Question 24

if med says: deep IM injection or very irritating to the tissues what do you do?

Answer 24

• hold pressure to the skin
• move to the right or left
• give shot
• wait 10 sec
• let skin go
• pull out needle

Question 25

IM injection guidelines cont.

Answer 25

-NEVER use larger than a 19 gauge needle for IM (usually 21-23)

Question 26

how do you determine gauge and length of needle?

Answer 26

• weight & muscle mass
• age
• injection site
• medication viscosity
• residual effects of the meds