IM injections Flashcards
pre-administration assessment
- medication history
- allergies
- current medication data
- diet history
- perceptual/coordination probs
- current condition
- physical assessment (lab values)
whats an ampule?
(little glass bottle with lid)
- use alcohol swab to snap top off
- use filtered needle, then screw new needle on
antidote for coumadin?
vit k! (green leafy foods)
post administration assessment
is the medication working?
- pain level
- blood value
- vital signs
- side effects / adverse effects
administration
- 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
parenteral medications are what?
-and examples
anything given by injection/infusion
-outside of GI
ex/ intradermal: sub Q, IM, IV
parenteral medications involve what
- invasive
- aseptic
- sterile procedure
- precise calculation of dosage
- proper site identification
- careful technique
mixing meds
- carpuget -> DO NOT NEED TO INJECT AIR
- dont contaminate one med with the other
- maintain aseptic technique
ways to minimize discomfort
- smallest needle suitable
- position client comfortably
- select proper site
- stabilize the skin
- hold syringe steady
- insert needle quickly & smoothly
- inject medication slowly
angle of insertion for IM
90 angle
average gauge & length of IM needle
- 23 gauge
- 1 1/4 long
airlock, aspirate, and massage for IM?
- no
- no
- no
syringe for IM needles
1-3 ml (depends on how fat the person is)
gauge of IM needles
19-25 (usually 23)
length of IM needles
usually (1- 1 1/2)
intramuscular tissue is
- vascular
- faster medication absorption than subQ
- less sensitive to irritating meds
- multiple nerve pathways
if IM administered improperly, damage may occur:
- nerves
- bones
- tissues
- blood vessels
IM sites (4)
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)
Deltoid
- no more than 1mL
- smallest IM injection site
- where clavicle hits acromium process -> 3 fingers then V
Ventrogluteal (side of thigh)
- 5-3mL
- find top of hip bone (illiac crest)
Dorsogluteal (booty)
contraindicated to use b/c easy to hit socratic nerve
Vastus Lateralis (hand at top of knee, hand at top of thigh)
-2mL
IM injection guidelines
- rotate sites
- avoid tender / bruised skin
- z track with highly irritating solutions**
if med says: deep IM injection or very irritating to the tissues what do you do?
- hold pressure to the skin
- move to the right or left
- give shot
- wait 10 sec
- let skin go
- pull out needle
IM injection guidelines cont.
-NEVER use larger than a 19 gauge needle for IM (usually 21-23)
how do you determine gauge and length of needle?
- weight & muscle mass
- age
- injection site
- medication viscosity
- residual effects of the meds
