injections

Question 1

subq heparin

Answer 1

1. check MD orders, allergies, lab vales and drug information
2. verifies meds using seven rights (right pt, right med, right route, right dose, right time, right documentation, right indication)
3. hand hygeine
4. selects correct med and calclates correct dose
5. removes vial cap if present and cleanses rubber seal w/ antiseptic
6. select 3 mL syringe with a 25 gauge 5/8th inch needle
7. draws proper amount of medication
8. hand hygeine
9. pt ID w/ 2 identifiers
10. introduce self to patient
11. explains procedures and provides education
12. performs 3 checks (1- MAR 2- check med label and expiration date 3- before admin)
13. applies gloves
14. selects injection site and assists pt to positioning
15. maintains pt privacy
16. cleanses site with antiseptic using circular motion
17. holds antiseptic swab in nondominant hand
18. holds syringe in dominant hands as grasping a dart
19. forms a pinch before injecting med
20. holds pinch and inserts needle quickly and firmly at 45-90 degree
21. uses one hand to inject medication over 30 seconds
22. withdraws needle quickly, releases fold
23. applies safety shield
24. apply gentle pressure to site, do not massage, hold swab for 30-60 seconds
25. properly dispose of needle and syringe and other supplies
26. performs hand hygeine
27. document meds
28. evaluate pt response

Question 2

subq insulin

Answer 2

1. check MD orders, allergies, lab vales and drug information
2. verifies meds using seven rights (right pt, right med, right route, right dose, right time, right documentation, right indication)
3. hand hygeine
4. selects correct med and calclates correct dose
5. removes vial cap if present and cleanses rubber seal w/ antiseptic
6. selects insulin syringe with 28-31 gauge needle
7. draws proper amount of medication
8. hand hygeine
9. pt ID w/ 2 identifiers
10. introduce self to patient
11. explains procedures and provides education
12. performs 3 checks (1- MAR 2- check med label and expiration date 3- before admin)
13. applies gloves
14. selects appropriate injection site and assists patient to comfortable position (abdomen or thigh)
15. maintains pt privacy exposing only injection site
16. cleanses with antiseptic in circular motion
17. holds syringe with good technique in dominant hand
18. forms a pinch of skin before injection
19. inject quickly and firmly at 45-90 degree angle and release pinched skin. after needle enters, grasp lower end of syringe barrel with nondominant hand to stabilize it. move dominant hand to end of plunger and slowly inject medication over several seconds
20. withdraw needle quickly while placing antiseptic swab applying gentle pressure
21. apply safety shield
22. properly disposes of needle and syringe and other used supplies
23. peforms hand hygeine
24. documents medications given
25. evaluates pt response
    20.

Question 3

deltoid IM

Answer 3

1. check MD orders, allergies, lab vales and drug information
2. verifies meds using seven rights (right pt, right med, right route, right dose, right time, right documentation, right indication)
3. hand hygeine
4. selects correct med and calclates correct dose
5. removes vial cap if present and cleanses rubber seal w/ antiseptic
6. selects 3mL syringe (2mL preferably) with 22-25 gauge needle
7. draws proper amount of medication
8. hand hygeine
9. pt ID w/ 2 identifiers
10. introduce self to patient
11. explains procedures and provides education
12. performs 3 checks (1- MAR 2- check med label and expiration date 3- before admin)
13. applies gloves
14. correctly landmarks deltoid using 3 fingers from acromian process
15. exposes upper arm appropriately
16. verbalizes assesment of site for contraindications to IM injections: e.g, skin lesions/infection hair, pain, brusing
17. cleanses injection site with antiseptic using circular motion
18. holds syringe in dominant hand like a dart
19. pulls skin taut (z-track) and inserts needle at 90 degree angle into muscle
20. injects correct dose of medication slowly
21. withdraws needle smoothly at same angle of insertion
22. applies gently pressue with gauze or pad
23. applies safety shield
24. properly disposes of needle and syringe and other used supplies
25. performs hand hygeine
26. documents meds given
27. evaluates pt resopnes - assess for allergic rxn, pain, burning, numbness, tingling, bruising, or induration

Question 4

ventrogluteal IM

Answer 4

1. check MD orders, allergies, lab vales and drug information
2. verifies meds using seven rights (right pt, right med, right route, right dose, right time, right documentation, right indication)
3. hand hygeine
4. selects correct med and calclates correct dose
5. removes vial cap if present and cleanses rubber seal w/ antiseptic
6. selects 3mL syringe and a 22-25 gauge needle
7. draws proper amount of medication
8. hand hygeine
9. pt ID w/ 2 identifiers
10. introduce self to patient
11. explains procedures and provides education
12. performs 3 checks (1- MAR 2- check med label and expiration date 3- before admin)
13. applies gloves
14. selects injection site and assists pt to positioning
15. maintains pt privacy
16. correctly landmarks ventrogluteal site and palpates muscle
17. cleanses injection site with antiseptic using circular motion
18. holds antiseptic swab in nondominant hand
19. holds syringe appropriately in dominant hand, grasping as a dart
20. uses z-track method with non-dominant hand
21. inserts needle at 90 degrees into muscle
22. aspirates back for blood return
23. inserts correct dose of med slowly and keeps needle inserted for 10 seconds
24. withdraws needle smoothly at same angle of insertion, releases skin and places antiseptic swab over injection site applying gently pressure - does not massage site
25. applies safety shield
26. properly disposes of needle and syringe and other used supplies
27. assists patient to comfortable position
28. hand hygeine
29. document med given
30. assess pt response