Injections

Question 1

4 types of injections

Answer 1

Intradermal
Subcutaneous
Intramuscular
Intravenous

Question 2

two indications for injections?

Answer 2

1) . parenteral access for improving, treating, or maintaining current illness/injury
2) . Vaccine administration

Question 3

contraindications for injections (6)

Answer 3

medicine allergy
lack of suitable site
coagulopathy
occlusive PVD
shock
impairment of peripheral absorption

Question 4

Intradermal injection: absorption? effect? most common site?

Answer 4

slow, little systemic absorption; local effect; ventral forearm 2-3 fingerbreaths distal to antecubital space

Question 5

subcutaneous injections common sites? onset?

Answer 5

outer arms, anterior thigh, upper buttocks; faster onset than oral

Question 6

Intramuscular injections: absorption?

Answer 6

deposit med into muscle tissue so readily absorbed (faster than subQ but slower than IV)

Question 7

four intramuscular injection sites?

Answer 7

1) . deltoid: lateral humerus, 2 or 3 fingerbreaths below acromion
2) . dorsogluteal (glut med): inject above and lateral to line between PSIS and greater trochanter
3) . ventrogluteal (glut med and min)
4) . vastus lateralis muscle: middle 1/3 of muscle is best

Question 8

preferred intramuscular site for infants, children and adults

Answer 8

vastus lateralis

Question 9

what type of technique is needed for all injection administrations?

Answer 9

ASEPTIC

Question 10

5 types of medications that can be injected?

Answer 10

1) . single dose ampules
2) . single or multi-dose vials
3) . vial containing powder + add sterile diluent/solvent
4) . prefilled cartridge
5) . filled syringe

Question 11

what three parts of an injection needle are sterile?

Answer 11

1) . inside of barrel
2) . shaft/tip of plunger
3) . entire length of needle

Question 12

small vs large needle gauge

Answer 12

larger needle number means smaller diameter

Question 13

SubQ needle gauge and size

Answer 13

25 gauge, 5/8 needle

Question 14

IM needle gauge and size

Answer 14

18-22, 1 1/2 in needle

Question 15

Intradermal needle gauge and size

Answer 15

26-17, 1/2 to 5/8 inches

Question 16

needle gauge choice depends on what?

Answer 16

viscosity of fluid

Question 17

how to inject intradermal?

Answer 17

hold forearm and stretch skin taut above injection site

Question 18

if no wheal presents after intradermal injection, what do you do?

Answer 18

redo at least 2 inches from first site

Question 19

intradermal anaphylaxis protocol

Answer 19

immediate epi injection and resuscitation procedures

Question 20

how to inject subQ?

Answer 20

pinch skin around site with nondominant hand, inject at 45 degree angle, and release skin as soon as needle is in

Question 21

what is important to remember when giving subQ or IM injections RIGHT BEFORE injecting med?

Answer 21

after needle is inserted, pull back on plunger to make sure there isn’t blood aspiration

Question 22

what do you not want to do when drawing up insulin?

Answer 22

DONT shake the bottle prior to drawing up (can change potency of drug)

Question 23

preferred site of heparin injection?

Answer 23

lower abdominal fat pad, 2 inches below umbilicus (between iliac crests)

Question 24

what two things do you NOT do when injecting heparin?

Answer 24

1) . DONT aspirate to check for blood return (may cause bleeding into tissues)
2) . DONT massage injection site (can cause localized bruises/hemorrhages)

Question 25

how to do IM injection?

Answer 25

press skin down and stretch site with thumb and index finger (pinch skin if emaciated pt), insert needle at 90 degrees, slowly inject med

Question 26

what is the purpose of an air bubble in the syringe during an IM injection?

Answer 26

it follows the medication into the muscle, which creates an air block to prevent med tracking to subQ

Question 27

whats the purpose of the Z track IM injection? what type of med is administered?

Answer 27

prevents leakage of med into subQ after injection; usually iron preparations

Question 28

Z track is only given where on the body?

Answer 28

upper outer quadrant of butt

Question 29

never inject more than ___ml of med in a single site when using Z track method

Answer 29

5ml

Question 30

Peds:
subQ injected where?
IM injected where?

Answer 30

subQ: thigh of infants and deltoid of older kids
IM: anterolateral upper thigh and deltoid

Question 31

never use ________ muscles as sites in kids <3yrs or those walking for <1yr

Answer 31

gluteal muscles

Question 32

what type of injections do you NOT massage after?

Answer 32

intradermal and heparin