Injections/Blood Draws

Question 1

Why would you chose injections over PO meds?

What are the advantages?

Answer 1

• pt cant take med PO
• vaccinations
• allergy testing

Advantages- avoid 1st pass metabolism

Question 2

Contraindications of Injections

Answer 2

• lack of suitable site for injection
• coagulopathy
• occlusive peripheral vascular disease
• shock
• impairment of peripheral absorption

Question 3

Complications of Injections

Answer 3

• anaphylactic rxn
• med errors
• infection at site
• injection pain
• ecchymosis at site

Question 4

5 Rights

Answer 4

right drug
right patient
right dose
right route
right time

Question 5

Routes of Drug Admin & Example of each

Answer 5

Intradermal (ID)- allergy/TB

SubQ- Insulin Heparin,Lovenox

IM- Abx, Narcotics, Sedatives, vitamin

IV- many drugs, vancomycin etc.

Question 6

Advantages of each route of drug admin

Answer 6

ID- slow absorption

SubQ- faster onset of drug than PO

IM- minimize pain from irritating drugs, larger volumes can be distributed, rapid absorption

IV- quick distribution and absorption

Question 7

Disadvantage of each route of drug admin

Answer 7

ID- small amount of drug

SubQ- greater expense than PO, smaller volume, drug can irritate tissue and cause pain, produce anxiety

IM- blood vessels and nerve damage, produce anxiety

Question 8

Sub Q injections are done where?

What type of syringe?

Answer 8

Lateral aspect upper arms

Lateral aspect of thigh

2in below umbilicus

TB syringe

Question 9

IM injections done where?

What type of syringe?

Check for blood return?

Answer 9

deltoid
gluteus medius/minimus
vastus lateralis* perferred site for infants

18-23 gauge

Check for blood return

Question 10

Insulin Injection Sites

Answer 10

• arms
• abdomen
• thigh
• buttock
• rotate injection sites

Question 11

Heparin Injection Sites

Answer 11

Lower abd fat pad, 2 inches below umbilicus

*rotate injection sites

Question 12

Heparin: do you aspirate to check for blood return?

Do you rub or massage site after injection

Answer 12

NO, NO

Question 13

Sub Q injection location in infant and older child

Answer 13

infant- thigh

child- posterior upper arm

Question 14

IM into Pediatric pt location

Answer 14

anterolateral aspect of upper thigh of infant and deltoid for children

Question 15

is it okay to use gluteal muscles in children younger than 3/those who have been walking less than a year?

Answer 15

NO, buttock should not be used in children because of risk of sciatic nerve injury

Question 16

After injection instruct patient to report the following..

Answer 16

fever

bleeding

SOB

Rash

Tenderness/ erythema

bruising