module 3- part C (intramuscular)

Question 1

IM meds are deposited into?

Answer 1

deep muscle tissue which has rich blood supply, so medication absorbs faster than by subcutanoues

Question 2

increased risk for drugs injecting directly into?

Answer 2

blood vessels using IM route

Question 3

what influences the needle size selection for IM?

Answer 3

-viscosity of med, injection site, patients weight, amount of adipose tissue

Question 4

a longer heavier gauge needle is used?

Answer 4

to pass through subcutaneous tissue and penetrate deep into the tissue

Question 5

many needles available are not?

Answer 5

long enough to reach muscle

Question 6

what degree insertion is IM?

Answer 6

90-degree angle insertion

Question 7

normal well developed adult tolerates how much med into a larger muscle w/o severe discomfort?

Answer 7

2-5ml

Question 8

4-5ml are unlikely to be?

Answer 8

absorbed properly

Question 9

children or older adults max can tolerate?

Answer 9

2ml

Question 10

do not give more than how much to small children?

Answer 10

1ml

Question 11

do not give more than how much to small infant?

Answer 11

0.5ml

Question 12

rotate IM injection site to decrease risk of?

Answer 12

hypertrophy

Question 13

emaciated or atrophied muscle absorb?

Answer 13

medication poorly

Question 14

what method is recommended for IM injections?

Answer 14

z track method!

Question 15

once med is injected, wait..

Answer 15

10 seconds then smoothly and steadily withdraw needle, apply gentle pressure

Question 16

what are IM injections usually giving?

Answer 16

steroids, immunizations, naloxone

Question 17

IM syringe for adult?

Answer 17

2-3ml

Question 18

IM syringe for infants and small children?

Answer 18

0.5-1ml

Question 19

in aqueous solution what gauge needle?

Answer 19

20-25 gauge needle,
in oil 18-21
it depends on length of needle

Question 20

why is the dorso-gluteal muscle not recommended for site of injection?

Answer 20

sciatic nerve location!! always consider underlying nerves, bones, blood vessels and volume of med

Question 21

observe site and ensure that it is?

Answer 21

free of pain, infection, necrosis, bruising, abrasions

Question 22

ventrogluteal site for IM?

Answer 22

• gluteus medius, situated deep away from major nerves
• easily identified by prominent bony landmarks
• preferred site for all adults, children, and infants, especially larger volumes
• less painful than vastus lateralis
• 5 ml max

Question 23

vastus lateralis muscle for IM?

Answer 23

• another injection site in adults
• prefer admin for immunizations in infants, toddlers, children
• 2.2ml max
• to relax muscle, have pt lie flat with knee slightly flexed and foot externally rotated

Question 24

deltoid muscle for IM?

Answer 24

• not well developed in many adults
• faster absorption rate
• potential for injury because of nerves within upper arm
• use site for small med volumes

Question 25

how to locate deltoid muscle?

Answer 25

palpate acromion process, place four fingers across deltoid muscle with top finger along acromion process
= injection site is three finger widths below

Question 26

pediatric considerations for IM?

Answer 26

• may be very anxious or fearful
• help with positioning and holding child sometimes
• distraction such as blowing bubbles and pressure at site before may help

Question 27

elderly considerations?

Answer 27

-decrease muscle mass which decreases absorption of IM

Question 28

for volumes less than 1ml use which syringe?

Answer 28

the tuberculin syringe

Question 29

preferred site for children of all ages

Answer 29

ventrogluteal

-as young as neborns

Question 30

deltoid muscle can be used for small?

Answer 30

small volumes in children

advantages: less pain, fewer adverse effects

Question 31

because children often jerk away, nurse should carry

Answer 31

an extra needle to exchange for contaminated one

Question 32

straighter the path of needle and a 90 degree angle, the…

Answer 32

less displacement and shear to tissue and possibly less discomfort

Question 33

IM injection is chosen when 2 things are required?

Answer 33

prolonged action, rapid systemic uptake (15-20 mins usually)

Question 34

a thin 82 year old pt requires an IM injection, what site, needle length and gauge should you pick?

Answer 34

ventrogluteal, 1 inch, 23 gauge

Question 35

although muscles can absorb medication well, what is the usual recommended maximum amt for med for adult?

Answer 35

3 mL

Question 36

why is it necessary to rotate sites for intramuscular injections?

Answer 36

• client is getting multiple injections
• client has a tenderness or hardness at the site
• client has bruising at the site
• client has scarring at the site

Question 37

what is the MOST important reason to check client 15-30 mins after injection?

Answer 37

to ensure they are not having difficulty breathing, wheezing, hives, or itchiness
=allergic reaction that could require intervention
anaphylaxis usually occurs within minutes on second exposure to med

Question 38

why is the needle kept inserted for 10 seconds after a intramuscular injection?

Answer 38

to allow the medication to disperse evenly

Question 39

preferred site for infants up to 12 months of age?

Answer 39

vastus lateralis

Question 40

preferred site for children 18 months or older?

Answer 40

-deltoid

Question 41

literature has clearly identified what site to be the best for IM?

Answer 41

ventrogluteal