Pharmacology: Injectable Medications Week 9

Question 1

Parenteral Injections

Answer 1

• ID (intradermal)
• Sub Q (subcutaneous)
• IM (intramuscular)

Question 2

Considerations for Giving Parenteral Injections

Answer 2

-map anatomical locations of sites (body size)
-volume to be administered
-when to apply gentle pressure
-when to aspirate (no longer recommended)
(pull back on syringe after needle is inserted to check for blood)

Question 3

Intradermal: Sites for Injection

Answer 3

• anterior forearm (like to use)
• upper back
• anterior upper chest

Question 4

Intradermal: Equipment (syringe, barrel, needle)

Answer 4

• special syringe TB (1 mL tuberculin syringe)
• 1 mL barrel
• 1/4 to 1/2 inch needle, 27 gauge

Question 5

Intradermal: Angle to Inject

Answer 5

• 10 to 15 degrees

- bevel up (to form bleb)

Question 6

Intradermal: Techniques

Answer 6

• clean skin with alcohol (let air dry)
• stretch skin
• do not aspirate
• do not apply gentle pressure (maintain bleb)
• does not require accommodation for body size

Question 7

Subcutaneous: Injection sites

Answer 7

in adipose/fat tissue

• abdomen (ie. Heparin)
• anterior thigh
• posterior upper arm

Question 8

Subcutaneous: Equipment (syringe, barrel, needle)

Answer 8

• insulin syringe
• 1 to 3 mL barrel
• 5/8 inch needle (3/8-1 inch)
• 25 to 30 gauge

Question 9

Subcutaneous: Angle for Injection

Answer 9

-45 to 90 degrees

Question 10

Subcutaneous: Techniques

Answer 10

-clean skin with alcohol
-pinch and lift skin
-can apply gentle pressure if not irritating
-may need to adapt to body size
>Smaller client –> decrease angle (30 degrees) or shorter needle (1/2 inch)
>Larger client –> increase angle (90 degrees) or longer needle (1 inch)

Question 11

Intramuscular: Injection Sites

Answer 11

• deltoid
• vastus lateralis
• ventrogluteal (preferred)
• dorsogluteal (no longer recommended)

Question 12

Intramuscular: Equipment (syringe, barrel, needle)

Answer 12

• 3 mL syringe
• 1 to 1/2 inch needle
• 21 to 25 gauge (18 if viscous)

Question 13

Intramuscular: Angle for Injection

Answer 13

-72 to 90 degrees (90 degrees)

Question 14

Intramuscular: Techniques

Answer 14

-clean skin with alcohol
-spread skin
-dart like motion
-aspirate/ inject slowly
-may apply gentle pressure to site
-may need to adjust to body size
>Thin Client –> shorter needle (5/8 inch), decrease angle (60 degrees)
>Heavier Client –> longer needle, depress skin

Question 15

Intradermal: Volume of Solution

Answer 15

less than 1 mL (0.5 mL)

Question 16

Subcutaneous: Volume of Solution

Answer 16

0.5 to 1 mL

Question 17

Intramuscular: Volume of Solution

Answer 17

1 to 4 mL depending on site and muscle size
-deltoid –> max 1 to 2mL
-vastus lateralis –> 1 to 2 mL
-gluteal muscles –> 1 to 3 mL or 4 mL
>some medications may be given in larger doses if muscle size permits but larger doses may have to be given in divided doses

Question 18

Z-Track

Answer 18

• for irritating medications
• seal deep in muscle to prevent leakage into subcutaneous layer
• change needle
• hold skin to the side
• leave needle in place for 10 seconds
• withdraw needle and release skin at the same time
• may apply gentle pressure