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cp 2 > pod 2 > Flashcards

pod 2 Flashcards

1
Q

What are some therapeutic rationales for administration of medications via the intramuscular route?

A

IM route provides faster medication absorption than subc because muscles greater vascularity

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2
Q

What are some advantages IM

A

Faster absorption (more blood supply compared to subc)

Helpful in emergency situations

Can inject volumes of medications (3mL in healthy adult, 2mL in deltoid)

Recommended for some meds like vitamin B12, viscous meds need to be given into deep muscles causing less irritation

Long-acting duration of effect (longer onset of action than IV)

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3
Q

What are some disadvantages IM

A

Greater risk of damage to blood vessels & nerves (accurate landmarking important)

Depending on size of needle the absorption can be erratic

Needle phobia

Contraindicated in pts on anticoagulants

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4
Q

What is the maximum volume of fluid that can be injected into an adult with well-developed muscles?

A

3mL

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5
Q

What is the recommended volume of fluid that can be injected into the deltoid muscle?

A

2mL

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6
Q

What kinds of medications are given via the intramuscular route?

A

Antibiotics, vaccines, psychotropic long-acting drugs, antiemetics, analgesics

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7
Q

What would be included in the holistic assessment of a client receiving an intramuscular injection?

A

Ensure the pt is relaxed, palpate the rule out any tenderness

Ask them about things (phobia, preferred spot)

Distraction

Applying pressure after receiving

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8
Q

What is the most common size of syringe used for an intramuscular injection?

A

3mL

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9
Q

What is the standard length and gauge of needle used for an intramuscular injection?

A

1.5-inch needle & 21 or 22 gauge

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10
Q

What are some factors that the psychiatric nurse should consider when choosing the most appropriate needle for an intramuscular injection?

A

Pts body weight and amount of adipose tissue can influence the size
Obese pt require needle 7.5 cm, thin pt 1.3-2.5cm needle

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11
Q

How do you prepare the site for injection?

A

*Good skin integrity

*Adequate muscle mass

*Be free of tenderness, lesions and bruising

*Sites should be rotated – however patient preference should be considered when choosing a site for injection

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12
Q

Describe the technique used to administer an intramuscular injection using the standard technique

A

1.Prepare the medication from vial with a fill needle, or ampule with filter needle

2.Change needle to correct IM needle—standard is 21/22g 1-1 ½ long

3.Preform hand hygiene and donne clean gloves

4.Landmark and assess that skin is free from lesions, tenderness, hardness, multiple injections, inflammation

5.Clean injection site with swab from center and move outward, allow to dry

6.Use thumb and forefinger or nondominant hand, pull the skin taut within 5cm(2”) of the selected site

7.With dominant hand insert the needle at 90 degrees angle using a darting motion

8.Use nondominant hand to hold the syringe, and with the dominant hand aspirate by pulling back slightly on the plunger as per agency policy

9.Slowly inject the medication (10sec a ml)

10.Remove, engage safety device and dispose syringe into sharps container

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13
Q

What is the rationale for aspirating prior to injecting medication?

A

Assess if needle is in muscle or blood vessel

Aspirating is contraindicated in admin of vaccines

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14
Q

What is the Z-track technique and when would this method be used?

A

Recommended because it minimizes local skin irritation by sealing meds in muscle tissue

Leaves a zigzag path that seals the needle track

Med can’t escape from muscle tissue resulting in full dose being admin

Cause less irritation to skin and subc tissues

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15
Q

Describe the technique used to administer an intramuscular injection using the Z-track technique

A

Prepare site with antiseptic swab

Pull overlying skin & subcut tissue 2.5-3.5 cm laterally

Holding skin taut with nondom hand

Insert needle & slowly inject

Needle remains inserted for 10 secs to let meds disperse

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16
Q

What are some interventions that the nurse can use to prevent needle stick injuries?

A

Do not recap

Dispose in right bin

Activate needle sharps protection equipment

17
Q

What is the preferred site for an adult?

A

Ventrogluteal site

18
Q

What is the preferred site for a child under 7 months of age?

A

Vastus lateralis site

19
Q

Ventrogluteal site

A

Offers deep site, situated away from major nerves & blood vessels

Offers less chance of contamination in incontinent pts

Identified easily by prominent bony landmarks

Preferred site for larger volume, more viscous

Less likely to have injury

20
Q

what muscle for ventrogluteal

A

Gluteus medius & minimus

21
Q

Why is ventrogluteal preferred site for an adult?

A

Away from major blood vessels

Poses less risk of abscess formation, tissue damage, muscle pain, nerve damage

22
Q

What position can the client be in when receiving an injection into ventrogluteal

A

lying down on side = relaxed muscles

23
Q

describe landmark of ventrogluteal

A

Nondominant hand

Find greater trochanter

Iliac crest

Iliac spine

Heel of hand over greater trochanter, point thumb towards groin, index finger to anterior iliac spine, other fingers on iliac crest, injection in V formation

24
Q

Vastus Lateralis site

A

Lacks major nerves & blood vessels

Facilitates rapid drug absorption

Used frequently with infants

25
Q

why vastus lateralis preferred site for seven months & younger

A

more muscle

26
Q

What position can the client be in when receiving an injection into vastus lateralis

A

Lying down legs extended

Sitting

27
Q

landmark vastus lateralis

A

Greater trochanter & top of knee, inject in middle of muscle

Anterior lateral aspect of thigh

28
Q

Deltoid site

A

Easily accessible but not well developed in most

May be used for small amounts

Not used in children

Use of muscle involves potential for injury to brachial artery & radial & ulnar nerves

Recommended for hep B & rabies

29
Q

why deltoid not used for IM often

A

Usually used for small amounts of liquid

Use of muscle involves potential for injury to brachial artery and to the radial & ulnar nerves

30
Q

max volume for deltoid

A

2mL

31
Q

landmark deltoid

A

Expose upper arm & shoulder

Relax arm

Palpate lower edge of acromion process (base of triangle)

Inject 3 to 5 cm below acromion process

32
Q

why dorsogluteal recommended when all others aren’t

A

big enough muscle to insert into, need to be done correctly, receive up to 4mL

But don’t usually use this site because the sciatic nerve is close and if hit, possible paralysis & large blood vessels

33
Q

position pt in for dorsogluteal

A

lying on stomach or standing

34
Q

landmark dorsogluteal

A

Muscle located upper outer quadrant of butt, approx 5-8cm below iliac crest

cp 2 (6 decks)

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