Unit 4 Parenteral Medications

Question 1

ID

Answer 1

Intradermal (Into Skin)
Allergy, TB, Vaccinations 
Max drug amount = 0.5mL
Discomfort due to nerve endings
27 gauge 
Pull skin TAUT

Question 2

Slowest Absorption Rate (Local Effect)

Answer 2

Intradermal (ID)

Question 3

Site Selection for ID

Answer 3

Ventral Surface of Inner Arm

upper arms, upper chest, upper back

Question 4

Max Amount of Drug for ID

Answer 4

0.5mL

Question 5

Needle Size (ID)

Answer 5

27 gauge

Question 6

Angle for ID

Answer 6

15 degree angle, bevel up

Question 7

Depth of ID

Answer 7

1/8th below skin
STOP when bevel tip is under skin
DO NOT RUB/ MASSAGE

Question 8

Subcutaneous Injections

Answer 8

Loose C.T. just below dermis
PINCH & STICK
0.5-2.0mL
25 gauge

Question 9

Most Common Sub-Q injections

Answer 9

Heparin & Insulin

Question 10

Site Selection for Subcutaneous Injections

Answer 10

Thigh, Upper Hips, Upper Back, Abdomen
Alternate sites, Mark and Document
Avoid sites of compromised tissue (skin, atrophy, edema..)

Question 11

Fastest Route of Absorption for Subcutaneous

Answer 11

Abdominal

Question 12

Sub-cu Max Amount

Answer 12

2mL

Question 13

Sub-cu Needle

Answer 13

Length Determines Injection Angle 
25g 5/8"  --> 45 degree angle 
25g 3/8" --> 90 degree angle
25g 1/2' --> child --> 90 degree
Pinch 1 inch for 45 degree angle; 2 for 90

Question 14

Heparin Injections

Answer 14

Subcutaneous Injection 
Abdomen 
25g 3/8" @ 90
DO NOT aspirate 
Be aware of Lab Work

Question 15

IM (Intramuscular Injection )

Answer 15

Deep in muscle tissue
Rich Blood Supply–> Quick Absorption
Max 3mL of Med
Z-track

Question 16

IM Needle Size

Answer 16

21-23 gauge (23g most common)
1-1.5”
Depends on muscle mass, type of solution, amount of fat & age

Question 17

IM Sites

Answer 17

Deltoid
Dorsogluteal
Ventrogluteal
Vastus Lateralis

Question 18

Ventrogluteal

Answer 18

site of choice
1-3 ml
Suitable for children over 1 year

Question 19

Site of Choice For IM

Answer 19

Ventrogluteal

Question 20

Vastus lateralis

Answer 20

1-3 ml
recommended site infants <1year
between top and bottom of femur

Question 21

Rectus Femoris

Answer 21

CAN SELF INJECT
Quadriceps-ant aspect of thigh
Considerable discomfort

Question 22

Dorsogluteal

Answer 22

may damage sciatic nerve
Not used for those under 3 unless they have been walking for a year
1-3 ml

Question 23

Deltoid

Answer 23

small muscle → .5-1ml 23-25g 1 in needle

Rapid absorption → no more than 1ml
Good Site for adults if dose is small
Hep B Vaccine frequently given

Question 24

Z-Track

Answer 24

Prevents leakage or tracking into SQ tissue
Cleanse, displace the skin, insert needle at 90
Wait 10 sec b4 w/d needle
RECOMMENDED for ALL IMs
DO NOT MASSAGE