Unit 4 Parenteral Medications Flashcards
ID
Intradermal (Into Skin) Allergy, TB, Vaccinations Max drug amount = 0.5mL Discomfort due to nerve endings 27 gauge Pull skin TAUT
Slowest Absorption Rate (Local Effect)
Intradermal (ID)
Site Selection for ID
Ventral Surface of Inner Arm
upper arms, upper chest, upper back
Max Amount of Drug for ID
0.5mL
Needle Size (ID)
27 gauge
Angle for ID
15 degree angle, bevel up
Depth of ID
1/8th below skin
STOP when bevel tip is under skin
DO NOT RUB/ MASSAGE
Subcutaneous Injections
Loose C.T. just below dermis
PINCH & STICK
0.5-2.0mL
25 gauge
Most Common Sub-Q injections
Heparin & Insulin
Site Selection for Subcutaneous Injections
Thigh, Upper Hips, Upper Back, Abdomen
Alternate sites, Mark and Document
Avoid sites of compromised tissue (skin, atrophy, edema..)
Fastest Route of Absorption for Subcutaneous
Abdominal
Sub-cu Max Amount
2mL
Sub-cu Needle
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
Heparin Injections
Subcutaneous Injection Abdomen 25g 3/8" @ 90 DO NOT aspirate Be aware of Lab Work
IM (Intramuscular Injection )
Deep in muscle tissue
Rich Blood Supply–> Quick Absorption
Max 3mL of Med
Z-track
IM Needle Size
21-23 gauge (23g most common)
1-1.5”
Depends on muscle mass, type of solution, amount of fat & age
IM Sites
Deltoid
Dorsogluteal
Ventrogluteal
Vastus Lateralis
Ventrogluteal
site of choice
1-3 ml
Suitable for children over 1 year
Site of Choice For IM
Ventrogluteal
Vastus lateralis
1-3 ml
recommended site infants <1year
between top and bottom of femur
Rectus Femoris
CAN SELF INJECT
Quadriceps-ant aspect of thigh
Considerable discomfort
Dorsogluteal
may damage sciatic nerve
Not used for those under 3 unless they have been walking for a year
1-3 ml
Deltoid
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
Z-Track
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