TEST 2 ID, IM, IV, Sub Q injections

Thigh

Vastus lateralis

ID

intradermal

IM

intramuscular

LMWH

low molecular weight heparin

IM injection sites

Thigh Arm Hip

There is better medication absorption with IM injections True False

True

What degree is used for IM injections

90 degrees

You should massage a Z-track injection site True False

False

Technique to Sub-q injections

- 45 or 90 degree angle - pinch an inch - average to thin (not necessary in case of ample fat - inject slowly - wait 1 seconds before withdrawing needle (prevents leakage)

ID injections are used for

- allergy testing - administration of the TST (PPD) (Mantaux test)

Key points for ID injection

- hold skin taught - bevel UP - parallel to pt skin @ a 5-15 degree angle - insert needle slowly about 3mm (1/8) inch - bevel should be visible under skin - release skin, DO NOT aspirate - slowly inject creating a pale wheal - blot any blood; do not rub or cover w/bandage

Sub Q syringe size

1-3ml

Needle gauges used for ID injection

25-28 G that is 3/8 - 5/8 inches long

Sub q needle size and length

3/8 - 5/8 needle (obese pts may need longer) 25-27 G (can go up to 31G)

What angle do you give Sub-q injections

45 or 90 degrees

Injection degree for ID

5-15 degrees

Arm

Deltoid

Needle size for IM injection

Dependent on: - viscosity of med - pt muscle mass - 21-25 G needle - 1-3 inches long

Syringe size for IM injection

Dependent on: Volume of med Viscosity of med Patient muscle mass Usually between 1-5 mL

Why should you aspirate for IM injections?

Depending on the angle, to make sure that you are not injecting into the venous system (when aspirating, if you see blood, pull out because you are in a vessel)

You should always expel the nitrogen bubble from syringe for sub-q injections True False

False

Which medications should you NOT massage area of Sub-Q injection site?

Heparin LMWH Insulin

What types of medication is given Sub-q

Heparin/LMWH Insulin

Sub-q insulin site

Lateral aspect of mid upper arm Abdomen Front of thigh

Syringes used for ID injection

TB (tuberculin) syringe 1 mL syringe

What will you see when you do an ID injection?

Wheal

What is the point of the Z-Track method?

Zigzag path prevents the medication from reaching the subcutaneous layer or skin surface by sealing off the needle track.

Sub-q heparin/LMWH site

abdomen

Typical site for PPD

forearm

Sub-Q

subcutaneous

Hip

ventrogluteal site