Injectable Medication Administration Pretest

Syringe Parts

three parts -the barrel -the tip -the plunger keep the inside of all three parts sterile as you prepare and admin injection

Needles

-available in variety of sizes and lengths -sterile needles are packaged individually in sealed sleeves or together with a syringe. -filter needles are a specific type of needle required when drawing up certain types of meds but CAN NEVER be used to administer an injection. -gauge reflects diameter of needle -larger the gauge = narrower or smaller diameter of needle -length chosen based on intended purpose -packaging always indicates needles gauge and length -most equipped with safety device to reduce risk of needle stick injury -

Z-track technique

-for all intramuscular injections to prevent tissue irritation caused when med leaks into subcutaneous tissues -displace about 1 to 1 1/2 inches of the skin and subcutaneous tissue at the site with the side of your nondomiant hand. Maintain this displacement throughout the injection and release it immediately after you withdraw the needle from the skin. -insert the needle at a 90 degree angle for all intramuscular injections -use a quick darting motion to insert it -inject the medication slowly and smoothly, then hold the needle in place for 10 seconds to allow the medications to disperse -withdraw the needle quickly at the same angle at which you inserted it. -Cover the site with dry gauze immediately and apply gentle pressure. -Do not massage the site

Syringes

-packaged for single use -available in a variety of sizes up to 60 mL -typically use 1 to 5 mL -some packaged with needle that may be pre-attached. if so, make sure it is securely attached before using. -needle may need to be changed depending on the route of admin and size of client

Vials

-plastic or glass containers with liquid or powdered meds packaged airtight and sterile environment -sealed with rubber stopper -access med by pushing a sterile needle through the center of the stopper -may be single use or preservative has been added to solution for multidose

Needle Parts

-slanted tip or bevel -the shaft -hub (part that attaches to the syringe) -keep all three parts sterile in prep for admin -packaged with caps to prevent contamination and injury

Prefilled Unit Dose Syringe System

-uses the prefilled syringe along with a reusable plastic or metal syringe holder into which the prefilled syringe is loaded to administer the medication -load the syringe into the holder, barrel first -turn the blue lock a half turn, then rotate the plunger rod until it is fully screwed on -uncap needle, then eject air and any excess med while holding the needle end lower to prevent contact with the medication on the needle or your hand

Syringe measurement

-vary in measurement markings on the barrel -always read the calibration on the syringe carefully to ensure accurate measurement of med -always use an insulin syringe to measure insulin; the insulin concentration should correspond with the scale of the insulin syringe -accurate admin of med also includes measuring the dose at the correct part of the plunger

Multidose vial

-when you are the first user follow policy for labeling vial for subsequent users -if you are subsequent user follow policy for determining whether vial is acceptable to use or should be discarded.

A nurse is preparing to administer an intramuscular injection at the ventrogluteal site. Which of the following needle lengths should the nurse select for an adult of average size? 1/2 inch 1 inch 1 1/2 inches 2 inches

1 1/2 inches The nurse should use a 1 1/2-inch needle for an adult of average size when giving an intramuscular injection in the ventrogluteal area.

Intramuscular

Diameter: 18-25 gauge Length: 5/8 to 1 1/2 inch Angle: 90 degrees

Intradermal (needle selection)

Diameter: 25-27 gauge Length: 1/2-5/8 inch Angle: 5 to 15 degrees

Subcutaneous (needle selection)

Diameter: 25-27 gauge Length: 3/8-5/8 inch Angle: 45 to 90 degrees

Subcutaneous Insulin

Diameter: 25-31 gauge Length: 5/16-1/2 inch Angle: 45 to 90 degrees

A nurse is preparing to administer a subcutaneous injection to a client. Which of the following should the nurse assess first? -The client's level of knowledge about the medication -If the client has allergies to the medication -Where the most appropriate injection site is -The reason the client is receiving the medication

If the client has allergies to the medication The priority data the nurse should identify is the client's medication allergies to determine if they are allergic to the medication prior to administration.

Deltoid Injection

Landmarks -acromion process -axillary line -insert the needle at a point two to 3 finger widths below the acromion process, above the axillary line in the middle of the triangular shaped deltoid muscle in the midline of the lateral aspect of the arm. -carefully locate the deltoid muscle using the anatomical landmarks. *potential for injury due to proximity to the brachial artery and radial nerve.

Which of the following terms indicates that a medication is given via an injection? Enteral Sublingual Transdermal Parenteral

Parenteral - indicates that a medication is given via an injection.

A nurse is preparing to administer an insulin injection to a client. Which of the following actions should the nurse take?

Rotate the injection sites. Rotating injection sites prevents tissue damage from repeated injections at the same site.

A nurse is preparing to administer an intradermal injection. Which of the following actions should the nurse take to ensure proper technique? -Rub the injection site after withdrawing the needle. -Pinch 1/2 inch of skin and administer the injection at a 45° angle. -Use a tuberculin syringe with a 5/8-inch, 25 gauge needle. -Choose a site that is at least 1 inch from the umbilicus.

Use a tuberculin syringe with a 5/8 - inch, 25 gauge needle This is the correct size syringe and needle for administering an intradermal injection.

A nurse is preparing to give an intramuscular injection into the left ventrogluteal muscle. Which of the following actions should the nurse take to locate the site of injection? -Measure two fingerbreadths below the acromion process. -Measure a handbreadth above the knee and a handbreadth below the greater trochanter. -Use the heel of the hand and index finger to locate the vastus lateralis muscle. -Locate the upper, outer quadrant of the buttocks.

Use the heel of the hand and index finger to locate the vastus lateralis muscle. This will locate the ventrogluteal site.

After med admin via injection

dispose of syringe and needle in sharps container -position the holder so that it is cradling the syringe -unscrew the plunger rod from the plunger of the syringe -rotate the blue lock a half turn. maintain same position, bring holder over to a sharps container and carefully invert the holder over the opening, letting the syringe and needle drop into container.

Ventrogluteal Injection

landmarks are the head of the greater trochanter and the anterior superior iliac spine. -place the heel or palm of the hand on the greater trochanter with your thumb pointing toward the client's abdomen. -Extend your index finger up to the anterior superior iliac spine, then spread your other fingers back along the iliac creast. -insert needle in the V formed between index and third fingers.

Vastus Lateralis Injection

landmarks are the head of the greater trochanter and the knee -insert needle into the middle third of the muscle at least one hand width below the greater trochanter and one hand width above the knee in the anterolateral aspect of the leg.

When using a syringe with a non-Luer-lock tip ...

secure the needle to the syringe by pushing it on, then twisting slightly while applying pressure.

When using a syringe with a Luer-lock tio ...

secure the needle to the syringe by twisting it onto the threaded tip

Never recap a needle

that has been in contact with a client