Med Admin II

Question 1

Type of Injection:
Used with irritating
preparations as iron and Vistaril

Answer 1

Z track

IM

Question 2

Preferred method for all IM injections.

Answer 2

Z track

Question 3

Anatomical Site:

Ventrogluteal sites

Answer 3

Z track - IM

Question 4

Landmarks & Injections

1. Retract tissue laterally and hold while needle is in tissue.
2. Inject drug slowly
3. Wait 10 seconds.
4. Pull needle straight out.
5. Release skin to its normal position.

Answer 4

Z track - IM

Question 5

Injection Angle/Needle Length

90 degree angle

Answer 5

Z track-IM

Question 6

Considerations

1. Always Aspirate
2. Never Massage
3. Use new needle after drawing medication into the syringe.
4. Preferred method for all IM injections

Answer 6

Z track- IM

Question 7

Anatomical Site

1. Below top 2 layers of epidermis, e.e. stratum corneum and stratum lucidum.
2. Anterior forearm
3. Lateral & posterior upper arm
4. Posterior chest

Answer 7

Intradermal

Question 8

Landmarks & Injection

1. Bevel of needle should be practically visible through the skin.
2. Create a small wheal or bleb.
3. Mark skin around wheal with indelible ink.

Answer 8

Intradermal

Question 9

Injection Angle/Needle Length

1. 5-15 degree angle.
2. 27G or smaller
3. 3/8” to 5/8” needle

Answer 9

Intradermal

Question 10

Volume

0.01 - 0.1 mL

Answer 10

Intradermal

Question 11

Considerations

1. Avoid areas where clothing could irritate skin.
2. Offers slowest absorption rate.
3. Used for tuberculin skin test & allergy test
4. Report hoarseness, wheezing
5. Do not massage.

Answer 11

Intradermal

Question 12

S.C. or s.q.

Answer 12

Subcutaneous

Question 13

Anatomical Site

1. Anterior thighs
2. Abdomen from below navel to iliac crests, excluding midline.
3. Outer aspects of upper arms.
4. Flanks

Answer 13

Subcutaneous

Question 14

Anatomical Site
AVOID:
1. Midline of body
2. Areas on body with skin or tissue abnormalities.
3. Bony prominence
4. Areas near nerves or large blood vessels.

Answer 14

Subcutaneous

Question 15

Injection Angle/Needle Length

1. 45-90 degree angle
2. 25-27G
3. 1/2” to 5/8” needle angle must be individualized depending on amount of subcutaneous tissue.

Answer 15

Subcutaneous

Question 16

Volume
Usual: 0.5 to 1mL
Maximum 2mL

Answer 16

Subcutaneous

Question 17

Special Considerations

1. 45 deg angle is used when pt has very little SQ fat.
2. 90 deg angle is used with most pts.
3. Insert needle to the hub.

Answer 17

Subcutaneous

Question 18

Special Considerations

1. May pinch if pt is very lean or to stabilize tissue in area lots of SQ fat (“fluffy”). Try not to pinch small area for heparin injections.
2. Don’t Massage or rub after - esp heparin!

Answer 18

Subcutaneous

Question 19

Special Considerations

1. Do NOT need to aspirate.
2. After injection, wait a few seconds for medication to penetrate tissue, esp with heparin/lovenox.

Answer 19

Subcutaneous

Question 20

Preferred IM site in clients 6+ yo

Answer 20

Ventrogluteal

Question 21

Anatomical site: gluteus medius and minimus muscles

Answer 21

IM- ventrogluteal

Question 22

Anatomical Site

1. Palm of opposite hand on greater trochanter
2. Index finger on anterior superior iliac spine.
3. Spread middle finger posteriorly as far as possible along iliac crest.
4. Check sponginess of muscle
5. Inject in the triangle formed if adequate muscle mass.

Answer 22

IM - ventrogluteal

Question 23

1. 90 deg angle.
2. 1”- 1.5” long
3. 22-27G - usually 22G
4. 18-25G if oil based meds

Answer 23

IM - ventrogluteal

Question 24

Volume
1-3mL
Maximum 3mL

Answer 24

IM - ventrogluteal

Question 25

Considerations | 1. Ideal - supine; also prone, sidelying

Answer 25

IM - ventrogluteal

Question 26

``` Considerations Advantages 1. Removed from major nerves and blood vessels 2. Good muscle density 3. Shallow s.c. fatty layer 4. Landmarks are easy to identify ```

Answer 26

IM - ventrogluteal

Question 27

Location: Anterior vastus lateralis muscle

Answer 27

IM - Vastus Lateralis

Question 28

Landmark & Injection: Divide thigh into thirds between greater trochanter and patella - use middle third. - Boundaries are mid-anterior & mid-lateral thigh

Answer 28

IM - Vastus Lateralis

Question 29

Landmark and Injection: | In children: compress muscle and/or lift away from femur

Answer 29

IM - Vastus Lateralis

Question 30

Injection Angle/Needle Length: 1. 90 deg angle 2. 1"-1.5" long - adult 3. 5/8"-1" - child 4. 22-27G usually 22G 5. 18-25G if oil based meds

Answer 30

IM - Vastus Lateralis

Question 31

Volume Usual 1-3mL Max 3 mL

Answer 31

IM - Vastus Lateralis

Question 32

Considerations 1. Ideal - supine 2. Also sitting 3. Knee slightly flexed

Answer 32

IM - Vastus Lateralis

Question 33

Considerations Advantages 1. Free of major nerves and blood vessels 2. Safest in children LESS than 6yo

Answer 33

IM - Vastus Lateralis

Question 34

Location Boundaries: 1. 3 fingers below acromion process 2. line parallel to axilla on bottom 3. on sides lines are parallel to the arm 1/3 and 2/3 of the way around the outer lateral aspect 4. Completely expose muscle 5. Choose patient's non-dominant arm

Answer 34

IM - Mid-deltoid

Question 35

Injection Angle/Need Length 1. 90 deg angle 2. 1"-1.5" long - adult 3. Generally shorter unless patient is very large 4. 5/8" to 1" - child 5. 22 to 27 G, usually 22G

Answer 35

IM - Mid-deltoid

Question 36

Volume 1. Usual - 0.5mL 2. Max 2 mL preferably of non-irritating medication

Answer 36

IM - Mid-deltoid

Question 37

Considerations | 1. Arm at side with elbow flexed to relax muscle

Answer 37

IM - Mid-deltoid

Question 38

Advantages | 1. Good for small volume, vaccine injections

Answer 38

IM - Mid-deltoid

Question 39

Disadvantages 1. pain more noticeable 2. holds small volume 3. Muscle mass small 4. Brachial and axillary nerves are close by

Answer 39

IM - Mid-deltoid