Intramuscular Injections
This angle is used when administering an IM injection.
What is a 90 degree angle?
Common sites for subcutaneous injections.
What is the abdomen and lateral aspects of the upper arm and thigh?
page 827- Common subcutaneous sites include the abdomen, lateral aspects of the upper arm and thigh, scapular area of the back and the ventrodorsal gluteal area.
The patient should be placed in this position when administering oral medications.
What is sitting or with the head of the bed elevated?
page 836- Administer medications with water while the patient is sitting or has the head of the bed elevated.
This form of an oral medication can not be crushed.
What is an enteric coated or sustained-release tablet?
page 820- enteric coated or sustained release tablets should never be crushed. Crushing a sustained release medication allows absorption to occur all at once rather than over the desired absorption time.
This practice is meant to ensure that medications are safely administered to all patients.
What is performing the 6 rights of medication administration and checking the medication label against the MAR 3 times.
This anatomical landmark is used when locating the deltoid muscle.
What is the acromial process?
When a small amount of tissue is available, the nurse inserts the needle at this angle when giving a SC injection.
What is 45 degrees.
page 827- typically the nurse pinches approximately 2 inches of tissue and inserts the needle at a 90 degree angle, when less tissue is available, the nurse pinches 1 inch of tissue and inserts the needle at a 45 degree angle.
The 3rd medication check takes place here.
What is at the beside?
page 836- enter the patient's room, perform patient identification, check allergies, assess patient knowledge, and educate the patient. Recheck the label on the medication with the MAR a 3rd time.
When administering ear drops in an adult patient, this technique is used to straighten the auditory canal.
What is gently pulling the pinna up and back?
Page 824- Straighten the auditory canal of an adult patient by gently pulling the pinna up and back.
What is on the left side with the upper knee flexed?
page 825- Position the patient on the left side, with the upper knee flexed, left lateral recumbent position.
Once the IM injection site has been cleaned with alcohol for 30 seconds, the nurse should do this before injecting the medication.
What is allow the site to air-dry?
page 855- clean the site with alcohol. allow the site to air-dry.
The maximum amount that to be given in a single subcutaneous injection.
What is 1 mL?
page 827- the volume of medication administered should not exceed 1 mL by this route.
What is "some capsules can be opened and added to small amounts of applesauce, pudding, or ice-cream. Certain tablets can be crushed."
page 820- special techniques are used for patient who have difficulty swallowing large tablets. Some capsules can be opened and added to small amounts of certain foods. Certain tablets may be crushed.
When administering an ophthalmic medication, what technique can be used by the nurse to prevent loss of medication through the tear duct?
Maintain slight pressure on the inner canthus of the eye.
page 823- Maintain slight pressure on the inner canthus to prevent loss of medication through the tear duct and reduce the systemic effects of the medication.
This route of medication administration uses compressed air or oxygen.
What is a nebulizer?
page 842- Connect the tubing to the air compressor source (nebulizer machine, compressed air source, or compressed oxygen source).
This method should be used when administering IM injections that discolor tissue or are irritating to tissue.
What is the Z-track method?
page 829- IM injections that discolor tissue or are irritating to tissue are administered by the Z-track method. This technique seals the medication into the muscle tissue, with no tracking of medication into the subcutaneous tissue.
When mixing insulins, this type of insulin is draw up first?
What is regular insulin?
No- inject air in NPH
River- inject air in Regular
Runs- withdraw the Regular
North- withdraw the NPH
These assessments should take place before administering an oral medication. Name one.
What is, "ability to swallow, level of consciousness, gag reflex, and whether the patient is experiencing nausea or vomiting?"
page 820- the patient's ability to swallow, level of consciousness, gag reflex, and whether the patient is experiencing nausea and vomiting are assessed to ensure the patient's ability to take medications by the oral route and to prevent aspiration.
With this type of medication, the nurse must wear gloves to avoid absorption of medication through the nurse's skin during placement.
What is a topical medication.
page 821- Gloves and applicators are used to avoid absorption though the nurse's skin during placement of the topical medication
Ear drops should be at room temperature for this reason.
What is to prevent nausea, pain, and dizziness?
page 821- the internal ear is very sensitive to temperature changes- it is important to use eardrops at room temperature to prevent nausea, pain, and dizziness.
According the WHO (world health organization) this site is no longer recommended for IM injections.
What is the dorsogluteal muscle?
page 828- in 2004, the WHO recommended that the dorsogluteal muscle not be used for routine IM injections due to the proximity to the sciatic nerve and superior gluteal artery and increased risk of injecting into thick layer of fat present.
This type of insulin should never be mixed with another insulin.
What is Lantus or long-acting insulin?
When administering a liquid medication, a syringe should be used to measure the amount anytime it is less than this amount of liquid.
(for larger than this amount, a graduated medication cup can be used)
What is 10 mL?
page 836- when using a multidose bottle and if it is less than 10 mL needed, use a syringe to measure. If more than 10 mL is needed, use a graduated medication cup.
The nurse knows that when inserting a rectal suppository that it should be inserted this far.
What is past the internal sphincter or approximately 3-4 inches?
page 825- gently push the suppository along the rectal wall; continue until the suppository is inserted past the internal sphincter, approximately 3-4 inches.
What is "have the patient blow the nose first"?
page 824- box 35.10 procedural concern, have the patient blow the nose first.