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Pharm Parent 105
Pharm Parenteral Routes CCC PN105
Question | Answer |
---|---|
Three sites for injections | deltoid, vastus lateralis, and ventrogluteal muscles |
Before giving injection, examine site to determine | adeuqate muscle tissue |
Areas to avoid | lesions, trauma, inflammation, bony prominences |
IM angle to insert needle | 90 degrees |
IM - after puncture, do this | aspirate plunger to check for blood return |
This confirms needle placement in muscle | lack of blood on aspiration |
Angle to withdraw needle | angle of insertion |
Do not _________________ site after IM injection | massage |
If blood is withdrawn upon IM aspiration | withdraw needle and start over |
Before injection, always check to see if patient is on | blood thinners |
Landmarks for deltoid muscle injection | acromion process and axillary line |
Where to insert needle in deltoid | 2-3 finger lengths below acromion process, above axillary line |
Landmarks for vastus lateralis injection | head of greater trochanter and knee |
Where to insert needle in vastus lateralis | middle third of muscle at least one hand width below greater trochanter and above knee |
Landmarks for ventrogluteal injection | head of greater trochanter and anterior superior iliac spine |
Reason to not use dorsogluteal site for injection | paralysis from sciatic nerve damage |
What determines injection volume and needle size | age and size of patient and type of medication |
If prescribed medication is greater than recommended dosage for particular site | Then break into smaller injections and give at different areas |
Adult deltiod dose | 1ml |
Contraindications for deltoid injection | infant or toddler age |
Adult vastus lateralis dose | 3ml |
Infant vastus lateralis dose | 1ml |
Small infant vastus lateralis dose | 0.5ml |
Preferred injection site for infants | vastus lateralis |
Adult/ ventrogluteal dose | 3ml |
Infant ventrogluteal dose | 1ml |
Small infant ventrogluteal dose | 0.5ml |
Toddler ventrogluteal dose | 2ml |
Age 3 and older ventrogluteal dose | 2-3ml |
Adolescent ventrogluteal dose | 3ml |
Intradermal injections are used for | skin testing and administering local anesthetics |
Sites for intradermal injections | inner forearm and upper back |
What to avoid when giving intradermal injection | lesions and hair |
Type of syringle for intradermal injection | tuberculin or small (1ml) |
Angle of insertion for intradermal injection | 5-15 degrees, almost parallel to skin |
When giving intradermal injection, make sure skin is | pulled taut |
Bevel should be facing ____ for all injections | up |
Intradermal injections should be given ___ | slowly |
Watch for skin to ____________ when giving intrdermal injection | blanche and wheal |
___ indicates intradermal injection was given incorrectly | bleeding or absence of wheal |
SubQ injections are used for | slow absorbing medication |
IM injections are used for | rapid absorbing medication |
Favored site for subQ injections | large areas that are easy for patient to reach for self-administration |
Most commong sites for subQ injections | upper outer arm, abdomen (2in from unbilicus), anterior thigh, scapula, upper ventrodorsal gluteal |
To prevent tissue damage from repeat injections | rotate injection sites |
Amount to administer subQ | 1ml |
To determine subQ needle length | equivalent to 1/2 width of skinfold from pinching tissue up from underlying muscle |
Angle to insert subQ injection for average sized person | 45-90 degrees |
angle to insert subQ injection for obese person | 90 degrees |
Best subQ site for thin person | upper abdomen |
You do not have to __________ before giving subQ injection | aspirate |
Once subQ needle is inserted | release pinched skin and use hand to stabilize syringle |
vastus lateralis needle size, oil-based or viscous solutions | 18-25 gauge, 1-1.5" |
vastus lateralis needle size, aqueous solution | 22-27 gauge, 1-1.5" |
vastus lateralis needle length for infant | 1" |
deltoid needle size | 5/8-1" |
ventrogluteal needle size, oil-based or viscous solutions | 18-25 gauge, 1-1.5" |
ventrogluteal needle size, aqueous solutions | 22-27 gauge, 1-1.5" |
infant, toddler, 3+ children ventrogluteal needle size | 21-25 gauge, 1/2-1" |
intradermal needle size | 25-27 gauge, 3/8-5/8" |
SubQ needle size | 25-30 gauge, 3/8-5/8" |