Administering Intramuscular Injections
Preparation:
- Review procedure "Administering Intramuscular Injections" in Fundamentals of Nursing.
Checklist Performed
Procedure |
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1. Gather supplies: MAR, alcohol swabs, vial or ampule of medication, clean gloves and 3 ml syringe, #20 to #22 gauge 1" to 1 1/2" inch needle. |
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2. *Calculate the correct amount of medication to administer. |
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3. *Wash hands. |
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4. *Using five rights of medications check against MAR and note any allergies. |
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4. Withdraw correct medication from vial or ampule and recap using one-handed method. Use filter needle to withdraw medication from an ampule, replace with injection needle after drawing up medication. |
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5. Label syringe with the name of the drug using tape or preprinted medication labels. |
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6. *Identify client using two identifiers found on MAR and ID bracelet. Recheck medication against MAR. |
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7. Explain procedure and reason for medication to client. |
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8. Apply clean gloves and determine appropriate site. Use anatomical landmarks to locate exact injection site. |
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9. Cleanse injection site with alcohol swab in a circular motion starting at site and working away from area. |
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10. Using nondominant hand spread skin with thumb and forefinger. |
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11. Remove needle guard and hold syringe like a dart between thumb and forefinger. |
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12. Insert needle at a 90-degree angle to client's skin surface. |
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13. Using nondominant hand stabilize syringe while using dominant hand to aspirate on plunger. If no blood appears slowly inject medication. If blood appears remove needle and prepare a new dose of medication. |
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Checklist Performed
Procedure |
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14. Withdraw needle and use alcohol swab to apply pressure to site. Gently massage site. |
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15. Dispose of syringe and needle directly into sharps container. Do not recap. |
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16. *Wash hands
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17. Using the sixth right of medication administration correctly document procedure according to hospital policy.
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Student passed ___ did not pass ___ procedure
Evaluator _________________ Student______________________
Hints from previous students and faculty:
IM and SQ Injection Sites
Dorsogluteal (upper outer quadrant of buttock): greatest for damage of the sciatic nerve. Place hand on iliac crest and locate posterior-superior iliac spine; draw an imaginary line between the trochanter and iliac spine and inject in the upper outer quadrant. Or you can divide the buttocks in fourths and inject in the upper outer aspect of buttocks. DO NOT USE IN CHILDREN UNDER 5 YEARS OF AGE! Muscle is not developed enough to tolerate injection
Ventrogluteal (side): preferred site is away from major blood vessels and sciatic nerve. To find the site, place the palm of the left hand on R trochanter; index finger points toward anterior-superior iliac spine…spread first and second fingers to form a V and inject in the middle of the V.
Deltoid (arm): one hand 2-3 fingers widths below the acromion process and the other at the axilla. Use 1" below the process in children.
Vastus Lateralis : anterior lateral aspect of the thigh; no major blood vessels or nerves nearby; safe for all ages. Identify greater trochanter then place hand on knee. The site is in between these two landmarks
