Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes

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Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes
2014-03-02 22:49:01
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  1.                       injections are made into the dermal layer of skin just below the epidermis.
  2. Small volumes, usually only                      mL, are injected.
  3. Common sites for injections (should be hairless and receive little friction from clothing):
    • 1. The upper chest
    • 2. The scapula areas of the back
    • 3. The inner aspect of the forearms
  4. Insert the needle at a             degree angle with the needle bevel upward.
    15 degree
  5. a small              will appear on the surface of the skin as the solution enters the intradermal area.
  6. Do Not               any needles that have been used.
  7. Do not wipe with              after an intradermal injection.
  8. After administration, always chart the                ,                  ,                       ,                    , &                      .
    date, time, drug name, sites, and dosage

  9. This route of administration is slow, making it the route of choice for allergy testing, local anesthetics, and Tb Vaccinations
  10. These injections are made into the loose connective tissue between the dermis and muscle layer. (insulin, Heparin)
  11. This type of injection is slower and drug action is generally longer than with IM or IV injections?
    Subcutaneous injections
  12. Many drugs cannot be administered by this route because no more than                mL can ordinarily be deposited at the SQ site.
  13. Commonly used drugs for injection by SQ route are:
    • 1. heparin
    • 2. insulin
  14. Needle lengths of 3/8, 1/2, and 5/8 inch are routinely used for this route of administration.
  15. These needle lengths are routinely used for Subcutaneous administration:
    3/8, 1/2, & 5/8
  16. Common sites used for Subcutaneous injections are:
    • 1. Upper arms
    • 2. anterior thighs
    • 3. abdomen
  17. Common used gauges used for Subcutaneous injections are:
    25-29 gauge
  18. a plan for                      injection sites should be developed for all patients who require repeated injections.
  19. Easy to reach sites for SQ self administration are:
    abdomen and thigh
  20. When administering A SQ injection, it is very important to rotate the injection site to prevent                and                     , which slows the absorption rate of the insulin.
    Lipoatrophy or lipohypertrophy
  21. Absorption is know to be fastest when administered in the                      .
  22. When administering a SQ injection, check the accuracy of the med order against the med being prepared at least               times during the preparation phase.
  23. Always wear               during a SQ injection.
  24. For subcutaneous injection, grasp the skin area of the site selected and create a small roll or               .
  25. For SQ injections, insert the needle quickly at a                degree angle, and slowly inject the medication.
    45-90 degree
  26. Injections made by penetrating a needle through the dermis and subcutaneous tissue into the muscle layer and deposits the medication deep within the muscle mass.
    Intramuscular injections
  27. Intramuscular injection absorption is more            than SQ injections because muscle tissue has a greater blood supply.
  28. Site selection is especially important with IM injections because incorrect placement of the needle may cause damage to                or                .
    nerves or blood vessels
  29. A large, healthy muscle free of                  or                 should be used for Intramuscular injections.
    infections or wounds
  30. The usual amount injected IM at one site is               to                mL.
    0.5mL to 2mL
  31. In infants and children, the amount for IM injection in one area should not exceed                mL
  32. Needles commonly used for IM injections are            to             inches long although there is significant difference among needle lengths appropriate for an obese patient, an infant, or an emaciated or debilitated patient.
    1 to 1 1/2 inches
  33. Commonly used gauges for IM injections are:
    20 to 22 gauge
  34. Common used sites for IM administration of medication include the following:
    • 1. vastus lateralis
    • 2. Rectus femoris
    • 3. Gluteal area
    • 4. Deltoid muscle
  35. Located on the anterior lateral thigh away from nerves and blood vessels. One hand below the greater trochanter and one hand above the knee
    Vastus lateralis
  36. Generally the preferred site used for IM injections in infants, because it has the largest muscle mass for that age-group.
    Vastus lateralis
  37. This IM injection site lies just medial to the vastus lateralis muscle but does not cross the mid line of the anterior thigh.
    Rectus femoris
  38. This IM injection site's primary advantage is used more easily by patients for self administration.
    Rectus femoris
  39. This site must not be used in children younger than 3 years of age because the muscle is not well developed from walking.
    Gluteal area
  40. This site is easily accessible when the patient is in a prone, supine, or side-lying position.
    Ventrogluteal Area
  41. Located by placing the palm of the hand on the lateral portion of the greater trochanter, the index finger on the anterior superior iliac spine, and the middle finger extended on the iliac crest.
    Ventrogluteal Area
  42. To use this site of administration the patient must be placed in a prone position on a flat table surface.
    Dorsogluteal Area
  43. This site is identified by drawing an imaginary line from the posteriosuperior iliac spine to the greater trochanter of the femur. The injection should be given at any point between the imaginary straight line and below the curve of the iliac crest.
    Dorsogluteal area
  44. This site is often used because of ease of access in the standing, sitting, or prone positions.
    Deltoid muscle
  45. In the deltoid area, the volume of med administration should be limited to              mL or less, in adults
  46. A                     method may be appropriate for medications that are particularly irritating or that stain the tissue.
    Z-track method
  47. Z-track method injections should always be given in the                         site
  48. For the z-track method stretch the skin approximately           inch to one side.
  49. For z-track method injections, insert the needle, aspirate, and gently inject the medication and wait              seconds before removing the needle.