b. Option : If patient’s muscle mass is small, grasp body of muscle between thumb and forefingers. c. After needle pierces skin, still pulling on skin with nondominant hand, grasp lower end of syringe barrel with fingers of nondominant hand to stabilize it. Move dominant hand to end of plunger. Avoid moving syringe. d. Pull back on plunger 5 to 10 seconds. If no blood appears, inject medication slowly at rate of 10 sec/mL. e. Wait 10 seconds, smoothly and steadily withdraw needle, release skin, and apply gauze gently over site. 16. Apply gentle pressure to site. Do not massage site. Apply bandage if needed. 17. Help patient to comfortable position. 18. Discard uncapped needle or needle enclosed in safety shield and attached syringe into puncture- and leak-proof receptacle. 19. Remove gloves and perform hand hygiene. 20. Stay with patient for several minutes and observe for any allergic reactions. Evaluation 1. Return to room in 15 to 30 minutes and ask if patient feels any acute pain, burning, numbness, or tingling at injection site. 2. Inspect site; note any bruising or induration. Apply warm compress to site. 3. Observe patient’s response to medication at times that correlate with onset, peak, and duration of medication. 4. Ask patient to explain purpose and effects of medication Recording and Reporting Immediately after administration, record medication, dose, route, site, time, and date given on MAR. Correctly sign MAR according to agency policy.
Record patient teaching, validation of understanding, and patient’s response to medication in nurse’s notes and electronic health record (EHR). Report any undesirable effects from medication to patient’s health care provider and document adverse effects in record. Special Considerations Teaching : Patients who require regular injections (e.g., vitamin B12) need to learn techniques of self- administration. Teach a family member or significant other injection techniques and the importance of rotating sites to decrease the risk for hypertrophy. Have patient perform several return demonstrations of medication preparation to validate that learning has taken place. Pediatric : Children can be very anxious or fearful of needles. Help with proper positioning and holding the child is sometimes necessary. Distraction such as blowing bubbles and pressure at the injection site before giving the injection can help alleviate anxiety. Gerontologic : Older patients may have decreased muscle mass, which reduces drug absorption from IM injections. In addition, older adults may have loss of muscle tone and strength that impairs mobility, placing them at high risk for falls from guarding an injection site. Home Care : Self-administration of an IM injection is difficult, especially in the vastus lateralis. Teach a significant other to identify and administer injections in this site. Instruct adult patients who require frequent injections to apply EMLA cream to the injection site before administration. Patients need instruction in safe disposal of syringes and needles.
- Fall '12
- Nursing, Hypodermic needle, Syringe, ampule