IM, SubQ, ID Flashcards

Hypodermic needle
Terms Definitions
Needle lengths range from __ to __
5/16 to 2 inches
Needle gauges range from __ to __
18 to 30
The larger the gauge/diameter, the smaller the gauge/diameter
Larger gauge=smaller diameter
Criteria to consider when choosing your equipment
Route of administrationViscosity of the solutionQuantity to be administeredBody size of patientType of medication
You should use powders within __ hours
When do you use intramuscular injections?
When meds need to be absorbed quickly, in areas with many blood vessels
Sites of intramuscular injections
VentroglutealVastus lateralisDeltoidDorsogluteal
Smaller muscles such as the deltoid shouldn't get more than __ mLs
What position should the client be in to receieve an IM injection in the ventrogluteal?
Supine or lateral
How many mL are usually used in IM injections in the ventrogluteal?
1-3 mL
What size gauges are usually used in IM injections in the ventrogluteal?
20-30 gauge
What is the preferred site for IM injections?
What size needles are used for IM injections?
1.5 - 2.5 inch
What are the landmarks for the ventrogluteal injection site?
Palm over trochanterMiddle finger up to iliac crestGo between middle finger and ring finger
How many mL are usually used in IM injections in the deltoid?
0.5-1, no more than 2
What size gauge should be used for IM injections in the deltoid?
23 or 25 gauge
What size needle should be used for IM injections in the deltoid?
5/8 to 1 1/2 inch
What are landmarks of the deltoid muscle?
AcromionClavicleHead of humerus
What site is preferred for IM injections in infants <7 months?
Vastus lateralis
How many mLs would you give in an IM injection in the vastus lateralis?
Pedi up to 1 mLAdult 1 - 1.5 mL
What size gauge should be used for IM injections in the vastus lateralis?
20-30 gauge
What size needle should be used for IM injections in the vastus lateralis?
1 1/4 - 2 1/2 in
Where do you place your hands before giving IM injection in vastus lateralis?
Palm over greater trochanter, other palm above kneeLateral side
Why is Z track used?
To prevent medication from leaking to surface or subq tissueAdvised for meds that cause skin discoloration
What is the choice site for Z tracking?
For IM injections - No more than __ mL recommended in one site
4 mL
Why do we rotate IM injection sites?
To reduce discomfort
If drawing from vial and ampule, which do you draw from first?
Potential complications associated with IM injections
MyofibrosisInjury to nervesSterile abscessInjection into a vessel
What is myofibrosis?
Hardening; development of sclerotic/scar tissue
What can cause osteomylitis?
Injury from IM injection caused by the medication deposited into the tissue
Each time you inject into a vial, you need to...
Change the needle because the rubber top makes the needle less sharp
What size syringe are used with intradermal injections?
1 mL
What size gauge are used with intradermal injections?
25-27 gauge
What size needle are use with intradermal injections?
1/4 - 5/8 inch
Intradermal injections are frequently used for...
Allergy testing and tuberculosis screening
Common sites for intradermal injections
Inner lower armUpper chestBack beneath the scapula
At what angle do you insert the needle for an intradermal injection?
10 - 15 degree
Do you massage the site of an intradermal injection?
Subcutaneous injections are given where?
Into the loose and connective tissue between the second layer of skin and the muscle
Common sites for subcutaneous injections include:
Outer aspect of upper armsAnterior aspect of thighsAbdomenScapular areasUpper ventrogluteal or dorsogluteal
Medications commonly administered by the subcutaneous route include:
VaccinesPreoperative medicationsNarcoticsInsulinHeparin
What dosages are usually given by the subcutaneous route?
0.5 mL to 1 mL
What size syringes are usually used for subcutaneous injections (how many mL's)?
2 mL
What size gauges are used for subcutaneous injections
25 gauge, 5/8 inch for adults1/2 inch for children
What angle is used for subcutaneous injections?
45 degrees
How do you determine needle length for subcutaneous injections?
Pinch tissue and select lenth that is 1/2 the width of the skinfold
Insulin syringes are supplied in what unit sizing?
30, 50, 100
Insulin needle size & gauge size is generally...
30 gauge5/16 length
Heaparin is given with what kind of syringe?
Tb (1 ml size)
Subq injections should be given at what angle?
45 - 90 degrees
In subq injections, if more than 1/2 inch of adipose tissue choose what angle, and what do you do to the skin?
Choose 90 degree angle and spread the skin
In subq injections, if skin is thin or lean, what angle do you choose, and what do you do to the skin?
Choose 45 degree angle and pinch the skin
If bleeding occurs after a subq injection, what can the nurse do?
Apply pressure
When mixing insulins, get clear/cloudy first.
Insulin is absorbed more quickly where?
Insulin is absorbed more slowly where?
Current recommendations for insulin injections are to rotate sites..
Within an anatomical area
Does the nurse aspirate before giving insulin?
What site is Heparin given?
What size/gauge needle is used to administer Heparin?
3/8 inch25 or 26 gauge
What angle do you insert a Heparin injection?
90 degree
If administering Heparin and client is very lean, what actions?
Use longer needle (maybe) and insert at 45 degree angle
Do you aspirate before administering Heparin?
Do you massage the site after subq injection?
No, could cause bleeding, bruising, or hasten drug absorption
Lovenox come in what kind of syringes?
Individual prepared syringes
When administering ____, there will be an air bubble that the nurse should not remove.
In what site should Lovenox be given?
Alternate left and right anterolateral and posterolateral abdominal wall
Do you aspirate before administering Lovenox?
What medications are given subq?
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