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NURSING INJECTIONS
INJECTIONS
• Is insertion into the body with a syringe • Is a way to give medication• Has a different a technique for each type• Requires standard precaution & some require
sterile technique• Can cause complications– Hematoma– Bleeding– Infection
INJECTIONS
• Type of Injections– Subcutaneous– Intradermal– Intramuscular– Intravenous (a separate lesson)– Z Track Method
SUBCUTANEOUS INJECTION
• Made into loose tissue between dermis & muscle layer• Absorption is slower that IM or IV• < 2 mL deposited• Always perform premedication assessment• Always follow 8 Rights of Administration• Given at 45 degree angle• Rotate injection site• Common sites :
– Upper arm– Anterior thighs– Abdomen
• Most common– Heparin– Enoxaparin (Lovenox)– Insulin
SQ TECHNIQUE
• Wash hands
• 2 identifiers
• 8 Rights of Administration
• Check master rotation
schedule
• Explain procedure
• Provide privacy
• Don gloves
• Expose site
• Cleanse skin (circular motion) & allow drying
• Grasp skin creating a small roll
• Insert needle @ 45 degree angle
• Inject slowly
• Withdraw needle w/gentle pressure
• DO NOT RECAP
• Remove gloves
• Wash Hands
• Provide emotional support & answer all questions as appropriate
• Education
SQ INJECTION
INTRADERMAL INJECTIONS• Into dermal layer• Small volumes usually 0.1 mL• Absorption is slow• Always perform premedication assessment• Routes:
– allergy sensitivity test– desensitization injections– local anesthetics– Vaccinations
• 15 degree angle• Sites
– on any surface– Hairless– Upper chest– Scapular– Inner forearms
ID TECHNIQUE
• Wash hands• Provide privacy• 2 identifiers• 8 Rights• Don gloves• Prepare solution
w/aseptic technique• Insert needle @ 15
degree angle bevel up
• Remove needle quickly• Do Not Wipe site
w/alcohol afterwards• DO NOT RECAP put in
sharps container• Wash hands• Provide emotional
support• Answer all question as
appropriate• Provide Education
ID INJECTIONS
INTRAMUSCULAR INJECTION
• Penetrates thru dermis and subcutaneous tissue into muscle layer
• Medication deep in muscle mass• Absorption more rapid than SQ• Site selection important• Incorrect placement may cause nerve or blood vessel
damage• Muscles free from infection or wounds• 0.5-2 mL & 0.5-1 mL for infants or children• Divide doses in amt. > 3 mL (adults)• 20-22 gauge
IM SITES
• Vastus Lateralis• Rectus Femoris• Gluteal area – dorsogluteal not used < 3yrs– Ventrogluteal < 2yrs
• Deltoid
IM TECHNIQUE• Wash hands
• 2 Identifiers
• 6 Rights
• Check agency policy if 0.1 or 0.2 mL or air
• Consult master rotation schedule• Explain procedure
• Provide privacy
• Don gloves
• Cleanse skin circular motion & allow drying
• Insert needle correct angle (90 degree) & depth
• Aspirate & then if no blood return
• Slowly inject gently w/steady pressure
• Remove needle apply gentle pressure
• Apply bandage
• DO NOT RECAP but put in sharps container
• Remove gloves
• Wash hands
• Provide emotional support & answer questions as appropriate
• Education
VASTUS LATERALIS INJECTION
IM INJECTIONS
Ventrogluteal Site Deltoid Site
Z TRACK INJECTION
• IM injection• 90 degree angle• Into dermis down to the muscle layer• Iron Dextran injections• Prevent Drug from staining or irritating
sensitive tissue
Z TRACK METHOD
• Always perform premedication assessment• Assess skin integrity• Assure skin is able to stretch ~1 inch• Wait 10 sec. after injection• DO NOT MASSAGE• Never Inject into Arm
Z TRACK METHOD
• Wash hands• 2 Identifiers• 8 Rights of Administration• Provide privacy• Don gloves• Expose dorsogluteal site• Calculate & prepare then add
0.5 mL of air• Position client• Cleanse area• Stretch skin to 1 side 1 in.
• Insert needle 90 degree angle• Aspirate & if no blood return• Gently inject med & wait 10
sec.• Remove needle allow skin to
return to its position• DO NOT MASSAGE OR RECAP
& dispose• Remove gloves• Wash hands, provide support• EDUCATE
Z TRACK METHOD
THANK YOU!