Drug Administration and Injection Techniques
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Questions and Answers

What should you always use to avoid administering medication from memory?

Always use the prescription chart.

Why is it important to check patient identification even for well-known patients?

To ensure the correct patient receives the appropriate medication.

What is the potential risk of leaving drugs on lockers?

Patients may forget to take them or another patient could mistakenly take them.

What should not be done with an unused dose of medication?

<p>Do not return it to a stock bottle.</p> Signup and view all the answers

How can staff ensure that local Policies align with current clinical practices?

<p>By informing their Manager of changes in practice.</p> Signup and view all the answers

What can you do to reduce potential medication errors when administering drugs?

<p>Administer drugs to a familiar group of patients.</p> Signup and view all the answers

Why is it important to consider the timing of doses for patients?

<p>Incorrect timing can lead to forgotten doses or mistakes by other patients.</p> Signup and view all the answers

What role do fail-safe policies play in drug administration?

<p>They alert staff to danger signals that may lead to an error.</p> Signup and view all the answers

What are the two sites mentioned for intramuscular injections in the provided content?

<p>The dorso-gluteal site and the ventro-gluteal site.</p> Signup and view all the answers

How can the vastus lateralis muscle be located for an injection?

<p>By measuring a hand's breadth down from the greater trochanter and up from the knee, identifying the middle third of the muscle.</p> Signup and view all the answers

What is the acceptable absorption volume for intramuscular injections in adults?

<p>1–4 ml.</p> Signup and view all the answers

What gauge needles are recommended for adult intramuscular injections?

<p>21 (green) or 23 (blue) gauge needles.</p> Signup and view all the answers

Why is it important to use a large needle for adult injections?

<p>To ensure that the injection reaches the muscle layer and does not end up in adipose tissue.</p> Signup and view all the answers

What is one of the required steps before preparing an intramuscular injection?

<p>Wash hands and put on gloves.</p> Signup and view all the answers

What type of procedure is preparing an injection considered?

<p>An aseptic procedure.</p> Signup and view all the answers

What checks should be performed concerning the injection equipment?

<p>Ensure that all equipment is sealed and used within its expiry date.</p> Signup and view all the answers

What is the purpose of flicking the top of a glass ampoule before use?

<p>To encourage all fluid to drain into the reservoir.</p> Signup and view all the answers

How should one protect their fingers when breaking the top off a glass ampoule?

<p>By using a tissue or piece of gauze.</p> Signup and view all the answers

What is the significance of cleaning the rubber bung of a vial before use?

<p>To prevent contamination of the medication.</p> Signup and view all the answers

What should be done before drawing medication from a closed vial?

<p>Draw up the equivalent amount of air into the syringe and inject it into the vial.</p> Signup and view all the answers

Why is it important to keep the needle bevel under the fluid level when drawing up a drug?

<p>To reduce the amount of air drawn up in the syringe.</p> Signup and view all the answers

What is the recommended angle for the needle and syringe when drawing up medication?

<p>A V shape.</p> Signup and view all the answers

What technique should be used to expel air bubbles from the syringe after withdrawing medication?

<p>Tap the syringe firmly while holding it needle uppermost.</p> Signup and view all the answers

How can larger syringes be adjusted to aid in the expulsion of air?

<p>By tipping the syringe to a slight angle.</p> Signup and view all the answers

Why is it important to change the needle before administering an injection?

<p>Changing the needle ensures that the injection is given with a clean, dry, sharp needle, which reduces pain and prevents possible sharps injuries.</p> Signup and view all the answers

What should a nurse do to verify a patient's identity before administering an injection?

<p>The nurse should call the patient by name and confirm their identity and consent.</p> Signup and view all the answers

What is the recommended angle for inserting a needle during an injection?

<p>The needle should be positioned just above the skin at a 90° angle.</p> Signup and view all the answers

What actions should be taken to prepare the injection site according to local policy?

<p>The skin should be cleaned with an alcohol swab for 30 seconds and allowed to dry for another 30 seconds.</p> Signup and view all the answers

What should the nurse do if the dose in the syringe is very small after expelling air?

<p>If the dose is very small, the nurse should not expel the air until after changing the needle to minimize wastage.</p> Signup and view all the answers

Why is it recommended to explain the reason for an injection to the patient?

<p>Explaining the reason helps the patient give informed verbal consent and allows them to prepare for the procedure.</p> Signup and view all the answers

How should the nurse position the patient before administering an injection?

<p>The nurse should assist the patient into an appropriate position depending on the chosen injection site, ensuring comfort and dignity.</p> Signup and view all the answers

What technique should be used to insert the needle during the injection?

<p>The needle should be inserted three-quarters of its length using a dart-like action.</p> Signup and view all the answers

What technique can be used to minimize discomfort for needle-phobic patients before an injection?

<p>Using ice or freezing spray can numb the skin before injecting.</p> Signup and view all the answers

Why is it important to rotate injection sites when administering subcutaneous injections?

<p>Rotating injection sites prevents overuse and reduces the risk of tissue damage.</p> Signup and view all the answers

What angle should the needle be positioned when administering an injection to avoid tissue displacement?

<p>The needle should be positioned at a 90° angle to the skin.</p> Signup and view all the answers

What is the recommended rate for injecting medication to allow muscle accommodation?

<p>The recommended rate is about 1 ml per 10 seconds.</p> Signup and view all the answers

What should be done after injecting medication to ensure proper diffusion?

<p>Wait for 10 seconds after the injection before removing the needle.</p> Signup and view all the answers

What is the primary reason to avoid injecting insulin into muscle tissue?

<p>Injecting into muscle may increase absorption rate and risk hypoglycemia.</p> Signup and view all the answers

What types of syringes are recommended for insulin administration?

<p>An insulin syringe or a 1 ml syringe with a 25 or 27 gauge needle is recommended.</p> Signup and view all the answers

What areas are preferred for self-administered subcutaneous insulin injections?

<p>The outer upper arms, upper thighs, and lower abdomen are preferred sites.</p> Signup and view all the answers

Study Notes

Drug Administration

  • Always use a prescription chart, never administer from memory.
  • Always check patient identification.
  • Never administer drugs you have not witnessed being prepared.
  • Never leave drugs on lockers to be taken later.
  • Never return an unused dose to a stock bottle.
  • Never leave an open drug cupboard or trolley unattended.
  • Trusts should have clear policies concerning drug administration, mechanisms, supervision and training for drug administration, and for reporting 'near misses'.
  • Policies should be followed to prevent error and litigation, as such policies promote good practice.
  • New knowledge and practice may become accepted within a trust, but not recorded immediately within Policies, you should ensure your manager is aware of these changes.

Intramuscular Injection

  • Vastus lateralis and rectus femoris are good sites for injections into toddlers with wasting muscles, as they are easy to bunch up.
  • Vastus lateralis is located on the side of the leg, and the rectus femoris is at the front of the thigh.
  • Typical absorption volume is 1-4 ml.
  • When giving an IM injection, a large needle should be used for adults to ensure the injection reaches the muscle layer, as short needles may result in the injection going into the adipose tissue, reducing effectiveness.
  • Use a sterile 2ml or 5 ml syringe, 2 x 21 (green) or 23 (blue) gauge needle, alcohol wipe, gauze swab, receiver, prescribed drug and prescription sheet, gloves, and apron.

Preparing an Intramuscular Injection:

  • Wash hands and put on gloves
  • Prepare drug vial, carry out the same checks as described in the procedure for oral drug administration.
  • When using a glass ampoule, flick the top of the ampoule to encourage all fluid to drain into the reservoir. Use a tissue or gauze to protect your fingers from glass cuts when breaking the top off.
  • When using a vial with a rubber bung, remove the cover using scissors or forceps. Clean the rubber bung with an alcohol wipe
  • Assemble needle and syringe, uncap the needle
  • Never resheath an uncapped needle.
  • If the drug requires mixing with a diluent, draw up the equivalent amount of air into the syringe, steady the vial on a flat surface, insert the syringe into the vial and inject the vial with the air.
  • Ensure drug is dissolved before aspirating the medication into the syringe.
  • Keep the needle bevel under the fluid level at all times, to reduce the amount of air drawn up in the syringe.
  • Adjust the angle of needle and syringe to a V shape while drawing up.
  • Withdraw the required amount into the syringe. Remove the vial, hold the syringe with the needle uppermost, and tap the syringe firmly to encourage air bubbles to rise to the top.
  • Change the needle - this ensures the injection is given with a clean, dry, sharp needle, reducing pain and preventing possible sharps injury.
  • Recheck the amount of dose in the syringe after you have expelled the air, to ensure you still have the right amount.
  • If the dose is very small, do not expel the air until after you have changed the needle, so you have minimal wastage.

Administering Intramuscular Injections

  • Explain the reason for the injection to the patient to allow them to consent to receive the injection.
  • Take the prepared injection and prescription sheet to the patient's bedside.
  • Call the patient by name, and confirm their identity and consent.
  • Close the curtains to provide privacy, and assist the patient into an appropriate position, depending on the chosen injection site, draping the bed and their nightclothes.
  • Locate the site by identifying the anatomical landmarks, and encourage the patient to relax.
  • If local policy dictates, the skin should be cleaned with an alcohol swab for 30 seconds, and allowed to dry for 30 seconds.
  • Remove the needle cap, stretch the skin taut with your thumb and index fingers of your non-dominant hand.
  • Position the needle just above the skin at a 90° angle, holding the syringe barrel like a dart. Warn the patient that they will feel a sharp prick.
  • Insert the needle three-quarters of its length in, using a dart-like action.
  • Aspirate to allow any blood to surface.
  • Consider using ice or freezing spray to numb the skin before injecting, particularly for needle-phobic patients or children.
  • Use the Z track technique.
  • Rotate injection sites and document to ensure no one site is overused.
  • Enter the skin firmly with a controlled thrust, positioning the needle at an angle of 90° to prevent shearing and tissue displacement.
  • Inject medication steadily and slowly - about 1 ml per 10 seconds - to allow the muscle to accommodate the fluid.
  • Wait 10 seconds after completion of the injection to allow diffusion throughout the muscle.
  • Then remove the needle at the same angle as it entered.
  • Apply gentle pressure to the site, but do not massage as this can irritate the local tissue.

Subcutaneous Injections

  • Small amounts of medication (0.2–2 ml) are given into the subcutaneous tissue to allow a slow, sustained absorption of medication.
  • Subcutaneous injections are an ideal route for insulin, which requires frequent injections, but are also used regularly for heparin.
  • Preferred sites for self-administered SC injections are the outer upper arms, the upper thighs, and the lower abdomen around the umbilicus.
  • Nurses can also use the back of the upper arms, outer thighs and upper buttocks, but these are not accessible for self-administration.
  • If medications are administered into the muscle, it will increase the absorption rate of the drug and in the case of insulin may result in hypoglycaemia, therefore, it is important to ensure the injection does not go too deep.

Equipment for subcunatneous injections

  • Insulin syringe or a 1 ml syringe with a 25 or 27 gauge needle.

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Description

This quiz covers essential practices for drug administration, including the importance of prescription charts and patient identification. It also highlights proper techniques for administering intramuscular injections in pediatric patients and the considerations for site selection. Understanding these guidelines is crucial for ensuring patient safety and effective medication management.

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