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Questions and Answers
Which of the following is NOT one of the Ten Rights of Medication Administration?
Which of the following is NOT one of the Ten Rights of Medication Administration?
What is the preferred injection site for larger volumes of medication?
What is the preferred injection site for larger volumes of medication?
Which injection angle is appropriate for intradermal injections?
Which injection angle is appropriate for intradermal injections?
What is the primary purpose of reporting medication side effects to the nurse?
What is the primary purpose of reporting medication side effects to the nurse?
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Which medication administration site is most suitable for infants and children?
Which medication administration site is most suitable for infants and children?
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What is the maximum volume generally recommended for intramuscular injections in the deltoid muscle?
What is the maximum volume generally recommended for intramuscular injections in the deltoid muscle?
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What should be confirmed before administering any medication from a multi-dose vial?
What should be confirmed before administering any medication from a multi-dose vial?
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Which of the following statements is true regarding the vastus lateralis injection site?
Which of the following statements is true regarding the vastus lateralis injection site?
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What is a common reason for a client to display an adverse reaction after an intramuscular injection?
What is a common reason for a client to display an adverse reaction after an intramuscular injection?
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Which method is advised for reducing pain at the injection site prior to administration?
Which method is advised for reducing pain at the injection site prior to administration?
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What is the correct rounding rule when using a 3-mL syringe for drug calculations?
What is the correct rounding rule when using a 3-mL syringe for drug calculations?
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Which of the following should be avoided to prevent contamination during medication mixing?
Which of the following should be avoided to prevent contamination during medication mixing?
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What is a critical consideration when teaching clients about safe disposal of syringes and needles?
What is a critical consideration when teaching clients about safe disposal of syringes and needles?
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Which condition is a contraindication for administering IM injections?
Which condition is a contraindication for administering IM injections?
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What is one of the advantages of using IM injections over oral administration?
What is one of the advantages of using IM injections over oral administration?
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Which of the following clients might be suitable for IM injections?
Which of the following clients might be suitable for IM injections?
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What may hinder IM drug absorption in a patient experiencing a specific condition?
What may hinder IM drug absorption in a patient experiencing a specific condition?
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Which of the following limitations applies to IM injections?
Which of the following limitations applies to IM injections?
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What is a significant risk associated with injecting into the wrong tissue plane during an IM injection?
What is a significant risk associated with injecting into the wrong tissue plane during an IM injection?
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Why are depot injections particularly beneficial?
Why are depot injections particularly beneficial?
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Which aspect of IM injections requires specific skills that cannot be delegated to UCP?
Which aspect of IM injections requires specific skills that cannot be delegated to UCP?
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Study Notes
Indications for Intramuscular (IM) Injections
- Suitable for noncompliant or uncooperative patients.
- Used when patients cannot receive medications through alternative routes.
- Necessary if the medication is exclusively available for IM administration.
Contraindications for IM Injections
- Not recommended for sites with active infections like cellulitis or dermatitis.
- Contraindicated in patients with known allergies or hypersensitivity to the drug.
- Avoid in cases of acute myocardial infarction, as muscle enzyme release complicates management.
- Caution with thrombocytopenia and coagulation defects due to bleeding risks.
- Not suitable in hypovolemic shock; compromised vascularity affects absorption.
- Myopathies or associated muscular atrophy can delay absorption and increase complication risks.
Advantages of IM Injections
- Allows rapid and uniform drug absorption, particularly with aqueous solutions.
- Provides quicker onset of action than oral or subcutaneous routes.
- Bypasses first-pass metabolism and gastric absorption factors.
- Efficacy comparable to intravenous drug delivery.
- Effective for emergencies like acute psychosis and status epilepticus.
- Depot injections enable slow, sustained drug release.
- Can administer larger volumes than subcutaneous injections.
Disadvantages of IM Injections
- Absorption varies based on muscle bulk and vascularity.
- Onset and duration of action is fixed and cannot be adjusted.
- Difficult landmark identification in children or restrained patients.
- Risk of inadvertent subcutaneous injection leading to delayed action.
- Can be a painful procedure.
- Suspensions and oily drugs are unsuitable for IM administration.
- Self-administration is challenging, complicating patient independence.
- Drug precipitation from rapid solvent absorption may alter efficacy.
IM Administration: Delegation and Collaboration
- IM injection administration cannot be delegated to unlicensed care providers (UCP).
- Nurses must instruct UCP on monitoring for medication side effects and patient condition changes.
Ten Rights of Medication Administration
- Right medication, dose, patient, route, time/frequency.
- Right documentation, reason, right to refuse, patient education, and evaluation.
IM Injection Angles
- Intramuscular: 90 degrees.
- Subcutaneous: 45 to 90 degrees.
- Intradermal: 15 degrees.
Intramuscular Sites
- Ventrogluteal: Preferred for larger volumes, less painful, accommodates 1-3 mL (up to 5 mL for exceptions).
- Vastus Lateralis: Rapid drug absorption, ideal for pediatric immunizations, accommodates 0.5-2 mL.
- Deltoid: Accessible but limited volume (up to 1 mL), used for adult vaccinations.
Administering Intramuscular Injections
- Monitor for unexpected outcomes: localized pain, blood aspiration during injection, adverse reactions, and patient understanding of procedures.
- Special considerations for home care: instruct caregivers on site identification, needle disposal, and potential application of EMLA cream for pain.
Mixing Medications for IM Injections
- Some medications require mixing from vials or ampules; consult compatibility charts.
- Ensure compatibility when mixing to avoid unnecessary injections.
- Follow proper protocols to prevent contamination between medications.
Drug Calculations for IM Injections
- Use the formula: Desired Dose x Volume mL / Dose on Hand.
- Convert volumes to mL, with specific rounding rules based on syringe type (e.g., 3-mL round to nearest tenth).
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Description
This quiz explores the indications, contraindications, and advantages of intramuscular (IM) injections. Designed for healthcare professionals, it covers essential knowledge for safe and effective medication administration. Test your understanding of when and how to use IM injections appropriately.
