Intramuscular Injections Overview

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Questions and Answers

Which of the following is NOT one of the Ten Rights of Medication Administration?

The right documentation

The right medication

The right dosage form (correct)

The right patient education

What is the preferred injection site for larger volumes of medication?

Subcutaneous site

Ventrogluteal (correct)

Deltoid

Vastus Lateralis

Which injection angle is appropriate for intradermal injections?

30 degrees

90 degrees

45 to 90 degrees

15 degrees (correct)

What is the primary purpose of reporting medication side effects to the nurse?

To monitor patient safety and response to medications Signup and view all the answers

Which medication administration site is most suitable for infants and children?

Vastus Lateralis Signup and view all the answers

What is the maximum volume generally recommended for intramuscular injections in the deltoid muscle?

1 mL Signup and view all the answers

What should be confirmed before administering any medication from a multi-dose vial?

Compatibility of medications Signup and view all the answers

Which of the following statements is true regarding the vastus lateralis injection site?

It is free from major nerves and blood vessels. Signup and view all the answers

What is a common reason for a client to display an adverse reaction after an intramuscular injection?

Mixing incompatible medications Signup and view all the answers

Which method is advised for reducing pain at the injection site prior to administration?

Applying EMLA cream or a Vapo coolant 1 hour prior Signup and view all the answers

What is the correct rounding rule when using a 3-mL syringe for drug calculations?

Calculate to hundredths, round to nearest tenth Signup and view all the answers

Which of the following should be avoided to prevent contamination during medication mixing?

Combining medications in the same syringe without checking compatibility Signup and view all the answers

What is a critical consideration when teaching clients about safe disposal of syringes and needles?

They should be disposed of in a sharps container Signup and view all the answers

Which condition is a contraindication for administering IM injections?

Active infection at the injection site Signup and view all the answers

What is one of the advantages of using IM injections over oral administration?

They provide rapid onset of action. Signup and view all the answers

Which of the following clients might be suitable for IM injections?

Clients unable to receive medications orally Signup and view all the answers

What may hinder IM drug absorption in a patient experiencing a specific condition?

Hypovolemic shock Signup and view all the answers

Which of the following limitations applies to IM injections?

Pain is associated with the procedure. Signup and view all the answers

What is a significant risk associated with injecting into the wrong tissue plane during an IM injection?

Delayed action of the drug Signup and view all the answers

Why are depot injections particularly beneficial?

They allow for slow, sustained, and prolonged drug action. Signup and view all the answers

Which aspect of IM injections requires specific skills that cannot be delegated to UCP?

Assessment of injection site for contraindications Signup and view all the answers

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.