Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes PDF

Chapter 10 Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes Clayton’s Basic Pharmacology for Nurses, 19th edition Michelle Willihnganz, MS, RN, CNE 1  Less...

Chapter 10 Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes Clayton’s Basic Pharmacology for Nurses, 19th edition Michelle Willihnganz, MS, RN, CNE 1  Lesson 10.1 Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes (1 of 2) 1. Describe the technique that is used to administer a medication via the intradermal route. 2. List the equipment needed and describe the technique that is used to administer a medication via the subcutaneous route. 3. Describe the techniques used to administer medications intramuscularly. 2  Lesson 10.1 Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes (2 of 2) 4. Describe the landmarks that are used to identify the vastus lateralis muscle, the rectus femoris muscle, the ventrogluteal area, and the deltoid muscle sites before medication is administered. 5. Identify suitable sites for the intramuscular administration of medication in an infant, a child, an adult, and an older adult. 3  Intradermal Route  Any skin surface can be used, but the preferred sites are upper chest, inner aspect of the forearms, and scapular area of the back  Two methods used for allergy testing  Intradermal injection method  Skin prick test (SPT) method 4  Audience Response Question 1  Which route of administration is used for allergy testing? a) Intravenous b) Intramuscular c) Subcutaneous d) Intradermal 5  Subcutaneous Route  Medication is deposited in the loose connective tissue between the dermis and muscle layer  Common drugs injected subcutaneously include:  Heparin  Insulin  Enoxaparin  Sites commonly used include upper arm, anterior thighs, and abdomen 6  Audience Response Question 2  The nurse is to administer a dose of insulin subcutaneously to an adult with a very thin build. After prepping the intended injection site and bunching the skin, at what angle of entry does the nurse inject the drug? a) 15 degrees b) 30 degrees c) 45 degrees d) 90 degrees 7  Intramuscular Route (1 of 4)  Injection deep into muscle mass  Sites include:  Vastus lateralis muscle  Rectus femoris muscle  Ventrogluteal area  Dorsogluteal area  Deltoid muscle  Age and muscle mass are factors to consider when giving IM injections 8  Audience Response Question 3  Of the following dosage amounts ordered for an adult patient, which one should the nurse question? a) 4 mL IM b) 5 mL IV c) 0.05 mL intradermal d) 1 mL subcutaneous 9  Audience Response Question 4  When choosing a needle for an IM injection for an adult, which gauge range is most appropriate? a) 16 to 18 b) 18 to 20 c) 20 to 22 d) 23 to 25 10  Audience Response Question 5  Which injection site must not be used in children younger than 3 years because of underdeveloped muscle? a) Rectus femoris b) Dorsogluteal c) Ventrogluteal d) Deltoid 11  Intramuscular Route (2 of 4)  Volume of medication  0.5 to 2 mL typical volume used for IM  1 mL or less is used for pediatric patients  Needles used  1 to 1½ inches long  Gauge commonly used: 20 to 22  Site commonly used in infants: Vastus lateralis  Sites commonly used in adults: Gluteal area, deltoid, vastus lateralis 12  Intramuscular Route (3 of 4)  Deltoid muscle: Not to exceed 1 mL in volume  Landmarks for deltoid include the acromion process and axilla  Identify correct sites for vastus lateralis muscle, rectus femoris muscle, and gluteal area  Z-track method: May be appropriate for medications that are particularly irritating or that stain the tissue 13  Intramuscular Route (4 of 4)  Provide right documentation of the medication administration and the patient’s response to drug therapy  Chart the date, time, drug name, dose, site, and route of administration  Perform and record regular patient assessments for the evaluation of the therapeutic effectiveness  Chart and report any signs and symptoms of adverse drug effects  Perform and validate essential patient education 14 Questions? 15