ID and Insulin F24 student.pdf

Intradermal Injections Intradermal injections are made into the dermal layer of skin just below the epidermis Small volumes, usually 0.1 mL, are injected. The absorption from intradermal sites is slow, making it the route of choice for allergy sensitivity tests, desensitization injections, local...

Intradermal Injections Intradermal injections are made into the dermal layer of skin just below the epidermis Small volumes, usually 0.1 mL, are injected. The absorption from intradermal sites is slow, making it the route of choice for allergy sensitivity tests, desensitization injections, local anesthetics, and vaccinations.  Intradermal Injections Typically given for skin testing Use a tuberculin (TB) or small syringe with a needle 1/8- to 5/8-inch needle 25 to 27 fine-gauge needle 1mL syringe Insertion angle is 5 to 15 degrees Inject only small amounts of medication (0.01 to 0.1 mL) Intradermal Injections Precautions If a bleb does not appear or if the site bleeds after needle withdrawal, the medication may have entered subcutaneous tissues. In this situation skin test results will not be valid. If administering allergy testing assess for anaphylactic reaction- dyspnea, wheezing, severe skin reaction Apply tourniquet above site to reduce reaction Intradermal Teaching Do not squeeze medication from site. Negative skin tests may not rule out allergies. Wear identification band listing all allergies. Do not wash off markings around site. Observe for skin reactions. Intradermal Sites Intradermal Allergy Testing Subcutaneous Injections Angles Perry, Anne Griffin. Clinical Nursing Skills and Techniques, 7th Edition. Mosby Subcutaneous Injection Sites  Insulin Injections Gather equipment- insulin syringe & medication Verify medication orders Check capillary blood glucose Confirm diet and activity for client Insulin Syringes Use for INSULIN ONLY—do not give insulin with any other syringe Measured in units Syringe calibrated to match insulin doses U-100 syringes for U-100 insulin NEVER think in terms of mL when giving insulin; think in units! Two types Lo-dose 1-mL sizes  Insulin Syringes Lo-dose insulin syringes Have 30- or 50-unit capacities Have enlarged scales for easy reading Standard insulin syringe Capacity of 100 units of insulin 2-unit increments SAFETY ALERT! Insulin is a high-alert medication. Always check insulin dosages with another nurse before administration. Subcutaneous Syringes & Needles Types of Insulin Rapid-acting Onset: 10 to 15 minutes; peak: 1 to 3 hours; duration: 3 to 5 hours Short-acting Onset: 30 minutes; peak: 2.5 to 5 hours; duration: 5 to 10 hours Intermediate-acting Onset: 4 hours; peak: 4 to 12 hours; duration: 16 to 24 hours Long-acting Onset: 1 hour; no peak; duration: 24 hours Insulin Properties When administering insulin, you need to know the following and act accordingly: Onset- Is the client eating? Peak- When will the risk of hypoglycemia occur? Duration- When will I need to give another dose? Lilley Types of Insulin Rapid-acting—all Short-acting: are clear solutions: Humalog Humulin R; (lispro)—onset Novolin ge