Clinical Topics # 3

Medication Administration Part 2 Parenteral Routes

Objectives: Students will: Identify practices to maintain safety in medication administration. Identify various kinds of syringes and their component parts Demonstrate safe administration of parenteral drugs for a variety of patients Discussion questions 1. Why are some medications given oral where others are given IM or su cutaneously! " medication may e given IM or Su #$ as opposed to orally for several reasons. %ne reason is the speed of a sorption. Medications in&ected directly into the ody are a sor ed faster than those taken orally. "lso' some medications can only e given IM or Su #$ (. What are the parts of a syringe and needle!
Parts of the Syringe o o o Plunger Barrel Tip

Parts of a Needle o o o Bevel Shaft Hub & gauge Number

). *+plain the length and ,gauge- or needle si.es! /he lower the gauge of the needle' the wider it is. /he length of a needle is measured in inches and ranges from 0-#)-. 1. What is a disposa le In&ection 2nit! " disposa le in&ection unit is a sterile' prefilled syringe' meant for single dose in&ections of medications. /hese disposa le in&ection units are placed in plastic /u e+ or 3arpu&ect in&ectors which properly dispense these units. 4. Descri e the in&ections sites for IM and su #q medications.
Sub-q administration sites are: a. uter posterior upper arms

b. !bdomen belo" #ostal margins to ilia# #rests #. !nterior aspe#ts of thighs. d. upper ventrals e. dorsal glutes $% administration Sites are: 1.) Ventrogluteal &the area of the gluteus medius' i. ( Safest Site To admin $% $n)e#tion ii. *e#ommended for in)e#tions larger than +ml 2.) Vastus Lateralis &anterior lateral aspe#t of thigh' 3.) Deltoid &shoulder'

5. 6ow does patient7s age and si.e impact parenteral medication administration! /he amount of medication as well as the length and gauge of the needle vary from patient to patient. If a person has a significant amount of adipose tissue' they will need a longer needle in order to properly administer the in&ection. 8. *+plain how to prepare and in&ection from an ampule and from a vial. Ampule Injections In order to get to the medication of the ampules' the neck must first e snapped off. /hen' the medication must e carefully aspirated into a syringe with a filter need to prevent any small particles from entering the syringe. Injections From Vial Insert the needle into the ottle and in&ect a small amount of air in order to prevent a vacuum from occurring. 9ou may want to use a filtered needle to prevent any particles of the ru er seal from eing suctioned into the syringe. :. What are the steps in performing an intramuscular in&ection! When administering an IM in&ection' use a longer' heavier gauge needle to pass the su #q tissue. ;ind a proper spot to administer the in&ection <either the ventrogluteal region' vastus lateralis' or the deltoid=. >e sure there are no lessions or open wounds. 2se the ?#track method and insert the needle into the muscle at a @A degree angle. @. What is the ?#track method of intramuscular in&ections! /he ?#track method of IM in&ections is a method of securing medication within the ody after in&ection. /he method is as follows: 2sing the ulnar side of your non#dominant hand' pull the skin of the site of administration taunt. Benetrate the skin with the need and hold it in place with the thum and the inde+ finger. Wait momentary to look for any lood. If no lood is present' slowly administer the education over a 1A second period. When the

medication has een administered' remove the needle and release the skin. /he skin returning to it7s original position aids in keeping the medication in place. 1A. What are the steps in performing a su cutaneous in&ection! 3hoose the needle ased on the patients si.e. ;ind an accepta le area of the outer posterior upper arms' the a dominal area elow the um ilicus to the iliac crests' anterior aspects of thighs' upper ventral or dorsal gluteal areas. Skin should e free of lesions and oney processes. Crasp the tissue. If you can grasp two inches of tissue' insert the needle at a @A degree angle. If you can grasp 1 inch of tissue' insert needle at 14 degrees. 11. What are the steps in performing an intradermal in&ection! ;ind an area on the skin free of oney processes or lesions. 2se a tu erculin or hypodermic syringe and insert the needle at a 4 to 14 degree angle with the evel of the need pointed up. .