Fundamentals of Nursing: Administering Intramuscular Injections

 
 
Fundamentals of  Nursing(1
st
 Stage)
 
Part I:  10  Theory-Practice
Administering Intramuscular
injections (IM)
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
2
Introduction
An intramuscular (I.M) injection is a procedure
used to insert (Drugs or Vaccines)into the
muscle tissue.
There is an adequate supply of blood. This
facilitates fast absorption, which can lead to
better effect.
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
3
 
 
The speed of absorption is 
faster for
intramuscular injection 
compared to
subcutaneous injection. 
because the
muscle tissue has a greater blood supply
than the area just under the skin.
Intramuscular injections should be
administered 
90 degree angle as
possible.
 
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
5
Sites of intramuscular injection
Sites of intramuscular injection
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
6
Vastus lateralis muscle
The muscle is thick and well developed.
Used in adult and is preferred site for
administration of biologicals
(immunizations) to infant.
The middle third  of the muscle is the
suggested site for injection.
 
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
 
6
 
7
Deltoid muscle
 
The injection site is in the center of
the triangle, about 3 to 5 cm below
the acromion process.
 
This site has a potential for injury
because the axillary nerve lies
beneath the deltoid
 
7
Deltoid muscle
 
Used for:
1.
small medication volumes (0.5 to 1  ml).
2.
Administration of routine immunization.
3.
When other sites are inaccessible
because of dressing.
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
7
Deltoid muscle
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
8
Ventrogluteal muscle
 
The ventrogluteal muscle involves the 
gluteus medius and
minimus.
It is situated deep and away from major nerves and blood vessels
and is a safe for all clients.
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
8
Ventrogluteal muscle
 
Is a preferred injection site for infants, especially for administration
of  irritating or oily solutions, children, and adults.
The index finger, the middle  finger, and the iliac  crest form V-
shaped triangle ,and the injection site  is the center of the triangle.
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
9
Gluteus medius muscle
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
10
 
1.
 Abscess.
2.
 Hematoma.
3.
 Injury to blood vessels.
4.
 Pain at the injection site.
5.
 Tingling or numbness.
6.
 Infection.
7.
 Bleeding.
8.
 Allergic reaction.
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
The Z-track method is recommended for I.M
injections. The Z-track technique, pulling the skin
either downward or laterally 
before injection
.
reduces leakage of medication into subcutaneous
tissue and minimizes pain.
The nurse selects an I.M site, the overlying skin
and subcutaneous tissues are pulled approximately
2.5-3.5 cm down or laterally to the side with the
ulnar side of non-dominant hand. The skin is held
in this position until the injection has been
administered.
11
 
Z –track method
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
Once the medication is injected, the needle remains inserted for 10 seconds to allow
the medication to disperse evenly. The nurse then releases the skin after withdrawing
the needle, which leaves a zigzag path that seals the needle track wherever tissue
planes slide across each other.
12
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
Equipment
 
13
 
 
1.
Syringe with needle
2.
Alcohol swab
3.
Gauze pad
4.
Medication vial or ampule
5.
Disposable gloves
6.
Medication administration record
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
1.
Acute pain
2.
 Anxiety
3.
Deficient knowledge regarding medication administration or drug therapy
4.
Fear
 
14
Nursing Diagnoses
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
15
Implementation
 
1.
Prepare medications for one patient at a time using aseptic technique.
2.
Close room curtain or door.
3.
Identify patient using two identifiers (i.e., name and birthday or name and account
number) according to agency policy.
4.
At patient’s bedside again compare MAR or computer printout with names of
medications on medication labels and patient name. Ask patient if he or she has
allergies.
5.
Discuss purpose of each medication, action, and possible adverse effects.
6.
Perform hand hygiene and apply clean gloves.
 
19
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
18
 
13. Discard uncapped needle or needle enclosed in safety shield and attached syringe
into puncture- and leak-proof receptacle.
14. Remove gloves and perform hand hygiene.
 
University of Basrah –
College of Nursing
Fundamentals of Nursing Department
 
 
 
19
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Learn about the theory and practice of administering intramuscular injections at the University of Basrah College of Nursing. Understand the importance of IM injections, the sites for administration including the vastus lateralis and deltoid muscles, proper techniques for injection, and more.


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  1. Fundamentals of Nursing(1st Stage) Part I: 10 Theory-Practice Administering Intramuscular injections (IM) University of Basrah College of Nursing Fundamentals of Nursing Department

  2. Introduction Introduction An intramuscular (I.M) injection is a procedure used to insert (Drugs or Vaccines)into the muscle tissue. There is an adequate supply of blood. This facilitates fast absorption, which can lead to better effect. University of Basrah College of Nursing Fundamentals of Nursing Department 2

  3. The speed of absorption is faster for intramuscular injection compared to subcutaneous injection. because the muscle tissue has a greater blood supply muscle tissue has a greater blood supply than the area just under the skin. than the area just under the skin. Intramuscular injections should be administered 90 degree angle as possible. because the University of Basrah College of Nursing Fundamentals of Nursing Department 3

  4. Sites of intramuscular injection University of Basrah College of Nursing Fundamentals of Nursing Department 5

  5. Vastus Vastus lateralis lateralis muscle muscle The muscle is thick and well developed. Used in adult and is preferred site for administration of biologicals (immunizations) to infant. The middle third of the muscle is the suggested site for injection. University of Basrah College of Nursing Fundamentals of Nursing Department 6

  6. University of Basrah College of Nursing Fundamentals of Nursing Department 6

  7. Deltoid muscle Deltoid muscle The injection site is in the center of the triangle, about 3 to 5 cm below the acromion process. This site has a potential for injury because the axillary nerve lies beneath the deltoid 7

  8. Deltoid muscle Deltoid muscle Used for: 1. small medication volumes (0.5 to 1 ml). 2. Administration of routine immunization. 3. When other sites are inaccessible because of dressing. 7

  9. Deltoid muscle Deltoid muscle University of Basrah College of Nursing Fundamentals of Nursing Department 7

  10. Ventrogluteal Ventrogluteal muscle muscle The ventrogluteal muscle involves the gluteus minimus minimus. . It is situated deep and away from major nerves and blood vessels and is a safe for all clients. gluteus medius medius and and University of Basrah College of Nursing Fundamentals of Nursing Department 8

  11. Ventrogluteal Ventrogluteal muscle muscle Is a preferred injection site for infants, especially for administration of irritating or oily solutions, children, and adults. The index finger, the middle finger, and the iliac crest form V- shaped triangle ,and the injection site is the center of the triangle. University of Basrah College of Nursing Fundamentals of Nursing Department 8

  12. Gluteus Gluteus medius medius muscle muscle University of Basrah College of Nursing Fundamentals of Nursing Department 9

  13. 1. Abscess. 2. Hematoma. 3. Injury to blood vessels. 4. Pain at the injection site. 5. Tingling or numbness. 6. Infection. 7. Bleeding. 8. Allergic reaction. University of Basrah College of Nursing Fundamentals of Nursing Department 10

  14. Z track method The Z-track method is recommended for I.M injections. The Z-track technique, pulling the skin either downward or laterally before reduces leakage of medication into subcutaneous tissue and minimizes pain. before injection injection. The nurse selects an I.M site, the overlying skin and subcutaneous tissues are pulled approximately 2.5-3.5 cm down or laterally to the side with the ulnar side of non-dominant hand. The skin is held in this position until the injection has been administered. University of Basrah College of Nursing Fundamentals of Nursing Department 11

  15. Once the medication is injected, the needle remains inserted for 10 seconds to allow the medication to disperse evenly. The nurse then releases the skin after withdrawing the needle, which leaves a zigzag path that seals the needle track wherever tissue planes slide across each other. University of Basrah College of Nursing Fundamentals of Nursing Department 12

  16. Equipment 1. Syringe with needle 2. Alcohol swab 3. Gauze pad 4. Medication vial or ampule 5. Disposable gloves 6. Medication administration record University of Basrah College of Nursing Fundamentals of Nursing Department 13

  17. Nursing Diagnoses Nursing Diagnoses 1. Acute pain 2. Anxiety 3. Deficient knowledge regarding medication administration or drug therapy 4. Fear University of Basrah College of Nursing Fundamentals of Nursing Department 14

  18. Implementation Implementation 1. Prepare medications for one patient at a time using aseptic technique. 2. Close room curtain or door. 3. Identify patient using two identifiers (i.e., name and birthday or name and account number) according to agency policy. 4. At patient s bedside again compare MAR or computer printout with names of medications on medication labels and patient name. Ask patient if he or she has allergies. 5. Discuss purpose of each medication, action, and possible adverse effects. 6. Perform hand hygiene and apply clean gloves. University of Basrah College of Nursing Fundamentals of Nursing Department 15

  19. 19

  20. 13. Discard uncapped needle or needle enclosed in safety shield and attached syringe into puncture- and leak-proof receptacle. 14. Remove gloves and perform hand hygiene. University of Basrah College of Nursing Fundamentals of Nursing Department 18

  21. University of Basrah College of Nursing Fundamentals of Nursing Department 19

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