what is parental medication?

- a tuberculin syringe is VENTROGLUTEAL

- any medication used with 25 gauge , 3/8 - Location:
administration that to 1/2 inch needle. - lateral or ventral side of
involves inserting a drug the heat
directly into a vein SUBCUTANEOUS (SC or SQ) Landmarks:
(intravenous), muscle - injections made it to the - anterior iliac spine ,
(intramuscular), artery loose connective tissue greater trochanter of
(intra-arterial), abdominal between the dermis and femur.
cavity (intraperitoneal), the muscle layer . Muscle mass:
heart (intracardiac) or into - drug absorption is lower - gluteus medius and
the fatty tissue beneath than will IM injections. minimus
the skin (subcutaneous). - given at a 45 degree Injection area:
angle if the patient is thin, - opposing handover
Types of parenteral medication or at a 90-degree angle if greater trochanter , middle
1. intradermal or id the patient has ample finger pointed toward the
2. Intravenous or iv subcutaneous tissue. iliac crest , index finger to
3. subcutaneous or sc - usual siren's size is 2-3ml wired anterior superior
4. Intramuscular or im or tuberculin or insulin iliac spine , inject into the
syringe with needle length triangle created by these
Rights of medication of 3/8 to 5/8 inches and 25 fingers no major vessels
administration gauge or nerves.
1. right of patient - used to administer insulin
2. right of medication and heparin. VASTUS LATERALIS
3. right dosage Location:
4. Right route INTRAMUSCULAR (IM) - anterolateral aspect of the
5. Right time - The injection of a thigh
6. Right documentation substance directly into a Landmarks:
7. Right client education muscle . - greater trochanter, lateral
8. Right to refuse - given at a 90 degree femoral condyle
9. Right assessment angle Muscle mass:
10. Right evaluation. - usual syringe size is 2-3 - vastus lateralis muscle
ml or 5ml with needle Injection area:
INTRADERMAL length of 1 to 1½ inches - between one
- The administration of a and 20-23 gauge. handbreadth below the
drug into the dermal layer greater trochanter and
of the skin just beneath Factors to indicate size and one handbreadth above
the epidermis. length of the needle to be used the knee . width of area is
Purpose: to administer - the muscle from the midline on the
1. allergy and tuberculin - the type of a solution anterior surface of the
tests - the amount of adipose thigh to midline on the
2. vaccinations are tissue covering the muscle lateral thigh . best to inject
immunization (BCG) - the age of the client into outer middle third of
the thigh.
- not aspirated intramuscular injection sites - No major vessels or
- small volumes or 0.1 ml - Ventrogluteal nerves to avoid.
injected to form a small - vastus lateralis - divide the area or anterior
bubble like wheal/bleb - Deltoid lateral aspect of the time
just under the skin . - rectus femoris between trochanter of
femur and lateral femoral
 condyle into third , select injection site with the non-
the middle third. DORSOGLUTEAL dominant hand
- form a v with your fingers - most dangerous site ,
by separating your first trend is away from use PINCHING METHOD
finger from the other 3 Location: upper lateral aspect of
fingers . in place the heel the buttock INTRAVENOUS (IV)
of your hand on the bone Landmarks: posterior superior - it is the inclusion of liquid
or femur that tends before iliac spine, greater trochanter substances directly into a
the knee bends and aim Muscle mass: gluteus maximus vein . means “within vein”.
the injection right above muscle Purpose:
the v in the center of the Injection area: draw an imaginary 1. to start an infusion of fluid
thigh. line between the landmarks listed or blood.
above administered by injection 2. to withdraw a blood
DELTOID lateral and slightly superior 2 sample
Location: inches to the midpoint of this line. 3. to administer drugs
- Upper arm - avoid the sciatic nerve
Landmarks: and superior gluteal Special consideration:
- Acromion process , artery. 1. Observe aseptic
axillary fold technique to prevent
Muscle mass: triangle apex Techniques of IM injections infection during an
attack ciliary line and base of - Z track method injection .
triangle 2-3 fingers breadth below - Pinching method 2. to prevent contamination
acromion process. of solution , draw
Injection area: Z - TRACK METHOD medication from the
- in the middle of the - Seals the medication into ampule quickly . don't
triangle or into the belly of the muscle tissue. allow it to stand open.
the muscle mass . avoid - minimizes subcutaneous 3. To prevent needle
brachial artery and radial tissue irritation from contamination , avoid
nerve (BARN). tracking of the medication letting needle touch the
- Nerves to be avoided as the needle is outer surface of needle
when giving IM through withdrawn. cap , nurse hands ,
deltoid. - used more frequently now countertop , table
to decreased discomfort surface . ( outer edges of
RECTUS FEMORIS and pain. ampule/vial)
Location: - used for irritating 4. to prevent contamination ,
- Anterior aspect of the medication or vistaril and avoid touching length of
thigh. tissue staining meds or longer or inner part of
Landmarks: iron dextran imferon. barrel. keep of syringe
- between one - Use in ventrogluteal or covered with cap or
handbreadth below the dorsogluteal site. needle.
greater trochanter and - designed to deposit 5. to prepare skin , wash
one handbreadth above medications deep into skin soiled with dirt ,
the knee. muscle tissue released drainage or phases with
Muscle mass: the lateral side of tissue soap and water and dry.
- On top of the thigh only after needle has been 6. dry use friction and
Injection area: completely withdrawn. circular motion, swab from
- Center of the anterior - pull or push the skin 2 to center and move outward
middle aspect of the thigh 3 cm away from the in a 2 inch radius.
muscle.
AVOIDING PUNCTURE 3. perform hand hygiene a. remove any medication
INJURIES and observed other that is lodged in the head
1. Dispose and cap needles appropriate infection or upper stem of the
and sharps in puncture prevention procedures. ampule by flicking several
proof containers. any ( to prevent the spread of times the upper stem of
sharp instruments. microorganisms) the ampule with the use of
2. never been or needles 4. read the label on the fingernails. ( this will bring
before disposal. medication. (to make sure medication down to the
3. never recap used needles that the correct medication main portion of the
except under specified is prepared) ampule)
circumstances . 5. b. open the ampule with an
4. when recapping a needle a. before it is taken ampule opener or by filling
use a safety mechanical off the shelf; across the marked line
device. b. before and then breaking of the
5. use a one handed withdrawing the top . place a piece of
“SCOOP” method. medications gauze or alcohol wipe
c. after placing it between your thumb and
AMPULE back on the shelf the ampule neck, firmly
- It is a glass container or before disposing grasp the neck and
usual redesignated to hold it. quickly snap the top off
a single dose of drug. 6. Select the appropriate needle from the body by bending
1. vary in size from 1 and syringe for subcutaneous, it toward you . prefilled
to 10 ml or more. intramuscular or intradermal ampules may be opened
2. most have colored injections. (The needle size is without feeling . dispose of
marks around selected according to the depth of the top of the ampule in
them prescored for insertion and viscosity of the drug the sharps container .
easy opening. . the small bore allows non (The sterile gouge protect
3. if not prescored, viscous medications for the fingers from the
the neck is filed subcutaneous used to pass broken glass , and any
and broken off at easily) glass fragments will spray
that point. away from the nurse)
Small gouge needles with larger c. place the ampule on a flat
Preparing medication from an bore are used for withdrawing surface . attaching the
Ampule medication from ampules or vials. filter needle or stroll to the
(Facilitates the flow of medication science of the use of it is
Preparation: into the syringe) recommended . ( filter
1. check the medication needles are used for
order for accuracy and 7. Open the sterile syringe and withdrawing premixed
recency. ( prevents error secure the needle without liquid medications from
in giving medication . removing its protective covering multidose vials . this also
always remember that 10 needle cap , by grasping the filter out fine glass
rights in administering needle hob and turning the particles are slivers
medications.) syringe clockwise to tighten it. produced when ampule
2. Clarify any discrepancies ( this maintain sterility of cyrus top is broken)
in the order with the senior and needles to be used in d. Remove the cap of the
nurse or the physician , administering injections) needle and insert the
whichever is appropriate needle into the center of
in the agency. 8. prepare the medication for the ampule without
drug withdrawal: touching the rim of the
 ampule . the ampule will 1. prepare the material. ( to volume of the medicine to
need to be tilted if the save the nurse time and be withdrawn. this is done
needle does not reach the effort) by grasping the syringe
base. ( to maintain sterility 2. perform hand hygiene with one hand and pulling
of the needle) and observe other back on the blank with the
Variations: appropriate infection other hand . hold the
- with a non-dominant prevention procedures. syringe inverted , erect
hand , grasp the ampule ( to prevent the spread of and eye level. ( inversion
and turn the upside down microorganisms) of the vile and cyrus
or stabilized ampule on a 3. mix the solution , if allows the nurse to work
flat surface. necessary , rotating the at a level and withdraw an
- If inverted , keep the vial between the palms of accurate dose.)
needle tip below level of the hands , not by shaking 7. inject the air into the
the meniscus. ( Prevents it. ( some files contain upright vial through the
air from entering syringe aqueous suspension center of the rubber cap ,
and fluid from leaking out which settle when they maintaining sterility of the
while ampule is inverted) stand. sometimes shaking needle. ( air initially
e. Withdraw the medicine is contraindicated increased the pressure in
into the syringe. ( injecting because it may cause the the vial thus facilitating
air into the ampule is not mixture to foam) withdrawal of the drug .
necessary . it will cause 4. remove the protective after the drug is
displacement and loss of metal cap , or clean the withdrawn, this air
medications through rubber cup of a previously pressure returns to normal
leakage) opened vial with an because the equivalent
f. if used , filter needle is antiseptic swab or cotton volume of medicine has
removed and replaced ball with alcohol by been withdrawn.)
with injection needle , rubbing in a circular Keep safe the bevel of the
cover the needle as motion . discard the swab. needle above the surface
described. ( maintain ( the antiseptic cleans the of the medication. ( this
sterility of all articles used cop and reduces the will avoid creating bubbles
throughout the procedure) number of in the medication)
g. dispose the ampule and microorganisms) 8. withdraw the prescribed
used needles in the 5. attach a filter needle , as amount of medication by
sharps container. policy dictates , to draw up keeping the bevel of the
the premix liquid needle in the solution. ( air
VIAL medication from the will be drawn into the
- It is a small glass bottle multidose vials. ( filter syringe if the bevel of the
with sealed rubber ca p. needle prevents any solid needle is not immersed in
- In different sizes from particles from being grown the solution)
single to multi dose. up through the needle. 9. Hold the vial vertically at a
Reconstitution: facilitates withdrawal of level. ( this ensures that
- the technique of adding a the desired amount correct dosage or amount
diluents to a powdered solution from a vial) of drug is drawn into the
drug to prepare it for 6. ensure that the needle is syringe)
administration. firmly attached to the If necessary , tap the
syringe . remove the syringe barrel to dislodge
Preparation from vials needle cop and draw up air bubbles. this air can
an amount of air into the be ejected into the vial.
syringe that is equal to the ( topping will cause air
 bubbles to get to the top 3. prepare the medication 10. insert the tip of the needle
of the syringe) from a vial or ampule far enough to place the
10. when the correct volume 4. explain procedure to the bevel through the
of the medication plus a client. ( information can epidermis into the dermis.
little more is obtained , facilitate acceptance and The bevel outline should
withdraw the needle from compliance with the be visible under the skin
the vial , and replaced that therapy) surface. (this verifies that
cover the needle using a 5. select site which are free the medication into the
scoop method. (this of lesion , bruises and dermis)
ensures withdrawal of discoloration. E.g forearm 11. stabilize the syringe and
correct amount and which is 3-4 fingers width needle. inject the
prevents needle pricks) below the antecubital prepared skin testing
if necessary top the space. apply globe as solution carefully and
syringe barrel to dislodge indicated by agency slowly so that it will
air bubbles present in the policy. produce a small wheal on
syringe. ( tapping motion 6. clean the site or inner the skin.
will cause bubbles to get aspect of the forearm with 12. Withdraw needle quickly ,
to the top of the syringe a cotton ball with alcohol wipe excess solution on
where they can be ejected or antiseptic swab starting the site with dry cotton ball
out of the syringe) at the center and widening or with dry two by two
11. place the needle straight the circle outward. allow sterile gauze pad. do not
into the center of the area to dry thoroughly. massage the area
sheath. 7. remove the needle cap ( massage can dispense
remove used needle and and expel and the air the medication into tissue
replaced with the needle bubbles from the syringe or out through the needle
for injection. eject air from small air bubbles that insertion site)
the new needle and verify adhere to the plumber will 13. if administering a skin
correct medication volume not harm the tissues. test, encircle the wheal
before injecting the client. 8. grass silage in dominant with a blue or black ball
12. dispose the vial or return hand , close to the hub , pen. Indicate time do for
it to its storage place . holding it between thumb reading or interpretation of
dispose of the use needle and forefinger . hold results. interpretation of
in the sharps container. needle almost parallel to reading of results should
the skin surface , with be done by physician after
INTRADERMAL INJECTION bevell of the needle up. 30 minutes or as indicated
(the possibility of the by the agency protocol.
Assessment medication entering the 14. dispose of the syringe
- Appearance of injection subcutaneous tissue and needle into the sharps
site increases when using an container. ( do not recap
- specific drug action and angle greater than 15 to prevent needle stick
expected response degrees.) injuries)
- clients knowledge of drug 9. hold skin tautly on ventral 15. remove and discard
action and response forearm by grasping the gloves
dorsal forearm of the 16. record medication and
preparation for skin testing client with non dominant site of injection , reactions
1. prepare all materials hand. (taut Skin allows and other pertinent data
needed. easier entry of the needle after the procedure.
2. perform hand hygiene and less discomfort for the
client)
Positive ID skin test shows: a 3. literature and integrative of sight minimized
raised, red, itchy bump, and reviews of evidence discomfort)
surrounding flare around the indicate that the practice 4. wash hands and don
wheal of aspiration before gloves
vaccination injections into 5. Cleans the site with the
Common mistakes on marking deltoid has no basis in cotton ball with 70%
the wheal: Don't mark too far from specific evidence alcohol using a circular
the wheal. Never use a red pen motion , starting at the
SUBCUTANEOUS INJECTION center going outwards to
INTRAMUSCULAR INJECTION - it is the injection of a drug about 5 cm or 2 inches
into the subcutaneous diameter. discard the
Assessment below the skin tissue of swab appropriately . allow
- Client allergies to the body the area to dry thoroughly.
medication ( antiseptic minimizes or
- specific drug action , side drugs administered in lessens the number of
effects , and adverse subcutaneous microorganism in the
reactions - Vaccines skin).
- clients knowledge of and - Insulin 6. place and hold swap
learning needs about - heparin between third and fourth
medication fingers of non dominant
- tissue integrity of the Procedure: hand or positions web on
selected site 1. Identify the client and the client's skin above
- clients age and weight to explain the procedure intended site.( this
determine the site and according to the level of technique keeps the swab
needle size clients understanding. readily accessible when
- a client's ability or ( this ensures that the the needle is withdrawn)
willingness to cooperate right client receives the 7. remove needle from its
right medication.) cover.pull the cap straight
factors in the selection of needle 2. select the site of off. (This avoids
size and length administration. select one contaminating the needle
1. Muscle which has not been used by the outside edge of the
2. Type of solution frequently. ( correct cap)
3. Amount of adipose tissue administration minimizes 8. spell any air bubbles from
a=covering the muscle the stroma , facilitates the syringe by inverting
4. Age of the client absorption and lessens the syringe and gently
possible adverse effects pushing the flour until a
Special consideration such as infection at the drop of solution can be
1. In the administration of site. seen in the needle bevel. (
intramuscular injections , 3. provide privacy if the side expelling air and sure that
select a safe site located necessitate exposure of the correct amount of
away from the large blood the clients. ( it prevents solution is being
vessels , nerves , and the client from being administered. prevents
bone. embarrassed) injection of air into the
2. do not administer insights assist client to a position subcutaneous tissue)
which has injuries , in which arm , leg , 9. insert the needle by:
modules , lamps , abdomen can be relaxed , a. holding syringe
obsessed , tenderness , or depending on site to be between the thumb
other pathology. used. ( a relaxed position and forefinger as if
holding a pen of
 the dominant hand and minimizes discomfort while
90° insertion or needle is withdrawn)
hold the syringe
with the palm 12. lightly massage the site with
facing to the side the sterile cotton ball with
or upward for 45° alcohol . (this is to dispense the
insertion medication into the tissues and
b. Pinching or thus facilitates it absorption .
spreading the skin massaging is committed with
at the site with non heparin and insulin injections .)
dominant hand.
( pinching the skin 13. if bleeding occurs , apply
elevates the pressure to the site until it stops ,
subject aeneus and apply and other save
tissue and bandage if needed. ( bleeding
desensitize the rarely occurs with subcutaneous
area somewhat injections)
and thus lessen ,
the sensation of 14. dispose of used to fly
needle according to agency procedure.
insertion.Spreadin do not recap needle, discard it in
g the skin can sharps container ( to prevent
make it more firm yourself and others from injury
and facilitates and contamination
needle insertion .
spreading the skin 15. assist the client to a
out is used for comfortable position
those with
substantial 16. remove the gloves and wash
subcutaneous hands
tissue )
c. Piercing the skin 17. record the medication given ,
quickly with the dosage , time , route , any
purple upward at complaints of the client and the
45° angle or at 90° signature of the nurse
angle for obese
client
10. inject that medication by
holding the syringe steadily and
slowly pushing in the plunger.
( holding the syringe steady
minimizes discomfort for the
client)

11. remove the needle quickly

pulling the line of insertion while
pressing the skin with your non
dominant hand. ( depressing the
skin places counteraction on it