A nurse is planning to administer an IM injection into a client's deltoid muscle. Which of the following actions should the nurse take?
Inject the medication 12.7 cm (5 in) below the client's acromion process
Use a 21-gauge needle for the injection
Inject the medication at a 90-degree angle
Inject a volume of less than 2 mL
The Correct Answer is D
A. Injecting the medication 12.7 cm (5 in) below the acromion process is incorrect; the injection site should be approximately 2.5 to 5 cm (1 to 2 inches) below the acromion process.
B. A 21-gauge needle may be appropriate for some IM injections, but a 23- to 25-gauge needle is commonly used for deltoid injections due to the smaller muscle mass.
C. While IM injections into the deltoid are typically given at a 90-degree angle, the volume of medication is the critical factor for this injection site.
D. Injecting a volume of less than 2 mL is correct, as the deltoid muscle can accommodate this amount effectively, while larger volumes should be administered in larger muscles like the vastus lateralis or gluteus medius.
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Correct Answer is A
Explanation
A. Discarding the tablet and obtaining another dose is the safest option, as it ensures the medication's integrity and prevents any potential contamination.
B. Using the tablet's packaging to pick it up is not appropriate as it could introduce contaminants from the surface of the counter to the tablet.
C. Washing the tablet with alcohol is not advisable because it could alter the medication's properties or effectiveness.
D. Placing the tablet directly into a medication cup without addressing its contamination would also be inappropriate and could jeopardize client safety.
Correct Answer is A
Explanation
A. Washing the area of the puncture thoroughly with soap and water is the first and most immediate action to reduce the risk of infection and transmission of bloodborne pathogens. This should be done as soon as possible after the injury.
B. Going to employee health services is necessary but should follow immediate first aid measures.
C. Completing an incident report is important for documentation and accountability but is not the immediate priority after a needle-stick injury.
D. Reporting the incident to the charge nurse is necessary for proper protocol but does not take precedence over ensuring the injury is properly cleaned first.