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 ["B","E"]
Explanation
A. The provider's name is not an acceptable identifier for verifying the client; it does not confirm the identity of the patient receiving the medication.
B. A facility-assigned identification number is an acceptable identifier as it uniquely identifies the client within the healthcare system.
C. The facility room number is not reliable for identifying clients, as multiple clients can be in the same room or there could be room changes.
D. The partner's full name is not an appropriate identifier for the client; it does not confirm the identity of the patient.
E. The client's full name is an acceptable identifier as it is a primary method to verify the identity of the client before medication administration.
Correct Answer is C
Explanation
A. Performing the final medication check in the area where the medication was obtained does not ensure the correct patient is receiving the medication.
B. Documenting after administration does not allow for a final check of the medication against the patient’s identity and allergies.
C. Performing the final check at the client's bedside before administration allows the nurse to confirm the patient's identity, the medication's appropriateness, and the dosage immediately before giving it.
D. Reviewing the prescription at the nurses' station may not account for patient-specific factors that need to be confirmed at the bedside.