Parenteral drugs can be administered through four different routes:
1. Subcutaneous injection: injection into tissues just below the dermis of the skin
2. Intramuscular (IM) injection: injection into the body of a muscle
3. Intradermal injection: injection into the dermis just under the epidermis
4. Intravenous (IV) injection: injection into a vein
Failure to inject a medication correctly can result in complications such as:
A drug response that is too rapid or too slow
Nerve injury with associated pain
Localized bleeding
Tissue necrosis
Sterile abscess
Decreased therapeutic effect
To protect your patient from opportunistic infections, be sure to follow these procedures:
1. Perform hand hygiene for a minimum of 15 seconds before touching any equipment
2. Add the time, date, and your initials to the vial you have opened. - A multidose vial, properly labeled, can be used for up to 30 days after opening.
3. Swab the top of the opened or unopened vial with alcohol before piercing.Prevent contamination of the solution.
4. Avoid touching the length of the pluner or inner part of the barrel.
5. Avoid letting the needle touch contaminated surfaces, like the outer edges of the ampule or vial, the outer surface of the needle cap, your hands, or countertops and table tops.
6. After preparing medication, apply gloves.
7. Swab the injection site with alcohol to clean the site. If visibly dirty, wash with soap and water before swabbing.
8. Swab from the center of the site and move outward approximately 5 cm (2 inches) from the center.
The correct dosage is determined when the middle ring touches the sides of the barrel. This portion of the plunger head is lined up with the dosage volume. Remember, it is important that the plunger remain sterile. Therefore, do not touch the body of the plunger.
The needle gauge is the diameter of the shaft; the larger the gauge, the smaller the diameter.
The gauge of the needle chosen depends on the viscosity of the fluid to be injected. The length of the needle chosen depends on the size of the patient and the route of administration.
Long-beveled tips are sharper and narrower, which decrease patient discomfort during subcutaneous and intramuscular injections.
The skill of preparing injections from ampules and/or vials is inappropriate to delegate to nursing assistive personnel (NAP)
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Type of Injection
Needle Gauge
Needle Length
Intradermal
25 to 27
Three eighths to five eighths of an inch
Subcutaneous
25 to 27
Three eighths to five eighths of an inch
Intramuscular
20 to 25
One half to 2 inches
True
However, be sure NAP know the intended therapeutic effects of any ordered medication and any side effects that should be reported to you
The larger the gauge of the needle, the larger the diameter of the needle?
