Fundamental nursing chapter 34 parenteral medications
Download
1 / 37

Fundamental Nursing Chapter 34 Parenteral Medications - PowerPoint PPT Presentation


  • 1046 Views
  • Updated On :

Fundamental Nursing Chapter 34 Parenteral Medications. Inst.: Dr. Ashraf El - Jedi. Needles.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Fundamental Nursing Chapter 34 Parenteral Medications' - imala


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Fundamental nursing chapter 34 parenteral medications l.jpg

Fundamental NursingChapter 34Parenteral Medications

Inst.: Dr. Ashraf El - Jedi


Needles l.jpg
Needles

  • The needle gauge (diameter) refers to its width. For most injections, 18- to 27-gauge needles are used; the smaller the number, the larger the diameter. For example, an 18-gauge needle is wider than a 27-gauge needle. A wider diameter provides a larger lumen, or opening, through which drugs are administered into the tissue.


Injection routes l.jpg
Injection Routes

  • There are four injection routes for parenteral administration: intradermal injections (between the layers of the skin), subcutaneous injections (beneath the skin but above the muscle), intramuscular injections (in muscle tissue), and intravenous injections (instilled into veins; Fig. 34-8).


Slide5 l.jpg

Injection routes: intradermal (A), subcutaneous (B), intramuscular and subcutaneous in other than thin persons (C), and intravenous (D).


Intradermal injections l.jpg
Intradermal Injections

  • Intradermal injections are commonly used for diagnostic purposes. Examples include tuberculin tests and allergy testing. Small volumes, usually 0.01 to 0.05 mL, are injected because of the small tissue space.


Injection sites l.jpg
Injection Sites

  • A common site for an intradermal injection is the inner aspect of the forearm. Other areas that may be used are the back and upper chest.


Injection equipment l.jpg
Injection Equipment

  • A tuberculin syringe holds 1 mL of fluid and is calibrated in 0.01-mL increments (Fig. 34-9). It is used to administer intradermal injections. A 25- to 27-gauge needle measuring a half-inch in length commonly is used when administering an intradermal injection.


Slide9 l.jpg

Figure 34-9 • A tuberculin syringe.


Injection technique l.jpg
Injection Technique

  • When giving an intradermal injection, the nurse instills the medication shallowly at a 10- to 15-degree angle of entry


Subcutaneous injections l.jpg
Subcutaneous Injections

  • A subcutaneous injection is administered more deeply than an intradermal injection. Medication is instilled between the skin and muscle and absorbed fairly rapidly: the medication usually begins acting within 15 to 30 minutes of administration. The volume of a subcutaneous injection is usually up to 1 mL. The subcutaneous route commonly is used to administer insulin and heparin.


Injection sites12 l.jpg
Injection Sites

  • The preferred site for giving a subcutaneous injection of insulin and heparin is the abdomen.

  • Additional or alternative injection sites for insulin are the outer back area of the upper arm, where it is fleshier, and outer areas of the thigh and upper buttocks


Injection sites13 l.jpg
Injection Sites

  • Rotating within one injection site, preferably the abdomen, is recommended rather than rotating to a different area with each injection

  • The rate of drug absorption at various subcutaneous sites from fastest to slowest is abdomen, arms, thighs, and buttocks.


Injection equipment14 l.jpg
Injection Equipment

  • Insulin is prepared in an insulin syringe A 25-gauge needle is used most often


Injection technique15 l.jpg
Injection Technique

  • To reach subcutaneous tissue in a normal-sized or obese person who has a 2-inch tissue fold when it is bunched, the nurse inserts the needle at a 90-degree angle.

  • The tissue usually is bunched between the thumb and fingers before administering the injection to avoid instilling insulin within the muscle.


Slide16 l.jpg

Figure 34-11 • Angles and needle lengths for subcutaneous injections.


Intramuscular injections l.jpg
Intramuscular Injections

  • An intramuscular injection is the administration of up to 3 mL of medication into one muscle or muscle group. Because deep muscles have few nerve endings, irritating medications commonly are given intramuscularly.


Injection sites18 l.jpg
Injection Sites

  • The five common intramuscular injection sites are named for the muscles into which the medications are injected: dorsogluteal, ventrogluteal, vastus lateralis, rectus femoris, and deltoid.


Dorsogluteal site l.jpg
Dorsogluteal Site

  • The dorsogluteal site is the upper outer quadrant of the buttocks and is a common location for intramuscular injections. The primary muscle in this site is the gluteus maximus, which is large and therefore can hold a fair amount of injected medication with minimal postinjection discomfort. This site is avoided in clients younger than 3 years because their muscle is not sufficiently developed.


Slide20 l.jpg


Slide21 l.jpg

  • Divide the buttock into four imaginary quadrants. to the sciatic nerve with subsequent paralysis of the leg can result. To locate the appropriate landmarks

  • Palpate the posterior iliac spine and the greater trochanter.

  • Draw an imaginary diagonal line between the two landmarks.

  • nsert the needle superiorly and laterally to the midpoint of the diagonal line.


Ventrogluteal site l.jpg
Ventrogluteal Site to the sciatic nerve with subsequent paralysis of the leg can result. To locate the appropriate landmarks

  • The ventrogluteal site uses the gluteus medius and gluteus minimus muscles in the hip for injection.

  • This site has several advantages over the dorsogluteal site: it has no large nerves or blood vessels, and it is usually less fatty and cleaner because fecal contamination is rare at this site. The ventrogluteal site is also safe for use in children.


Slide23 l.jpg

  • To locate the ventrogluteal site: to the sciatic nerve with subsequent paralysis of the leg can result. To locate the appropriate landmarks

    • Place the palm of the hand on the greater trochanter and the index finger on the anterior-superior iliac spine (Fig. 34-15).

    • Move the middle finger away from the index finger as far as possible along the iliac crest.

    • Inject into the center of the triangle formed by the index finger, middle finger, and iliac crest.


Slide24 l.jpg

Figure 34-14 to the sciatic nerve with subsequent paralysis of the leg can result. To locate the appropriate landmarks • Dorsogluteal site.


Slide25 l.jpg

Figure 34-15 to the sciatic nerve with subsequent paralysis of the leg can result. To locate the appropriate landmarks • Ventrogluteal site.


Vastus lateralis site l.jpg
Vastus Lateralis Site to the sciatic nerve with subsequent paralysis of the leg can result. To locate the appropriate landmarks

  • The vastus lateralis site uses the vastus lateralis muscle, one of the muscles in the quadriceps group of the outer thigh. Large nerves and blood vessels usually are absent in this area,


Slide27 l.jpg


Slide28 l.jpg

Figure 34-16 hand above the knee and one hand just below the greater trochanter at the top of the thigh ( • Locating the vastus lateralis muscle.


Slide29 l.jpg

Figure 34-17 hand above the knee and one hand just below the greater trochanter at the top of the thigh ( • Spreading the skin at the vastus lateralis site and darting the tissue


Rectus femoris site l.jpg
Rectus Femoris Site hand above the knee and one hand just below the greater trochanter at the top of the thigh (

  • The rectus femoris site is in the anterior aspect of the thigh. This site may be used for infants. The nurse places an injection in this site in the middle third of the thigh, with the client sitting or supine (Fig. 34-18).


Slide31 l.jpg

Figure 34-18 hand above the knee and one hand just below the greater trochanter at the top of the thigh ( • Location of rectus femoris injection site.


Deltoid site l.jpg
Deltoid Site hand above the knee and one hand just below the greater trochanter at the top of the thigh (

  • The deltoid site in the lateral aspect of the upper arm (Fig. 34-19) is the least-used intramuscular

  • injection site because it is a smaller muscle than the others. It is used only for adults because the muscle is not sufficiently developed in infants and children. Because of its small capacity, intramuscular injections into this site are limited to 1 mL of solution.


Slide33 l.jpg

Figure 34-19 hand above the knee and one hand just below the greater trochanter at the top of the thigh ( • Deltoid site.


Slide34 l.jpg

  • There is a risk for damaging the radial nerve and artery if the deltoid site is not well identified. To use this site safely:

    • Have the client lie down, sit, or stand with the shoulder well exposed.

    • Palpate the lower edge of the acromion process.

    • Draw an imaginary line at the axilla.

    • Inject in the area between these two landmarks.


Injection technique35 l.jpg
Injection Technique the deltoid site is not well identified. To use this site safely:

  • When administering intramuscular injections, nurses use a 90-degree angle for piercing the skin (Skill 34-3).


Reducing injection discomfort l.jpg
Reducing Injection Discomfort the deltoid site is not well identified. To use this site safely:

  • Use the smallest-gauge needle that is appropriate.

  • Change the needle before administering a drug that is irritating to tissue.

  • Select a site that is free of irritation.

  • Rotate injection sites.

  • Numb the skin with an ice pack before the injection.

  • Insert and withdraw the needle without hesitation.

  • Instill the medication slowly and steadily.

  • Use the Z-track method for intramuscular injections.

  • Apply pressure to the site during needle withdrawal.

  • Massage the site afterward, if appropriate.


Nursing implications l.jpg
Nursing Implications the deltoid site is not well identified. To use this site safely:

  • Acute Pain

  • Anxiety

  • Fear

  • Risk for Trauma

  • Deficient Knowledge

  • Ineffective Therapeutic Regimen Management


ad