The unit educator is performing skill validations with unit staff. Which of the following actions by the staff nurses demonstrate a correct understanding of parenteral medication administration? Select all that apply. A)Injects subcutaneous insulin at a 90-degree angle into the lower abdomen of an obese client B)Inserts the needle at a 30-degree angle to administer an intradermal injection C)Massages the injection site after administering an intradermal medication D)Places client in a side-lying position to access the ventrogluteal site for IM injection E)Withdraws medication from a glass ampule using a 20-gauge, 1-in (2.5-cm) injection needle

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11ecbb05_cb46_10e4_b433_83e5d13de3c2_MD0009_00 Parenteral medications are administered via injection into body tissues using aseptic technique (eg, intradermal, intramuscular, subcutaneous, IV). Intradermal Administer injections at a 5- to 15-degree angle to reduce risk of injection into subcutaneous tissue (Option B). Apply firm pressure to the injection site to reduce bleeding. Massaging the site introduces medication into deeper tissues and should be avoided (Option C). Subcutaneous Administer injections at 90 degrees if 2 in (5 cm) of subcutaneous tissue can be grasped or at 45 degrees if only 1 in (2.5 cm) can be grasped (Option A). Intramuscular Acceptable sites include the deltoid, vastus lateralis, and ventrogluteal. The ventrogluteal is preferred as fewer large blood vessels and nerves are present. Position the client supine, prone, or side-lying with the knee and hip flexed when administering ventrogluteal injections. Flexing the knee and hip reduces muscle tension, improves access, and promotes client comfort (Option D) (Option E) A filter needle must be used when withdrawing medication from a glass ampule to prevent aspiration and injection of glass shards. After the medication is withdrawn, the filter needle is discarded and an injection needle (eg, 20-gauge, 1-in [2.5-cm] needle) is attached to the syringe. Educational objective: Use filter needles to withdraw medications from ampules to prevent aspiration and injection of glass shards. Perform intradermal injections at 5- to 15-degree angles and avoid massaging injection sites to prevent accidental subcutaneous administration. Administer subcutaneous injections at 45 or 90 degrees, depending on the volume of subcutaneous tissue.

The Unit Educator Is Performing Skill Validations with Unit Staff