professional organizations.
Question 8
After administering medication intramuscularly, what should the nurse do?
Your Answer:
Recap the needle to prevent injury, and discard it in an appropriate container
Rationale:
The nurse should assess the patient for acute pain, burning, numbness, or tingling at the injection site. Continued discomfort may indicate injury to underlying bones or nerves. Recapping needles increases the risk of a needle-stick injury. The uncapped needle (or needle enclosed in a safety shield) and attached syringe should be discarded into a puncture-proof and leakproof receptacle to prevent injury to the patient and health care personnel. After injection, the nurse should apply gentle pressure without massaging the site. Massage may damage underlying tissue. The Z track does not need to be reassessed for functionality.
Question 9
When preparing to administer a tetanus vaccine to a 65 kg adult, the nurse should choose which size needle?
Your Answer:
1 inch, 23 gauge needle
Rationale:
Needle size for IM injection is determined by medication viscosity, injection site, patient’s weight and age, and the amount of adipose tissue through which the injection must go. For adults weighing 60-70 kg, a 1 inch needle is used. Immunizations for adults should be administered with a 22-25 gauge needle. A 20 gauge needle may be used for more viscous medications. A 1½ inch needle may be used for adults weighing more than 70 kg.
Question 10
An elderly patient is being discharged home with an order for twice daily IM injections. What instruction should the nurse include for this patient?
Your Answer:
It will help absorption to get up and walk immediately after each injection.
Rationale:
Adult patients who require frequent injections should be instructed to apply topical analgesic to the injection site before administration. Self-administration of an IM injection is difficult. A family member or friend should be trained to administer the injection. Needles should be disposed of in sharps containers or containers that are in compliance with community guidelines. Cardboard does not provide safety from sharps injuries. Older adults may be at high risk for falls immediately after receiving an injection because of guarding the injection site and loss of muscle tone and strength.