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University of Pennsylvania School of NursingHelene Fuld Pavilion for Innovative Learning
N5070 Medication Administration
Student Version – Fall 2024
Assignment: Administration of Injections
The procedures for administering intradermal, subcutaneous, and intramuscular
medications are invasive and pose a greater risk than oral medications. The safe
preparation and administration of these medications is a routine nursing responsibility
that relies on sterile technique, comprehensive knowledge related to the drugs dispensed
and precise mathematical calculations. IM injections offer a route of parenteral
administration of drugs that allows for faster absorption as muscle and tissue are highly
vascular in nature. The nurse who administers the medication is responsible for any
injury to the patient that may occur because of incorrect dosage, wrong time,
inappropriate route or site of administration and dispensing medications to the wrong
patient.
*You may use additional and outside resources for this assignment. You should reference
and cite each source.
*These assignments are to be done independently and any collaboration is considered a
violation of academic integrity.
LEARNING OBJECTIVES: (43 points)
1. What 4 principles are necessary to prevent infection during an injection?
(P&P, Ch. 22) (2 points)
1. Solution should be prevented from contamination. Ampules
should not remain open, and nurses should remove the
medication as quick as possible to avoid contamination.
2. Needle should be prevented from contamination. The
needle should be prevented from touching contaminated
surface such as table surface, hands, outer surface of needle
cap, ampule/vial’s outer edges. The inner/plunger length of
barrel should be avoided touching. The needle/cap should
always cover the syringe tip.
3. Make sure the skin is properly prepared. Using soap and
water for cleaning when skin looks soiled (for example,
contaminated with drainage, dirt/feces). Using antiseptic
swab and wash in a circular motion with friction. The
radius from the center of site to the outer edge of swab
should be 5 cm.
4. The transfer of microorganisms should be reduced. Hand
hygiene should be performed for at least 20 seconds.
5/2024
, 2. The most frequent route of exposure to bloodborne disease for health care
workers is from what? (P&P, Ch. 22) (1 point)
Needlestick injuries account for the most frequent route of exposure to bloodborne
disease.
3. List 3 common occurrences that lead to needle stick injuries. (P&P, Ch. 22) (3
points)
1. When the needles are recapped in an inappropriate way.
2. When IV lines and needles are mishandled.
3. When the needles are left at the bedside of the patient.
4. Complete the chart (for adults). (P&P, Ch. 22) (15 points)
Injection type Volume of Needle gauge Needle size Angle of Medications
medication/Syri insertion
nge size
Intradermal 0.01-0.1mL 25-27 gauge 3/8 to 5/8 inch 5 to 15 Tuberculin;
medication; degrees allergy tests
tuberculin/1 mL
TB syringe
Subcutaneous 0.5-1.5 mL 25 -27 gauge -1/8 to 5/8 inch; 5/8 inch (16 Water soluble
medication/ 1-3 (for insulin U- mm) medications,
mL syringe 500). -5/8 inch inserted at including
(immunization) 45 degrees. epinephrine,
23-25 gauge allergy
(Immunization) -5/16 to 3/16 ½ inch (12 medications,
inch (for insulin mm) insulin, opioids
28-31 (for U-100); inserted at and heparin;
insulin U-100) 90 degrees immunization
- ½ to 5/8 inch
(for insulin U-
500)
Intramuscular 2-3 mL 22 - 25 gauge Depends on 90 degrees Vaccines,
medication/ 2-3 injection site, toxoids,
mL syringe size age, BMI and antibiotics,
gender. Ranges hormones, and
from 5/8 inch to biological
1 ½ inches material;
Hepatitis B,
tetanus,
diphtheria, and
Tdap
5/2024
, 5. What gerontological considerations do you apply to your elderly patient
regarding administration of intradermal injections? (P&P, Ch. 22) (1 points)
Elderly patients have less elasticity in their skin, therefore, in order to make sure
intradermal injection is performed properly, the skin must be held taut. For those elderly
patients with long-term steroid therapy, nurses should pay attention to the risk of skin
tears. The response to test tends to gradually decline in patients older than 50, but
accurate results could still be observed.
6. Identify 3 sites for subcutaneous (SQ) injections. (P&P, Ch. 22) (3 points)
1. Outer aspect of upper arms
2. The abdomen region from below the margins to the iliac
crests
3. Anterior aspects of the thighs
7. Identify 3 factors that influence site selection for SQ injections. (P&P, Ch. 22)
(3 points)
1. If the injection site is free of skin lesions, underlying
muscles/nerves and bony prominences.
2. Patients’ body weight.
3. The amount of subcutaneous tissue (adipose tissue) for the
patient.
8. What site is used to minimize pain & bruising associated with low-molecular-
weight heparin? (P&P, Ch. 22) (1 points)
On the right/left side of the abdomen, at least 2 inches (5cm) from the umbilicus.
Also, inject the medication at a slower rate (around 30 seconds) could reduce pain
and bruising.
9. List 4 basic action times of insulin and provide 1 example of each.
(P&P Ch. 22) (4 points)
1. Rapid-acting insulin. Example: insulin lispro (Humalog) which the effect can be seen
around 15 to 30 minutes and have its peak effect at 0.5 to 2.5 hours with a duration
of action of 3 to 6 hours.
2. Short-acting insulin. Example: Regular insulin (such as Novolin R, Humulin R)
which the effect can be seen around 30 to 60 minutes and have its peak effect at 1 to
5 hours with a duration of action of 6 to 10 hours.
3. Intermediate-acting insulin. Example: isophane insulin suspension (NPH) which the
effect can be seen around 60 to 120 minutes and have its peak effect at 6 to 14 hours
with a duration of action of 16 to 24 hours.
4. Long-acting insulin. Example: insulin glargine (Lantus) which the onset is at 70
minutes and a duration of action of 18 to 24 hours.
10. Complete the chart regarding acceptable IM injections sites. Please describe
how to utilize the anatomic landmarks to identify the proper injection site &
advantages for use. (P&P, Ch. 22) (6 points)
5/2024
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