The client is to receive an intramuscular injection of a ...

[TFauchery]

The client is to receive an intramuscular injection of a medication that is supplied in a 2-mL cartridge and a second medication that is supplied in a vial.
 
  The total amount to be administered of these medications exceeds the volume of the cartridge by 0.5 mL. How should the nurse proceed?
  1. Administer the cartridge medication in one injection and the vial medication in a separate injection.
  2. Call the pharmacy for advice on administering these medications.
  3. Draw both of the medications up into a syringe for administration.
  4. Add as much of the vial medication to the cartridge as possible prior to injection, giving the balance in a separate injection.

Question 2

The nurse has just injected insulin subcutaneously into the client's abdomen. What action should the nurse take at this point?
 
  1. Massage the site to encourage absorption.
  2. Leave the needle embedded in the client's skin for 5 seconds after administration.
  3. Remove the needle rapidly by pulling it quickly from the skin.
  4. Cover the injection site with a pressure dressing for at least 15 minutes or until the bleb disappears.

[alvinum]

Answer to Question 1

Correct Answer: 3
Rationale 1: Giving two separate injections, no matter how the medication is divided, should be avoided if possible.
Rationale 2: There is no need for the nurse to consult the pharmacy for this standard technique.
Rationale 3: When the total amount of medication to administer exceeds the volume of the cartridge, the medication is drawn up into a syringe and is administered.
Rationale 4: Giving two separate injections, no matter how the medication is divided, should be avoided if possible.

Answer to Question 2

Correct Answer: 2
Rationale 1: Massage is contraindicated for most medications because it alters the delivery rate from the tissues.
Rationale 2: The American Diabetes Association recommends leaving the needle embedded in the client's skin for 5 seconds after injection of medication, particularly insulin. This allows for complete delivery of the dose.
Rationale 3: The needle should be removed slowly and smoothly to minimize pain for the client.
Rationale 4: Bleeding rarely occurs after subcutaneous injection, but short application of manual pressure (1-3 minutes) should cause bleeding to stop. There is no need for a pressure dressing for 15 minutes. Subcutaneous injections do not result in bleb formation.

[TFauchery]

TYSM

[dantucker]

Excellent