NRS 312 Lecture Notes - Lecture 2: Asepsis, Viscosity, Vastus Lateralis Muscle
❖ Parenteral Medication Concepts
➢ Bypass GI system
➢ It cannot be removed or retrieved once it is in the body- more dangerous medications
➢ Safety first- be very careful
❖ Equipment
➢ Sterile procedure. Follow sterile technique
➢ We are breaking through a pts first line of defense (skin) and giving an injection
➢ Diaeter of eedle= ko as a gauge. gauge is ery large ad ould’t used o hua
▪ gauge is a ery sall ad thi eedle. Do’t hurt as uh
▪ IM is usually 23 or 21 gauge
▪ Larger number = smaller needle diameter
▪ 21 gauge for IM is because fluid is more viscous or dense
➢ Syringe size
▪ Smaller volumes for injections up to 3ml
▪ Syringe can come with or without needles. Need to come sterile wrap with expiration date
labeled. They are usually packaged separately
❖ Intradermal injections
➢ 10-15 degree angle.
➢ Very small amount
➢ 5/8th of an inch.
➢ 25 gauge
➢ 0.1-1.0 ml
➢ Inner aspect of the forearm
➢ Just under epidermis so slower rate of absorption
❖ Subcutaneous injections
➢ 45-90 dregres angle, needs to stay in subcontanous tissue. We do’t at it i the IM space
➢ We would use a 1-3ml for SQ but wit hinsulin we would only use an insulin syringe (orange cap
and written in units)
➢ Slower absorption that IM but faster than intradermal
❖ Insulin and heparin
➢ Rotate sites because of scar tissue (lypohypertrophy)
➢ Bruising can occur
▪ Heparin or lovenox (enoxaparin) we want to be at least an inch or 2 away from bruise or
naval.
➢ Do’t assage. Soeties e apply opressio ut ot alays. Ca effet asorptio
❖ IM
➢ Everything we need to know is on the slide
➢ Gauge depends on viscosity of the fluid you are administering.
➢ Aspiration
▪ When you draw back on the syringe before injecting so you insure that you are not on a
vessel
▪ Vaccines we do not need to aspirate
▪ Can cause the patient more pain
▪ Starting to become evidence based policy
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Document Summary
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