ADMINISTRATION OF INJECTION

1. ADMINISTRATION OF INJECTION.

2. INTRODUCTION.
 The parenteral route refers to medication that given by injection or infusion, it means given
therapeutic agents out side the elementary tract (para= bedside , intestine).
 It is the forcing of food into the cavity of blood vessel body, tissue to hollow tube or needle.
 Advance injections technique consist of. Medication into artery, the Peritoneum Heart tissue spinal
cord and bones.

4. GENERAL INSTRUCTIONS.
Before giving any injection obtain the written order from the physician.
Maintain strict a septic techniques while sterilizing the equipment while administration
the injection
Separate syringes and needles when given inj.
The syringes be air tight needle should sharp patent.
Change the needle after withdrawing the drug.
Always give test dose in case allergic reactions
Observe ten right of administration medicine
Check the manufacturing and expiry date.
Always give comfortable and relax position

5.  Select appropriate site of injection.
 Site will be dependent upon the type of drug quantity and route of administration.
 Avoid bony prominences Check the area for any induration of tissue.
 Change the injection site, specially for the patient on insulin. To prevent of
lipodystrophy (wasting of the subcutaneous tissue).
 Expel the air from the syringe before the inj.
 Insert the needle quickly and gently inject the drug slowly and withdraw the needle
gently and quickly, they will be reduced the pain of injection.
 After the insertion, the needle always withdraw the piston to make sure that it is not
in a blood vessel. Case of intramuscular or subcutaneous injection, if they are
presence of blood in syringe without the needles and cue injection another side.

6.  Massage the area site of injection. It will be help easy absorb of drug. only im & sc.
 The solution for injection should be started clear and near natural in action.
 After giving injection observe the patient for same time.
 Recording should be done accurately and immediately after giving injection by the
person who was given it & sign.

7. ARTICLES.
 A sterile covered tray containing –
 1) sterile syringes and needles of various sizes 2ml, 5ml, 10 ml and needle
of 18, 20, 21, and 22 numbers 4cm long enter into muscles. Use separate
needle for piercing the rubber stopper
And giving the injection.
2) Started hotel site in Delhi Park to clean the area of injection to be given.
Distill water in ample to dissolve the powder drugs.
Spirit strap to clean the skin.
pair of sterile gloves

8.  In clean square tray containing:-
 Chetan forces in Los Angeles to handle the serial articles.
 bowl with water received the new syringe and needles.
 Drug ordered to give the patient..
 File to cut open the ampules .
 Kidney tray and paper bag to receive t.

9. SAFETY MEASURES
 Ten rights of medication administration
 Right clients.
 Right drugs.
 Right dosages.
 Right time.
 Right route.
 Right to patient education.
 Right to documentation.
 Right to refuse.
 Right assessment.
 Right evaluation.

10. Asepsis
 Sterile syringes and needles.
 Freshly distilled and sterile water for injections.
 Drugs used for injection should be sterile.
 Handling the drugs and equipment used for injections with aseptic technique.
e.g washing your hands before touching equipment not touching and contaminating the syringe and
needles.
Cleaning of the injection site with antiseptic to reduce the number of bacteria present in the skin.
Protecting the injections and the equipment's during the transportation of the injection to the client.
Example, needle is covered with protector.

11. SELECTION OF THE SITE OF INJECTION
 The selection depend upon the following.
 Routine of the administration order by dr.
 Quantity of drugs.
 Condition of patient.
 Muscular depend adult child, emaciated (extremely thin and weak because of illness,
lack of food, etc.)
 Knowledge of anatomical position of nerve.
 Rotation of the site is necessary to avoid tissue trauma.

12. Technical skill.
 Take the required equipment for the procedure.
 Nurse must be very skillful while giving injection. According to
the route ordered
 Select correct site for injection.
 Prepare the medication doors accurately.

13. Selection of equipment for injection.
 Description of syringes and needle.

14. Routes of
administration
Size of syringe Size of needles
Intradermal. 1ml calibrated in 0.01ml units
(tuberculin syringe)
26 or 27 gauge diameter
And 3/8 to 5/8 inch length
Subcutaneous 1ml calibrated in 40 or 80 units (insulin
syringe)
25 Gauge and ½ to 5/8
or
2,3ml syringes calibrated in 0.1ml Same as above
Intramuscular 2,5ml celebrated in 0.2 ml 21, 22, 23 gauge
1 to 2 inches in length
Intravenous Size depends upon the amount 18 to 21 gauge 1to 2 inches
Of fluids to be injected

15. Forms of medications available.
 TABLETS
 Referring the medication from tablet and using which for injection it condemned today. The obvious
problem asset with this method, it is a difficult to maintain sterility of drug.
 POWDER.
 Some drugs are available in powder forms in sterile sealed vails and ampules.
 sterile normal saline or distinction. Water is roots for dissolve them.
 Some amount of solvent added should be:-
To prevent error of giving less or extra.
To avoid local tissue damage due to the overall concentrated solution.
To give maximum therapeutic dosage.
Prepare the solution just before the time of administration to prevent contamination of
drug.

16.  SOLUTION IN AMPULES AND VIALS.
 The ample have two parts up for portion called the stem.
 The lower part as the base.
 Where the ampules is broken with files.
 .

17.  Parenteral medications are supplied in sterile vials, ampules, and
prefilled syringes. Ampules are glass containers in 1 ml to 10 ml
sizes that hold a single dose of medication in liquid form. They
are made of glass and have a scored neck to indicate where to
break the ampule. Because there is risk of being cut by glass
when opening a glass ampule, the nurse should use an ampule
breaker or wrap an alcohol swab package around the neck of the
ampule for protection (See Figure ). A blunt fill needle with
filter must be used when withdrawing medication to prevent
glass particles from being drawn up into the syringe. Never use a
filter needle to inject medication directly into a patient

19. Ampules

20.  PREPARATION FROM VAIL
 avoid Airborne infection and contamination.
air should not be introduced in the ample while taking drugs from ample
Some vials contain single or multiple doses, which has rubber stopper and metal cap,
which can be removed.
Rubber clean with sprit swab
To prevent the formation of vacuum into the bottle the piston of the syringe is
withdrawn to the required amount of medication mark and need an inserted at the right
angle through the rubber cap.
The bottle eats inverted and the air is injected in the bottle. The piston is then
withdrawal until the required amount of fluid is in the syringe When the needle is
hub/amounts is supported by the forefinger, while the. Needle point is withdrawn.
a multi-dose vial must be labelled with the date it was opened. Check hospital policy to
see how long an open vial may be used

21. PREPARATION FROM VAIL

22. SCIENTIFIC PRINCIPLES OF INJECTIONS
 A) ANATOMY AND PHYSIOLOGY
 The meaning may be inserted under top layer of skin, in to the skin into the muscles or in to a blood
vessel.
 The skin contain numerous blood vessels nerves careful selection of site can be avoided injury this
area. The common side of injection are-
 1) intra dermal injection are given at forearm e.g flexor surface. It is given for local effect. The fluid, it’s
taken up quickly by lymph vessels and carried to the bloodstream.
 2) Subcutaneous injection are outer of arm or thigh. Loose areolar tissue are found under the skin. It is a
contain plenty of blood supply, limb vessels and nerves. The effect subcutaneous injection appears
within the short time. Drugs are given subcutaneously for their general effect.
 3) Intramuscular injection are given into the deltoid muscles of shoulder gluteus muscles of buttocks,
rectus femoralis, muscles of the anterior aspect of the thigh and vastus lateralis muscles on the lateral
aspect of the thigh. Muscles are well supplied with blood vessels and poorly supplied with the sensory
nerves, so there is less pain.

23. at forearm e.g flexor surface

24. Loose areolar tissue s.c injection

25. deltoid muscles of shoulder gluteus muscles of buttocks and rectus femoralis,
muscles of the anterior aspect of the thigh and vastus lateralis muscles on the
lateral aspect of the thigh

26.  4) The site for intravenous injection are basilic Or median cubitus vein in Antecubital space of arm.
Walls of the rain are elastic and the May. Dilate and contract when the needle is enters.

27.  Vein contain sensory nerves As the needle. Persist the blood vessel wall a little pain is experienced.
 Infusion solutions in large amount of immediately increase the heart rate of blood pressure and
relieve the thrust.

28. B) MICROBIOLOGY
 Giving injection is an sterile procedure, so all recruitment must be sterile and aseptic Technique must
be used while giving injection.
 Wash and thoroughly before and after the procedure to avoid cross infection.
 Use sterile drugs for injection.
 Use autoclave or disposable syringe and needles for each patient.
 Clean the top vail or neck of ampules with the alcohol swab before the putting the needle into the
drug.
 The water used for preparation of solution should be freshly distilled and sterile to prevent pathogenic
infection.
 The bacteria are always present on the skin, So clean the area of injection to minimize the number of
bacteria present on the skin.
 Disinfect the infect the equipment immediately after use.

29. C)PHYSICS.
 pressure is related with all needles injection when a solution is drawn from ampule into the syringe,
the needle is put into the fluid The plugger is pulled back the Pressure is in the. Syringe lowered.
 Fluids trend to flow to an area of low pressure, so that solution comes into the syringe.
 When a solution is drawn from the rubber capped vail the piston is pulled back to admit as much air
as a fluid is desired The needle is Introduce into the vail and the air is expelled from the syringe into
the vail. so that air pressure within the vial is raised And when the piston is released, the compressed
air in the vail pusher, the solution into the syringe.
 The pressure in the tissue is greater than the capillaries, so that the fluid is force into the capillaries.
 Fluid leaves an in invested flask by the force of gravity in a clamp is used on tubing. It should be
applied near as possible to needle to prevent the development of negative pressure within the tubing.
 While collecting the blood, the pressure within the bottle is lower by removing the air in the bottle
when it is connected to a vein blood runs into it because pressure of in the blood is greater than in
the bottle.

30.  Blood flows slower than an aqueous solution because the rubber tubing offers more resistance
to viscous substances
A larger needle is used with transfusion of blood the rate of flow should be regulated
according to the tolerance of the patient.
Application of warmth and massage stimulates circulation and aids in absorption of the drug

31. D)CHEMISTRY
 The hydrogen ions concentrate on the blood has much important the average ph of value of the blood
it is approximately 7.4 means that its blood is slightly alkaline.
 coma usually occurs within the PH of blood falls slightly below the 7.0, when the blood rise up to the
7.7 to 7.8 tetany occurs (Tetany is a symptom that involves involuntary muscle contractions and overly
stimulated peripheral nerve).
 Buffer salts such as sodium bicarbonate and disodium phosphate constantly remain with blood and
keep the blood ph limits buffer substances prevent the changes in hydrogen ions concentration. The
kidney and lungs also plays an important role A large part of maintaining of normal acidic balance
solution for the substance injections should be clear, sterile and clearly natural in reaction, non
haemolytic the substances should be soluble in water.
 the Selective flow of the certain components of solution through semi permeable membrane is called
osmosis and resulting pressure is called osmotic pressure.
 Osmosis is the passage of water molecules across a membrane. Diffusion is the process brought about
by the movement of the molecules of water, gases, and dissolved substances. All electrolytes possess
the property of the exerting osmotic pressure.

32.  Solution developing same osmotic pressure as the blood are called isotonic solution.
 Those are producing less osmotic pressure than that blood called hypotonic solution.
 And those producing more than blood is called hypertonic solution.
 The Blood contains 0.9 % salt of calcium sodium potassium and magnesium.
 Physiological salt solution is 0.9% sodium chloride combines with the blood is very well.
 Hypertonic solution destroyed the red blood cell hypertonic glucose solution are occasionally used to
reduce oedema.
 Concentrated plasma of serum given intravenously raises the asthmatic pressure of the blood And these
drawn fluid from the tissue into the vascular system.

33. E)Pharmacology:-
 The drugs which are given by the injection are classified as follows,
A) PREVENTIVE ACTION- Antitoxin toxic vaccines antibiotics.
B) REMEDIAL ACTION (Remedial Action' is a term referring to actions taken by businesses to
counteract deficiencies on undesirable characteristics in their product)- Antibiotics specifics.
C) PALLIATIVE ACTION (A palliative is an action that is intended to make the effects of a
problem less severe but does not actually solve the problem).- Narcotics sedative local
anaesthetics general anaesthetics, General anaesthetics.
D) SUBSTITUTION THERAPY :- Hormones minerals vitamins & fluids.
E)

34.  DIAGNOSTIC AIDS :-
 Dye for kidney gallbladder and study it used.
 Penicillin is usually given intramuscular because the acidity of gastric juice destroyed its effectiveness if
it is measured in units.
 Toxins and antibiotics are given in units, units of diphtheria antitoxins is used amount of antitoxin.
What will neutralised 100 minimum lethal doses of the career toxins.
 Depravities of opium are given by hypodermic route.
 Fortwin or eight derivatives are used before and after the operation.
 Procaine is used for local anaesthetics.
 Insurance is destroyed by the digestive enzymes of the stomach so it is given subcutaneously.

35. Psychology
 Explain the procedure thoroughly to win the patient when the confidence and get the cooperation to
allow fare. Every person have fear of pain due to injection
 Proper position will help to the relax the patient while giving injection
 Distracting the patient while giving injection will minimise the pain
 When is also reduced by the using of sharp needle of small gauge.
 Maintain privacy if needed
 Before giving winter anything, we can provide bedtime review comfortable position.

36. Mathematics
 Correct an accurate door should be given to the patient. Have good effort to give correct dose
divided to a desired dose by the Quantity contained in a single unit of the stock rate search and the
amount in outer table in cubic million to the answer obtain will be the portion of unit to use for the
new dosage e.g.
 Give 75MG pentadiene from the 2ML ample containment. 50MG of pen 13 for ML. 75 / 50 is equal to
one and half ML to be given.
 Given 2mg of wymesone from 2ml vail containing 4mg per ml
4mg = 1ml
i.e. 2mg = ½ ml

38. TYPES OF INJECTION.
 A) HYPODERMAL OR SUBCUTANEOUS
INJECTION:-
 Medicines when introduced into the
 subcutaneous tissue, or areolar tissue,
 just below the skin.
 It is called hypodermic or subcutaneous
injection.

42. B) HYPOSPRAY.
 The hypothesis permit drug
 to be sprayed through the skin
 without a needle pressure of 125
 pounds is created device which
 forces the drug into the tissues
 without pain and visible mark

43. I)INTRAVENOUS.
 Intravenous usually refers
 to a way of giving a drug or
 other substance through a nee
 dle or tube inserted into a vein.
 Also called IV.

44. c)INFUSION.
When a large quantity of
medicines are to be introduced
into the body, it’s called infusion.

45. INTRA ARTERIAL INJECTION
 administration of drugs into the carotid or vertebral arteries is intra-arterial injection

52. K) TRANSFUSION.
 It is the introduction of the whole blood or plasma into the vein or artery to supply actual volume of
blood or Introduce constituents. As clotting factor or antibiotics, which are deficient in client.

61. E) INTRAMUSCULAR INJECTION.
 Medicine when injected into the muscles, it’s called intramuscular injection.

65. F) INTRAOSSEOUS
Intraosseous infusion (IO)
is the process of injecting
medications, fluids, or
blood products directly
into the marrow of a bone;

67. G)INTRAPERITONEAL INJECTION
Medicine when introduce
into the peritoneal cavity.
It’s called intraperitoneal
injection.

68. H)INTRASPINAL OR INTRATHECAL INJECTION.
 Medicine is inserted into the spinal cavity. It’s called intraspinal.or intrathecal injection.

70. J) Venesection or cut down
 The loop of thread is cut and two
strands are form under the vein, one
of which is used to the vein to
prevent the escape of blood and the
other to tie the cannula in place. The
vein is then cut partially between the
two ligatures, the cannula is passed
and the proximal ligature tied to
keep the cannula in place. This is
done in emergencies