procedure for nursing pharmacology

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Republic of the Philippines
NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY
General Tinio, Cabanatuan City, Nueva Ecija
ClinicalLearningSkillsLaboratory
PHARMACOLOGY (NCM 106)
CHECKLIST:
ADMINISTERING INTRAMUSCULAR INJECTION
Name: ______________________________________________________________ Score:
Block: ________________________ Date:____________________________
PROCEDURE
Performed Comments
YES NO
ASSESSMENT
1. Assess:
 Client allergies to medication(s)
 Specificdrugaction,side effects,andadverse reactions
 Client’s knowledge of and learning needs about the
medication
 Tissue integrity of the selected site
 Client’s age and weight to determine site and needle
size
2. Determine:
 Determine whether the size of the muscle is
appropriate to the amount of medication to be
injected.
PLANNING
1. Assemble equipmentandsupplies:
 Sterile medication (usually provided in an ampule or
vial or prefilled syringe)
 Syringe andneedleof asize appropriateforthe amount
and type of solution to be administered
 Antiseptic swabs
 Clean gloves
IMPLEMENTATION
1. 1. Checkthe Chart / Record
• Checkthe label onthe medicationcarefullyagainstthe Chart
to make sure that the correct medicationisbeingprepared.
• Followthe three checksforadministeringthe medication
and dose.Readthe label onthe medication(1) whenitis
takenfromthe medicationcart,(2) before withdrawingthe
medication,and(3) afterwithdrawingthe medication.
• Confirmthatthe dose iscorrect.
2. Organize the equipment

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3. Performhand hygiene andobserve other appropriate
infectioncontrol procedures(e.g.,clean gloves)
4. Prepare the medicationfrom the ampule or vial for drug
withdrawal.
5. Provide for clientprivacy
6. Prepare the client.
• Priorto performingthe procedure,introduce self andverify
the client’sidentityusingagencyprotocol.
• Assistthe clienttoa supine,lateral,prone,orsitting
position,dependingonthe chosensite
7. Explainthe purpose of the medicationand how it will help,
usinglanguage that the clientcan understand.
8. Select,locate,and clean the site.
• Selectasite free of skinlesions,tenderness,swelling,
hardness,orlocalizedinflammationandone thathasnot been
usedfrequently.
• If injectionsare tobe frequent,alternatesites.Avoidusing
the same site twice ina row.
• Locate the exactsite forthe injection.
• Applycleangloves.
• Cleanthe site withanantisepticswab.Usinga circular
motion,startat the centerandmove outwardabout5 cm (2
in.).
• Transferandholdthe swab betweenthe thirdandfourth
fingersof yournondominanthandinreadinessforneedle
withdrawal,orpositionthe swabonthe client’sskinabove the
intendedsite.Allowskintodrypriorto injectingmedication
9. Prepare the syringe for injection.
• Remove the needle coveranddiscardwithoutcontaminating
the needle.
• If usinga prefilledunit-dosemedication,take cautionto
avoiddrippingmedicationonthe needle priortoinjection
10. Injectthe medicationusing a Z-track technique.
• Use the ulnarside of the nondominanthandtopull the skin
approximately2.5cm (1 in.) tothe side.Undersome
circumstances,suchas foran emaciated clientoran infant,
the muscle maybe pinched.
• Holdingthe syringe betweenthe thumbandforefinger(asif
holdingapen),pierce the skinquicklyandsmoothlyata 90-
degree angle,andinsertthe needle intothe muscle
• Holdthe barrel of the syringe steadywithyournondominant
handand aspirate bypullingbackon the plungerwithyour
dominanthand

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Remarks:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
RatingScale:
Excellent : 96 – 100%
Very Satisfactory : 90 – 95%
Very Good : 85 – 89%
Good : 80 – 84%
Fair : 75 – 79%
Poor : 74 and below
__________________________________________________
Student’sPrintedName and Signature
JHONEE F. BALMEO,RN.
SkillsLaboratoryInstructor
PrintedName and Signature
• If the needle isina small bloodvessel,ittakestime forthe
bloodto appear.If bloodappearsinthe syringe,withdraw the
needle,discardthe syringe,andprepare anew injection.
• If blooddoesnotappear,injectthe medicationsteadilyand
slowly(approximately10 secondspermilliliter) while holding
the syringe steady.
11. Withdrawthe needle
• Withdrawthe needle smoothlyatthe same angle of
insertion.
• Applygentle pressure atthe site withadry sponge.
• It isnot necessarytomassage the area at the site of
injection.
• If bleedingoccurs,applypressurewithadrysterile gauze
until itstops.
12. Activate the needle safety device or discard the uncapped
needle andattached syringe intothe proper receptacle.
13. Remove anddiscardgloves.Performhandhygiene.
14. Document all relevantinformation.
• Include the time of administration,drugname,dose,route,
and the client’sreactions.
15. Assessthe effectivenessofthe medicationat the time it is
expectedtoact.
EVALUATION AND DOCUMENTATION
16. Conduct appropriate follow-up, such as:
• Desiredeffect(e.g.,relief of painorvomiting)
• Anyadverse reactionsorside effects
• Local skinor tissue reactionsatinjectionsite (e.g.,redness,
swelling,pain,orotherevidence of tissue damage).
TOTAL