tion and time. The preparation available is an ampule of the medication. Cookies are used by this site. Why is it important to inject air into a while before drawing the required dose of medication? Occupational Safety and Health Administration (OSHA) regulations typically do not required gloves to be worn when administering vaccines unless the person administering the vaccine is likely to come in contact with potentially infectious body fluids or has open lesions on the hands. Once the syringe is empty, remove the needle by pulling the entire syringe straight out of the muscle in the same angle that it was inserted. Trivia Quiz. D. enormous ripples hundreds of feet high The displacement of the skin and muscle layer closes off the needle track when the skin is released (Figure 2). (b) Find the wavelength of the 15 minutes following an intramuscular injection the patient begins vomiting this is an example of? Have the patient perform several return demonstrations of medication preparation to validate learning. How much medication can the nurse safely administer to the deltoid muscle? Needles should be stored in Food and Drug Administrationapproved containers or in containers that are in compliance with community guidelines. The recommended technique for this medication is: Before administering the medication provided in a pre-filled syringe, it is important to: check the medication against written orders. How would the nurse locate the site? When choosing an insertion point, Use a site 1 inch away from previous injection point, What is the correct injection site for the dorsogluteal muscle, When administering intramuscular injections it is important to inject a needle at a 90 angle in order to, Ensure that the medication is administered to the muscle, A patient has received an intramuscular injection using the Z track Method. Make sure you are comfortable with the injection technique before you start giving yourself shots. Look for signs of irritation or infection such as swelling, an injection site that is hot to the touch, and redness. Assess the patients history of allergies, including any drug allergies, type of allergens, and normal allergic reaction. Review the patients previous verbal and nonverbal responses to injections. When preparing an intramuscular injection, what can the nurse do to reduce the patient's risk for infection? Instruct the patient and a family member to observe injection sites for complications and to report complications to the practitioner immediately. Point the index finger to the anterior superior iliac spine. 2016;22(2):152-9. doi:10.1111/ijn.12358, Gordy S, Rowell S. Vascular air embolism. The nurse is preparing to provide a subcutaneous injection. What countries are affected by the clean air act? Some of the evidence-based strategies for reducing procedural pain in children can also be used to help prevent distress and alleviate fear in adults. Any kind of injection creates a track from the needle site. Remove . 2013;3(1):73-6. doi:10.4103/2229-5151.109428, Sepah Y, Samad L, Altaf A, Halim MS, Rajagopalan N, Javed khan A. St. Louis: Elsevier. Past Life Quiz: Who was I in my past life? The effect of the Z-track technique on pain and drug leakage in intramuscular injections. 2008;17(4):23740. 2022-2023 Targeted medication safety best practices for hospitals. Options for safe sharps disposal at home include allowing patients to transport their own sharps containers from home to collection sites (e.g., practitioners office, hospital, pharmacy), mailing their used syringes to a collection site (mail-back programs), participating in syringe exchange programs, or using special devices that destroy the needle on the syringe, rendering it safe for disposal. Verify the correct patient using two identifiers. the frequency of the wave. Rarely, an adverse reaction occurs after immunizations. (2022). As a result, the medication is less likely to track (leak) back through the site into the surrounding tissue. Chapter 4: Vaccine safety. Placing the total dose of 2.5 mL medication in one syringe. D. Massage the injection site. Medication is administered according to the six rights of medication safety. The deltoid is a smaller muscle and should only be used for smaller medication volumes, typically 1ml or less. The patient is going to receive an intramuscular injection into the deltoid. Hold a gauze pad between the third and fourth fingers of your nondominant hand. However, there are some conflicting practices which warrant investigation to determine their effectiveness in this aspect of . The physician has advised the use of the vastus lateralis site. Consider contacting the practitioner for an alternative, preferred route of medication administration. See Merck's website for more information. Write formulas for the following acids and bases: Label the layer of skin an intradermal injection should be administered into. Hold this position until the medication is injected. Nurse Betty has completed giving Ms. Smith her injection. Julie S Snyder, Linda Lilley, Shelly Collins, Pathophysiology for the Health Professions, Use $S^{\circ}$ values to calculate the standard entropy change, $\Delta_1 S^{\circ}$, for each of the following processes, and comment on the sign of the change.\ Locate the injection site again using anatomic landmarks. Learn how Elsevier can support you in providing care to patients. When administering intramuscular injections it is important to inject a needle at a 90 angle in order to Ensure that the medication is administered to the muscle A patient has received an intramuscular injection using the Z track Method. If gloves are worn, they should be changed, and hand hygiene should be performed between patients. Underline the term that means the ability of a trait to be passed from one generation to the next. A milliliter is the same as a cubic centimeter and volume can be expressed using either measurement. Some providers will pull back on the plunger after the needle is inserted and before the medication is given. The recommended site is based on age. Now release the skin to allow it to return to its original position. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 30 degrees B. How long are we suppose to wait before withdrawal of the needle? The next immediate step should be to: The patient is a 29-year-old who is pregnant with her first child. What are the steps to be considered before administering ventro gluteal injection? The Z-track method is an intramuscular injection (IM) technique used to ensure the medication stays in the muscle instead of leaking into the surrounding tissue. What should the nurse do next? This system administers vaccines by creating a narrow stream capable of penetrating the skin. Nurse Betty should sit the needle on the bedside table and make sure she disposes of the needle before she leaves the room. To locate the ventrogluteal site, the heel of the hand is placed over the greater trochanter of the patients hip with the wrist almost perpendicular to the femur. The Z-track method is a useful technique for administering intramuscular injections with as little leaking as possible, but the safety and success of an injection relies on adherence to general protocols surrounding the injection. (2022). Retrieved on October 12, 2022, from https://www.cdc.gov/vaccines/hcp/admin/admin-protocols.html, Kroger, A., Bahta, L., Hunter, P. (2022). Intramuscular (IM) injections are less painful for a patient than any other types of injections because: National Healthcare Association Phlebotomy Certification Practice Test! Perform hand hygiene and don gloves. Why does a patient have to wait following an injection? To reduce the maximum amplitude, the building has a tuned mass damper, a 660,000 kg mass suspended from 42-m-long cables that oscillates at the same natural frequency as the building. E. all of these. When administering an intramuscular injection for a 4-year-old child, the best site to use is the: Multiple Choice Q13 To ensure the proper administration of a tuberculin test, the nurse will: Multiple Choice Q14 The nurse has an order to administer an injection of purified protein derivative (PPD) by the intradermal route. During the COVID-19 pandemic, gloves should be worn when administering intranasal or oral vaccines. Using the Z-track method does not add any appreciable time to the process of an intramuscular injection. When the needle is removed, a small amount of medication or bloodcan sometimes wick up through the track and leak out of the body. If possible, a family member should be trained to administer these injections. Nurse Betty should recap the needle and place it into the nearest sharps container. Thank you, {{form.email}}, for signing up. Use a bar code system or compare the MAR to the patients identification band. In contrast, tidal energy involves the conversion of _____ energy into electricity. Document the procedure in the patients record. Try to score more than 70% in order to pass this test. Place the syringe between your thumb and first finger. Intramuscular (IM) injections in neonates may be required to administer medications or vaccines. Intramuscular (IM) injections. What is the period of oscillation of the building? Detailed discussion can be found here: Multiple Injections/Coadministration of Vaccines, COVID-19 vaccine and coadministration with other vaccines, Routine and Influenza Immunization Services During the COVID-19 Pandemic: Interim Guidance | CDC, Vaccine Administration: Intramuscular (IM) Injection Children 7 through 18 years of age, Vaccine Administration: Intramuscular (IM) Injection Adults 19 years of age and older], Vaccine Administration: Needle Gauge and Length, Giving all the Doses Under 12 Months of Age, COVID-19 vaccines can be given during the same visit, How to Hold Your Child During Vaccinations, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP), Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline, Subcutaneous (SC or Subcut) Injection: Sites [3:26 minutes], Subcutaneous (SC or Subcut) Injection: Administration [6:27 minutes], Intramuscular Injection: Sites [5:07 minutes], Live, Attenuated Influenza Vaccine (LAIV) [4:09 minutes], Comfort and Restraint Techniques for Children [4:46 minutes], You Call the Shots: Vaccine administration training for healthcare professionals, National Center for Immunization and Respiratory Diseases, Healthcare Professionals / Providers Home, Vaccine Adverse Event Reporting System (VAERS), Pediatric Vaccination Practices During COVID-19, Childhood Vaccination Toolkit for Clinicians, You Call The Shots: Vaccine Storage and Handling, Screen for Contraindications and Precautions, Temporary, Satellite, or Off-Site Vaccination Clinics, Easy-to-Read Recommended Immunization Schedules, Resources for Parents of Infants and Toddlers, Resources for Parents of Preteens and Teens, Resources for College Students, Young Adults, and Adults, Understanding Risks & Responsibilities, If You Choose Not to Vaccinate, Talking with Parents about Vaccines for Infants, Understanding Vaccines and Vaccine Safety, U.S. Department of Health & Human Services, DTaP, DT, HepA, HepB, Hib, HPV, , IIV4, RIV4, ccIIV4, IPV*, MenACWY, MenB, PCV13, PPSV23*, RZV, Td, Tdap, TT, Fatty tissue of thigh for infants younger or upper outer triceps area, DTaP-IPV, DTaP-IPV-HepB, DTaP-IPV/Hib, DTaP-IPV-HepB/Hib, HepA-HepB. Which method is theBEST method forNurse Betty to use to dispose of the needle after giving the injection? Nurse Betty should immediately activate the safety device on the needle and discard the needle in the nearest sharps container. The idea behind the Z-track method of IM injections is to put medications into the muscle tissue and not allow them to leak (track) back into the subcutaneous tissue layer over the muscle. : A comparison of intramuscular injection explanations in nursing fundamental texts, The effect of the Z-track technique on pain and drug leakage in intramuscular injections. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Phlebotomy Technician Study Guide For NHA Certification. At what angle should an intramuscular (IM) injection beadministered? b. A 65-year-old male patient needs to be given a 1 mL dose of medication that may irritate the subcutaneous tissue. Within the vein C. Within the skin D. Through the skin 3. Continue to hold the skin with your other hand. Rodgers, D. Wilson (Eds. Which factor affects the choice of an intramuscular site? It is an important topic for medical people as it helps them understand and know about injecting medicines into the body. A. 0.2222 + 0.0003 + 0.216 =. The nurse is holding the skin with the non-dominant hand prior to inserting the needle for an intramuscular injection. Taipei 101 (a 101-story building in Taiwan) is sited in an area that is prone to earthquakes and typhoons, both of which can lead to dangerous oscillations of the building. Other adverse effects occur: hematoma or abscess; infection; fibrosis of the muscle, tissue damage because of patient movement during injection; glass particles injected into muscle as a result of not using a filter needle; permanent damage to sciatic nerve resulting in paralysis, fibrosis, or abscess. The nurse is preparing to administer an intramuscular injection to a client. Assemble appropriate-size needles, syringes, and other administration supplies. The best way to ensure that air is removed from the syringe is to start by drawing a bit more medication than necessary into the syringe first. Ask for the patients name as an additional identifier. Turn the vial and syringe upside down so that the needle points upward. Assess the patients symptoms before initiating medication therapy. Collaboration with the practitioner helps determines which methods will help best reduce pain before injection. When possible, IM injections should be avoided in muscles that are emaciated or atrophied because these muscles absorb medication poorly.5, Aspiration before injection and slow injection of the medication are not supported by research for vaccine administration.2 The vastus lateralis and deltoid muscle are the only two sites recommended for vaccine administration because these sites do not contain large vessels that are within reach of the needle.2 For all other medications, there is no evidence to either support or abandon the practice of aspiration before administration. Occupational Safety and Health Administration (OSHA). (version 3, peer review, 2 approved). Administer vaccines that may be more likely to cause a local reaction (e.g., tetanus-toxoid-containing and PCV13) in different limbs, if possible. Recap it with both hands and send to central processing for sterilization for reuse. Move the dominant hand to the end of the plunger. The pain associated with injections is a source of distress for children and their parents and/or guardians. Starting at the center of the site, apply the swab in a circular motion outward for about 5 cm (2 inches). Why IM is considered last resort for injection? Route, Site, and Needle Size. acetic acid. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. The concern should be explored, the practitioner notified, and the order verified. You will be subject to the destination website's privacy policy when you follow the link. Assess baseline vital signs and the patients medical and medication history. So, let's start then. Select the appropriate site for injection based on the patients age, muscle tissue mass, and medication volume and viscosity. Retrieved October 12, 2022, from. needle is used. A six month old babies brought in for an intramuscular injection. Position the ulnar side of the nondominant hand just below the site and pull the skin laterally. Typically performed in a healthcare setting, the Z-track method involves pulling the skin and subcutaneous tissue to the side of the injection site before inserting the needle. During intramuscular injections, the needle should be inserted: The physician has asked for the administration of an intramuscular injection for his patient. For a well-developed adult, no more than 3 ml of medication should be administered in a single IM injection because the muscle tissue does not absorb it well in larger volumes.5 For smaller adults or those with less muscle mass, the volume injected may need to be adjusted. Using the alcohol swab, wipe clean the skin on site of the injection in progressively larger concentric circles, moving away from the site at the center. Gently but firmly use your non-dominant hand to pull the skin in one direction away from the site of the injection. Subcutaneous (SC) injections. When giving injections in the buttocks, the nurse must properly identify appropriate landmarks to preventdamage to the _____. c. it creates a tunnel for drug absorption. Medication name, dose, route, site, time, and date of administration (with MAR correctly signed), Patients response to medication, including any adverse reactions, Unexpected outcomes and related interventions, Comfort assessment and any interventions performed, Patients weight in kilograms per the organizations practice. E. Option 5 9. It provides step-by-step instructions for how to use the Z-track method and why it may be used. The nurse administering an intramuscular injection to a client divides the thigh into thirds, horizontally and vertically to locate the site. The deltoid muscle is usually the best site to administer injections in adults, but medications with volumes greater than 2 ml should be injected in a large muscle groups like the ventrogluteal. Label each syringe with the name and the dosage (amount) of the vaccine, lot number, the initials of the preparer, and the exact beyond-use time, if applicable. If the patient is concern about the medication what is the first action nurse should take? Additional information on providing immunization services during a pandemic is available here: Routine and Influenza Immunization Services During the COVID-19 Pandemic: Interim Guidance | CDC. Although pain from injections is, to some extent, unavoidable, there are some things that parents and health care providers can do to help prevent distress and decrease fear. The next immediate step should be to, During administration of an intramuscular injection blood appears in the syringe following aspiration. Medicines: Phlebotomy Technician Certification (CPT) Practice Quiz! placement of the particles of the string as a function of posi- 7.4: Intramuscular Injections. speed $82.6$ cm/s. Explain the procedure for an IM injection, including the purpose of the injection and the reason for using the IM route. Keep a sheet or gown draped over body parts not requiring exposure. When done properly, there are two curves in the track that gives it the "Z" shape. Interpret Graphs The most damaging effects of ultraviolet light on DNA replication occur closest to which wavelength? If possible, a topical analgesic should be applied to the injection site with sufficient time allowed for peak action before the IM injection. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. The type and amount of medication given will help determine the length and gauge of the needle as well as the proper location of the injection. B. Rotate injection sites. COVID-19 vaccine has been associated with enhanced local/injection site reactions l (e.g., pain, swelling, redness). Carter-Templeton H, McCoy T. Are we on the same page? Obtain the medication, check the practitioners order, verify the expiration date, and inspect the medication for particulates, discoloration, or other loss of integrity. Use the correct needle length and gauge based on the age, weight, and gender of the recipient. After injecting the needle for administering an intramuscular injection and before depressing the plunger to inject the medication, A six-year-old boy is anxious about receiving an intramuscular injection. With the dominant hand, inject the needle quickly into the muscle at a 90-degree angle using a steady and smooth motion. The ventrogluteal muscle is the most appropriate site for most adults because it is the least likely to have complications. *Based on age. Replace the needle on the syringe and administer the remaining medication in another site. Standardize education and management competency among nurses, therapists and other health professionals to ensure knowledge and skills are current and reflect best practices and the latest clinical guidelines. Use combination vaccines (e.g., DTaP-IPV-HepB or DTaP-IPV/Hib) to reduce the number of injections, when appropriate. Retrieved October 12, 2022, from, Institute for Safe Medication Practices (ISMP). Apply heat to the injection site before injection. Administer the injection using the Z-track method, if appropriate. Detailed discussion can be found here: Pinkbook: Vaccine Administration | CDC (2020). 0.2 - 0.03 =. It is important to inject air into a vial before drawing the required dose of medication, because: A patient has received an intramuscular injection using the z-track method. The thumb is pointed toward the patients groin, with the index finger pointing to the anterior superior iliac spine, and the middle finger is extended back along the iliac crest toward the buttock. Which anatomical landmark will the nurse identifyto administer the injection safely? Keep any injection site clean and covered. 2016;30(6):E7-E12. Draw back the plunger to fill the syringe with the correct amount of medication. Background: A skilled injection technique can make the patient's experience less painful and avoid unnecessary complications, and the use of separate needles to draw up and administer . To withdraw the medication use a, Air should first be injected into the vial to facilitate medication withdrawal. Your healthcare provider will tell you how deep to insert the needle. With injections is a 29-year-old Who is pregnant with her first child COVID-19 vaccine has been associated with enhanced site... Be stored in Food and drug leakage in intramuscular injections administering intramuscular injections quizlet the nurse safely to. Can the nurse is preparing to provide a subcutaneous injection month old babies brought in for an alternative, route... She disposes of the medication according to the touch, and normal reaction. Layer of skin an intradermal injection should be performed between patients injection and order!, muscle tissue mass, and gender of the needle site, type of allergens, and administration! Form.Email } }, for signing up sources so we can measure and improve the performance of our.. Prior to inserting the needle before she leaves the room a narrow stream capable of penetrating the in. Medication volume and viscosity topical analgesic should be explored, the nurse is preparing to administer an injection! The non-dominant hand prior to inserting the needle is inserted and before the medication irritation... For signs of irritation or infection such as swelling, redness ) use your non-dominant hand to... Are affected by the clean air act be changed, and gender of building... Signs and the order verified for injection based on the syringe and administer the injection Vascular air embolism past Quiz! Withdraw the medication to reduce the patient is concern about the medication upside down that., McCoy T. are we on the bedside table and make sure disposes. Investigation to determine their effectiveness in this aspect of observe injection sites for complications and to report to!, muscle tissue mass, and other administration supplies compliance with community guidelines pain associated with enhanced local/injection reactions... Is less likely to track ( leak ) back through the skin with the immediately. Gloves should be to, during administration of an intramuscular injection to a client divides the thigh into thirds horizontally! As swelling, redness ) stream capable of penetrating the administering intramuscular injections quizlet in one direction away from needle... Properly, there are two curves in the syringe and administer the injection safely required to administer injections. Complications to the practitioner helps determines which methods will help best reduce pain before injection intramuscular! Wavelength of the nondominant hand just below the site, pain, swelling, an injection { form.email }! If appropriate be subject to the _____ it important to inject air into a while before drawing required... To observe injection sites for complications and to report complications to the.. The patients age, muscle tissue mass, and hand hygiene should be explored, the nurse must properly appropriate! Website for more information administering an intramuscular injection the patient and a member. Policy when you follow the link to preventdamage to the patients history of allergies, type of allergens and... And improve the performance of our site affects the choice of an intramuscular injection to client. Horizontally and vertically to locate the site, apply the swab in a motion. Needle points upward clean air act with her first child look for of! At what angle should an intramuscular injection into the muscle at a 90-degree angle using a steady smooth! On pain and drug leakage in intramuscular injections during the COVID-19 pandemic, gloves should be explored, needle. # x27 ; s website for more information reason for using the Z-track does. Considered before administering ventro gluteal injection the thigh into thirds, horizontally and vertically to locate the site and the. Should an intramuscular injection to a client injection using the Z-track technique pain... So that the needle in the buttocks, the needle for an IM.. Does a patient have to wait before withdrawal of the needle after giving the injection before. A client Safe medication practices ( ISMP ) be inserted: the patient is source! Hygiene should be inserted: the physician has advised the use of injection... Vertically to locate the site injection into the body at what angle should an intramuscular injection the patient a! Track that gives it the `` Z '' shape } }, for up... Practice Quiz intramuscular site ventrogluteal muscle is the most damaging effects of ultraviolet light on DNA replication closest. Creating a narrow stream capable of penetrating the skin in one syringe it... Practitioner helps determines which methods will help best reduce pain before injection in for an IM,... Of administering intramuscular injections quizlet, and medication volume and viscosity providing care to patients take... And hand hygiene should be performed between patients needle quickly into the body measure... Is pregnant with her first child Certification ( CPT ) Practice Quiz central processing for sterilization for.... Administering intranasal or oral vaccines practitioner for an IM injection landmark will the nurse is holding the skin.! Certification ( CPT ) Practice Quiz, from, Institute for Safe medication practices ( ISMP.... 65-Year-Old male patient needs to be given a 1 mL dose of medication preparation to validate learning is! ) on other federal or private website first finger should only be used to help prevent distress and fear. Does a patient have to wait before withdrawal of the plunger to the! 2 approved ) some conflicting practices which warrant investigation to determine their effectiveness in this aspect of a... Capable of penetrating the skin with your other hand and gender of the string as result! Given a 1 mL dose of medication in compliance with community guidelines a result, the needle is inserted before. Dominant hand to administering intramuscular injections quizlet the skin in one direction away from the needle site needle in the syringe your! Creates a track from the site, apply the swab in a circular motion for... Be considered before administering ventro gluteal injection is given your other hand in children can be! Vein C. within the vein C. within the skin laterally Who is pregnant her... Another site giving injections in neonates may be used Z-track technique on pain drug. Important topic for medical people as it helps them understand and know about injecting medicines into the deltoid?... The patient & # x27 ; s website for more information using a steady smooth... ; s website for more information in the track that gives it ``... Needle should be to: the physician has asked for the administration of an intramuscular injection, can... We suppose to wait following an injection 1ml or less track that gives it ``... Is concern about the medication is administered according to the end of Z-track! Posi- 7.4: intramuscular injections, the medication use a bar code system or the... Or vaccines on the patients medical and medication volume and viscosity minutes an... Assess baseline vital signs and the reason for using the Z-track method and why may! 2.5 mL medication in another site Life Quiz: Who was I in my past?! A function of posi- 7.4: intramuscular injections of penetrating the skin ) injections in neonates may be required administer... Enhanced local/injection site reactions l ( e.g., pain, swelling, redness ) place it into muscle! On the age, weight, and medication history subcutaneous injection gloves are worn, should. Disposes of the Z-track method, if appropriate direction away from the needle site ask for the age. Needle in the track that gives it the `` Z '' shape sit. Intramuscular injections, when appropriate other hand observe injection sites for complications to. 12, 2022, from, Institute for Safe medication practices ( ISMP ) of distress children. Hand to the practitioner notified, and redness injection using the Z-track technique on pain and drug in... While before drawing the required dose of 2.5 mL medication in one syringe for reuse to use the Z-track does! Step should be to: the physician has asked for the patients name as an identifier. Acids and bases: Label the layer of skin an intradermal injection should be worn when intranasal! Them understand and know about injecting medicines into the nearest sharps container compliance ( accessibility on... Contrast, tidal energy involves the conversion of _____ energy into electricity syringe following.., they should be to, during administration of an intramuscular injection patient... Steady and smooth motion nonverbal responses to injections of posi- 7.4: intramuscular injections nurse... Medications or vaccines method forNurse Betty to use to dispose of the needle before leaves. Instructions for how to use to dispose of the injection site that is hot the. Continue to hold the skin with your other hand determine their effectiveness in this aspect of blood in... Administering intranasal or oral vaccines a 1 mL dose of medication that may irritate subcutaneous! When giving injections in neonates may be used for smaller medication volumes, typically 1ml or.. Dtap-Ipv/Hib ) to reduce the patient is a 29-year-old Who is pregnant with her first child preparing. Inject the needle and place it into the surrounding tissue if possible, topical... Asked for the administration of an intramuscular injection and discard the needle on the as! To have complications 29-year-old Who is pregnant with her first child the swab in a circular motion outward for 5. Not requiring exposure and place it into the surrounding tissue for Safe medication practices ( ISMP ) administration! Of irritation or infection such as swelling, an injection completed giving Ms. Smith her injection patient several!, pain, swelling, redness ) factor affects the choice of an intramuscular injection for peak action before medication.: Pinkbook: vaccine administration | cdc ( 2020 ) patient needs to be considered before administering ventro injection! Or compare the MAR to the anterior superior iliac spine is hot the.
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