GDA Nursing Class Note 5
Before using injections, it is important to follow certain steps to ensure safety and proper administration. Here are the general steps to consider:
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- Gather Supplies: Collect all the necessary supplies for the injection, including the appropriate syringe, needle, medication, alcohol swabs, cotton balls or gauze, adhesive bandages, and a sharps container for safe disposal of used needles.
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- Hand Hygiene: Wash your hands thoroughly with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer to reduce the risk of introducing bacteria into the injection site.
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- Check Medication: Verify the medication name, strength, and expiration date to ensure you have the correct medication. Double-check the prescribed dosage with the medication order or prescription.
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- Prepare the Injection Area: Choose the appropriate injection site based on the type of injection and the medication being administered. Cleanse the skin at the injection site with an alcohol swab using a circular motion, starting from the center and moving outward. Allow the area to air dry completely before proceeding.
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- Prepare the Syringe: Attach the appropriate needle to the syringe securely. Ensure that the needle is clean and sterile. If using a pre-filled syringe or a vial, draw up the correct dosage of medication into the syringe as per the healthcare professional’s instructions.
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- Remove Air Bubbles (if applicable): Hold the syringe upright with the needle pointing upward and gently tap it to move any air bubbles to the top. Slowly push the plunger to expel any trapped air until a small drop of medication appears at the needle tip.
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- Inspect the Syringe: Examine the syringe for any defects, leaks, or signs of damage. Make sure the dose is accurate and matches the prescribed amount.
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- Position and Stabilize: Position the patient comfortably, ensuring good visibility and access to the injection site. Use appropriate techniques to stabilize the body part or limb to minimize movement during the injection.
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- Administer the Injection: Hold the syringe like a pencil or as per the recommended grip, with the needle pointing toward the injection site. Insert the needle swiftly and smoothly into the skin at the correct angle and depth according to the type of injection.
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- Inject the Medication: Administer the medication slowly and steadily by gently depressing the plunger. Ensure the entire dose is delivered.
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- Definition of an Injection: An injection, also known as an “injectable” or “shot,” is a medical procedure where a substance is introduced into the body using a syringe and needle.
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- Types of Injections: There are different types of injections depending on the purpose and location of administration. Some common types include intramuscular (IM), subcutaneous (SC), intravenous (IV), intradermal (ID).
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- Administration: Injections are usually administered by healthcare professionals such as doctors, nurses, or pharmacists who are trained in proper injection techniques. However, some injections can also be self-administered under the guidance of healthcare professionals.
Purpose: Injections can serve various purposes, including:
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- Administration of medications: Injections are commonly used to deliver medications directly into the bloodstream or specific tissues for quick and efficient absorption. Examples include vaccines, antibiotics, insulin, and pain medications.
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- Diagnostic purposes: Certain injections, such as contrast media, may be used to enhance imaging studies like CT scans or MRIs to improve visualization of internal structures.
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- Therapeutic treatments: Some injections provide therapeutic benefits, such as joint injections for pain relief or corticosteroid injections for reducing inflammation.
Injections for taking blood are commonly known as venipuncture or blood draws. While not technically injections in the traditional sense, blood draws involve puncturing a vein with a needle to collect a blood sample. Here’s an overview of the process:
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- Preparation: Gather the necessary supplies, including a sterile needle, vacutainer tubes, alcohol swabs, tourniquet, gloves, cotton balls or gauze, adhesive bandages, and a requisition form for labeling the tubes.
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- Patient Preparation: Explain the procedure to the patient and address any concerns they may have. Ensure the patient is in a comfortable position, with their arm extended and the selected vein accessible.
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- Hand Hygiene: Perform proper hand hygiene by washing your hands thoroughly with soap and water or using an alcohol-based hand sanitizer.
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- Apply a Tourniquet: Apply a tourniquet a few inches above the intended puncture site. This helps to temporarily restrict blood flow and make the veins more visible and accessible.
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- Select and Cleanse the Puncture Site: Identify an appropriate vein for puncture, typically on the inner part of the elbow (antecubital fossa). Cleanse the site with an alcohol swab, starting from the center and moving outward in a circular motion. Allow the area to dry completely.
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- Prepare the Equipment: Attach the appropriate needle to a vacutainer tube holder or a syringe. Make sure the needle is securely attached.
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- Venipuncture Technique: Put on gloves and locate the selected vein. Hold the needle at a shallow angle (about 15-30 degrees) with the bevel facing up. With a quick and steady motion, insert the needle into the vein. Blood should flow into the vacutainer tubes or syringe.
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- Tube Collection or Syringe Filling: Fill the vacutainer tubes with the required volume of blood by inserting them into the tube holder and allowing the vacuum to draw the blood. Alternatively, if using a syringe, gently pull back on the plunger to draw blood into the syringe.
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- Tube Removal and Mixing (if applicable): Once the required amount of blood is collected, remove the vacutainer tubes from the holder, or if using a syringe, remove the needle from the patient’s vein. Gently invert the tubes several times to mix the blood with any additives in the tubes.
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- Needle Removal and Site Pressure: Withdraw the needle from the patient’s vein using a swift and controlled motion. Immediately apply gentle pressure with a cotton ball or sterile gauze at the puncture site to promote clotting and prevent bleeding. Instruct the patient to keep applying pressure while you dispose of the used needle.
Injecting insulin is a common method of administering this medication for individuals with diabetes. Here’s an overview of the process:
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- Insulin Types: There are different types of insulin, including rapid-acting, short-acting, intermediate-acting, and long-acting insulin. The specific type(s) prescribed will depend on the individual’s diabetes management plan.
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- Insulin Pens or Syringes: Insulin can be injected using insulin pens or syringes. Insulin pens are pre-filled devices that simplify the injection process, while syringes require drawing the appropriate dose from a vial.
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- Preparation: Gather the necessary supplies, including the prescribed insulin, insulin pen or syringe, alcohol swabs, and a sharps container for safe disposal.
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- Hand Hygiene: Perform proper hand hygiene by washing your hands thoroughly with soap and water or using an alcohol-based hand sanitizer.
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- Insulin Pen Preparation (if applicable): If using an insulin pen, attach a new pen needle. Prime the pen by dialing to the desired dose and expelling a small amount of insulin to ensure proper function.
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- Insulin Syringe Preparation (if applicable): If using a syringe, draw the prescribed dose of insulin into the syringe following the specific instructions provided.
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- Injection Site Selection: Insulin is typically injected into subcutaneous tissue, which is fatty tissue just beneath the skin. Common injection sites include the abdomen, thighs, upper arms, and buttocks. Rotate injection sites to prevent lipohypertrophy (thickening of the fatty tissue).
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- Injection Site Cleansing: Cleanse the injection site with an alcohol swab, starting from the center and moving outward in a circular motion. Allow the area to dry completely.
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- Insulin Injection: Hold the insulin pen or syringe like a pencil or with the grip recommended by the manufacturer. Pinch the skin at the cleaned injection site to create a small fold or use the recommended technique for the chosen site. Insert the needle into the skin at a 90-degree angle for most individuals. However, the angle may vary based on the individual’s body composition or specific instructions from their healthcare provider.
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- Insulin Delivery: For insulin pens, dial the prescribed dose, and press the injection button to deliver the insulin. With syringes, push the plunger gently to inject the insulin.
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- Needle Removal: After delivering the insulin, withdraw the needle gently and dispose of it safely in a sharps container. Do not recap the needle to avoid accidental needlestick injuries.
5 mL Syringe:
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- Capacity: A 5 mL syringe can hold up to 5 milliliters of liquid medication.
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- Common Use: 5 mL syringes are often used for larger volume injections, such as intramuscular (IM) or subcutaneous (SC) injections that require a higher dose of medication.
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- Graduations: The barrel of a 5 mL syringe is typically marked with gradations in milliliters (mL) to allow for accurate measurement of the medication being administered.
1 mL Syringe:
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- Capacity: A 1 mL syringe can hold up to 1 milliliter of liquid medication.
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- Common Use: 1 mL syringes are commonly used for smaller volume injections, such as subcutaneous (SC), intradermal (ID), or intravenous (IV) injections where precise measurement of medication is required.
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- Graduations: The barrel of a 1 mL syringe is typically marked with finer gradations in tenths or hundredths of a milliliter to allow for more accurate measurement of small volumes.