Medication Administration
IM Case Study
The physician has ordered a Hepatitis B vaccination for a 68 year-old female patient. The patient is frail and has recently lost weight. The vaccine is in an aqueous solution and come in a 0.5 mL dose to be given IM.
- In choosing the needle size, which is better for this patient--a 1" or 1 1/2" needle size?
- In choosing the needle gauge, which would be more appropriate for this patient--a 25 gauge or 20 gauge?
- In choosing an injection site for this patient, what are three things the nurse will consider?
- What IM injection technique is recommended to prevent irritation along the injection track?
Answers:
- A 1" needle size is preferred because of the patient's frailty.
- A 25-gauge needle is more appropriate for the aqueous solution and the patient's condition.
- Age, type of solution, the muscle, amount of adipose tissues covering the muscle, and tissue integrity are worth considering. (Any three of these answers are correct.)
- The Z-track technique is recommended to prevent irritation along the injection track.