Intramuscular Injections-Resource Units

Resource Unit

General Objectives: After 1 hour of student-clinical instructor interaction, the BSN-2B Group 1B students will be able to acquire sufficient knowledge, appropriate skills, and positive attitude towards the concept of Administering Intramuscular Medications.

Specific Objectives Content Methodology Time Allotment

Resources Evaluation

Specifically, the BSN-2B Group 1B students will be able to:

1.) Recall effectively the past existing knowledge on Musculoskeletal System Anatomy and Physiology, especially with the 5 major muscle areas unto which Intramuscular injections may be administered, through a pre-conditioning activity entitled “Match the Muscle”.

Mechanics:

The class will be divided into 2 groups. Each group is provided with 5 muscle names with descriptions, and pictures of 5 muscles are equally posted on each group's partition of the board. They are to correctly match the muscle names with descriptions to the pictures being posted. The first group to finish and to provide the correct alignment of concepts wins.

Muscle Names and Descriptions

• Deltoid Muscle -No more than 2 ml of medication may be injected on this muscle (even lesser with children) -Medication should not be irritating and should be quickly absorbed

• Dorsogluteal Muscle -Common injection site for adults because it is relatively free from nerves and major blood

• Activity-Based Learning: Cooperative Learning (Gaming)

• 10 minutes

• Pens• Bond Papers• Board• Scotch Tape• Scissors• Computer• Printer• Clinical Instructor• Students

•After 10 minutes of student-clinical instructor interaction, the BSN 2B- Group 1B students were able to effectively recall their past existing knowledge on Musculoskeletal Anatomy and Physiology, especially with the 5 major muscle areas unto which IM injections may be administered, through a pre-conditioning activity entitled “Match the Muscle”.

vessels.

• Rectus Femoris Muscle -Rarely used except for infants and self- administered injections

• Vastus Lateralis Muscle -Preferred site for IM injections in infants -A good site for healthy and ambulatory adults because there are few underlying major blood vessels and nerves -Muscle mass in this area tends to be inadequate in the elderly or the very ill, thus may be contraindicated

• Ventrogluteal Muscle -A large muscle mass that is free from major nerves and adipose tissue, and is also remote from the rectum, thus may minimize the risk for infection

Illustrations to Matchsee: Appendix A

2.) Explain properly the concept of Administering Intramuscular Medications.

3.) State correctly the indications for an Intramuscular injection.

• It is a method used to administer medications into the deep muscle mass, past the dermis and subcutaneous tissue and into the very deepest layers of the muscle, where the rich blood supply allows for rapid and full absorption.

• The common sites of IM injections are muscles that contain large blood vessels and nerves, so it is important to place needle correctly to avoid damage to the said structures.

• Recommended for patients who are uncooperative or can’t take medication orally and for drugs that are altered by digestive juices.

• The Intramuscular (IM) route is a common route for parenteral injections. Many antibiotics, preoperative sedatives, and narcotics are administered intramuscularly.

• Formal Discussion

•Traditional Oral Essay Lecture

• 10 minutes

• 10 minutes

• 30 minutes

• Pens• White Cartolina• Board• Scotch Tape• Clinical Instructor• Students

•Pens•White Cartolina•Board•Scotch Tape•Clinical Instructor•Students

•After 10 minutes of student-clinical instructor interaction, the BSN 2B-Group 1B students were able to properly explain the concept of Administering an Intramuscular Injection, through an Oral Essay Questioning.

•After 10 minutes of student-clinical instructor interaction, the BSN 2B-Group 1B students were able to correctly state the indications for an Intramuscular injection, through Factual Questioning.

4.) Demonstrate proper techniques according to the procedure for administering Intramuscular injections.

The students will be provided with a hand-out on the steps to follow in administering intramuscular medications.

After the C.I.'s demonstration, the students are asked to demonstrate the procedure with a partner. This would serve as a practice for the final return demonstration which would consequently follow.

Steps

1.) Perform hand hygiene.

2.) Prepare medication adhering to the five rights of medication administration.

3.) Identify client by checking identification bracelet and by addressing client by name.

4.) Explain procedure and purpose of medication to client.

5.) Verify allergies listed on medication record or electronic medication record.

6.) Don gloves.7.) Select injection site appropriate

for client's age.

8.) Assist client into position for comfort and easy visibility of injection site.

• Demonstration-Return Demonstration

• Medication Administration Record/ Electronic medication ticket Pen

• Appropriate size of syringe and needle for type of injection and viscosity of solution

• Disposable gloves

• Alcohol swab

• Distilled water

• Medication tray

• Hand-outs

• Clinical Instructor

• Students

•After 30 minutes of student-clinical instructor interaction, the BSN 2B-Group 1B students were able to return demonstrate the proper techniques according to the procedure for administering Intramuscular injections.

9.) Cleanse site with alcohol swab.

10.)Remove needle cap.

11.)Pull skin taut by at insertion by using the following sequence:

a.) Place thumb and index finger of non dominant hand over injection site (taking care not to touch cleaned area) to form a V. b.) Pull thumb and index finger in opposing direction, spreading fingers about 3 inches apart.

12.) Talk to client and warn of impending needlestick.

13.) Quickly insert needle at a 90 degree angle with dominant hand (as if throwing a dart). 14.) Move thumb and first finger of Non-dominant hand from skin to support barrel of syringe; place fingers on the barrel.

15.) Pull back on plunger and aspirate for blood return in syringe.

16.) If blood does return when aspirating pull the needle out, apply

pressure to the insertion site and repeat injection steps.

17.) If no blood returns, push plunger slowly and smoothly; encourage client to talk or take deep breaths.

18.) Remove needle at same angle It was inserted.

19.) Massage and clean insertion are with second alcohol wipe (if contraindicated for drug, apply firm pressure instead).

20.) Place needle on tray; do not recap.

21.) Remove gloves.

22.) Discard equipment appropriately.

23.) Perform hand hygiene.

24.) Document administration on Medication record.

Appendix A

DELTOID MUSCLEDORSOGLUTEAL MUSCLEVASTUS LATERALIS MUSCLE

Illustrations for the game “Match the Muscle”

VENTROGLUTEAL MUSCLE RECTUS FEMORIS MUSCLE