A client is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. What is the correct angle that the nurse should use for the needle insertion?
90 degrees
45 degrees
15 degrees
60 degrees
The Correct Answer is A
A) 90 degrees: For intramuscular (IM) injections, including in the ventrogluteal site, the needle should be inserted at a 90-degree angle to ensure that the medication is deposited deep into the muscle tissue. This angle allows the needle to penetrate the skin and subcutaneous tissue directly into the muscle where it can be absorbed efficiently. The ventrogluteal site, being a large and well-muscled area, is ideal for IM injections because it is less likely to cause damage to nerves or blood vessels, and a 90-degree angle ensures proper placement of the medication.
B) 45 degrees: A 45-degree angle is commonly used for subcutaneous injections which go into the fatty tissue just beneath the skin. This angle ensures that the medication is delivered into the correct layer of tissue, allowing for slow absorption. However, when administering an IM injection, a 45-degree angle would not be deep enough to reach the muscle and could result in improper placement, potentially affecting the medication's effectiveness and increasing the risk of irritation at the injection site.
C) 15 degrees: A 15-degree angle is far too shallow for an intramuscular injection and is typically used for intradermal injections, where the medication is injected just beneath the skin into the dermal layer. Using such a shallow angle for an IM injection would likely cause the needle to remain in the subcutaneous tissue, preventing the medication from reaching the muscle layer and significantly reducing its effectiveness.
D) 60 degrees: A 60-degree angle is too steep for intramuscular injections. At this angle, the needle may not effectively reach the muscle tissue and could cause the medication to be injected too superficially into the subcutaneous layer. This would not allow for proper absorption of the drug and may lead to irritation or a delayed therapeutic effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) 1 x soft bowel movement: This is the correct answer. Psyllium is a bulk-forming laxative that helps to relieve constipation by absorbing water into the stool, making it easier to pass. A therapeutic effect of psyllium would be the client experiencing a soft bowel movement, indicating the medication has helped to regulate the client's bowel movements and relieve constipation.
B) Gastric pH 2 (Normal pH: 1-4): While this is a normal gastric pH range, it is not related to the therapeutic effect of psyllium. Psyllium works in the gastrointestinal tract to promote bowel regularity, not to alter gastric pH. The pH measurement of gastric contents is not a relevant indicator of the medication's effectiveness.
C) 500 ml of urine output: This finding is not related to the therapeutic effect of psyllium. Psyllium is intended to address bowel function, not urine output. Adequate urine output should be monitored, but it is not the expected outcome for a patient taking psyllium.
D) Blood glucose: 95 (Normal Fasting Blood Glucose: 60-120): While a normal blood glucose level is important, it is not relevant to the action of psyllium. Psyllium does not have a direct effect on blood glucose levels, so a normal blood glucose result is not indicative of a therapeutic effect of the medication.
Correct Answer is C
Explanation
A) Hypersensitivity reaction: A hypersensitivity reaction typically involves an immune response where the body reacts to a substance as if it were harmful, leading to symptoms like rashes, swelling, or difficulty breathing. However, low hemoglobin and low white blood cell counts are not typical signs of a hypersensitivity reaction. This would involve more common allergic symptoms like itching or swelling, rather than hematologic changes.
B) Paradoxical reaction: A paradoxical reaction refers to when a medication causes an effect opposite to the expected result. For example, a sedative causing agitation instead of sleepiness. While a paradoxical reaction can involve unexpected effects, the hematologic changes (low hemoglobin and white blood cell counts) in this scenario do not align with this type of response.
C) Idiosyncratic reaction: An idiosyncratic reaction is an unusual or unexpected response to
a medication that is not related to the drug's pharmacologic properties or the dose given. It may be related to genetic factors or other individual differences in how a person metabolizes or responds to the drug. The low hemoglobin and low white blood cell counts in this case are unusual effects of diphenhydramine and suggest an idiosyncratic response, where the client’s body is reacting in an unexpected way to the medication.
D) Anti-cholinergic reaction: Anti-cholinergic reactions are typically related to symptoms caused by the blocking of acetylcholine, such as dry mouth, blurred vision, urinary retention, or constipation. While diphenhydramine has anti-cholinergic properties, the symptoms described (low hemoglobin and white blood cell counts) are not typical of an anti-cholinergic reaction.
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