A nurse is administering an IM injection of diphtheria-tetanus with pertussis (DTaP) to a 4-month-old infant. What would be the appropriate site for this injection?
Vastus lateralis
Deltoid
Dorsal gluteal
Ventrogluteal
The Correct Answer is A
A. Vastus lateralis: The Vastus Lateralis muscle (located on the anterolateral aspect of the thigh) is the preferred and safest site for IM injections in infants and toddlers (up to 3 years old) because it is large, well-developed, and lacks major nerves and blood vessels close to the injection site.
B. Deltoid: The deltoid muscle in the upper arm is not sufficiently developed in a 4-month-old infant. It is only recommended for use in children aged 18 months or older.
C. Dorsal gluteal: This site (upper-outer quadrant of the buttock) is contraindicated in children under 3 years old due to the risk of injury to the underdeveloped sciatic nerve. It is also generally discouraged in all clients due to the risk of nerve damage.
D. Ventrogluteal: While the ventrogluteal site (side of the hip) is the preferred site for older children and adults, it requires a well-developed muscle mass and reliable anatomical landmarks that are often less identifiable and less safe in an infant. The Vastus Lateralis is preferred for this age group.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Insert needle through side of stopper and draw medication into the barrel:The needle must be inserted straight through the center of the rubber stopper, not the side, to ensure the seal integrity is maintained and prevent coring (cutting out a piece of the stopper).
B. Pull back on the syringe's plunger and fill the barrel completely with the medication:Pulling back the plunger and filling the barrel completely (i.e., administering 3 mL in a 3-mL syringe) is not always correct; the volume should only match the dose ordered by the physician.
C. Draw an amount of air into the syringe equal to medication needed:To ensure easy withdrawal of the liquid medication and to prevent a vacuum from forming inside the vial (which makes withdrawal difficult), an equal volume of air must be injected into the vial first.
Remove the cover from the vial and clean with soapy water:The rubber stopper must be cleaned with an antiseptic swab (e.g., alcohol swab), not soapy water, before the needle is inserted. The protective cap is usually removed and the swab applied.
Correct Answer is C
Explanation
Step 1: Identify the ordered doses
- Regular insulin: 14 units.
- NPH insulin: 28 units.
Step 2: Add the doses together
- 14 + 28 = 42 units total.
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