A nurse is planning to administer an IM injection into a client's deltoid muscle. Which action should the nurse take?

Inject a volume of less than 2 mL.

Inject the medication at a 90 degree angle.

Inject the medication 12.7 cm (5 in) below the client's acromion process.

Use a 21-gauge needle for the injection.

Answer and Explanation

The Correct Answer is B

A) Inject a volume of less than 2 mL: While it is generally recommended to inject a volume of less than 2 mL into the deltoid muscle to avoid discomfort and ensure proper absorption, this is not the primary action to focus on when planning the injection.

B) Inject the medication at a 90 degree angle: This is the correct action. Administering an intramuscular (IM) injection at a 90-degree angle ensures that the medication is delivered deep into the muscle tissue, which is necessary for proper absorption and effectiveness.

C) Inject the medication 12.7 cm (5 in) below the client’s acromion process: The correct injection site for the deltoid muscle is typically 2-3 finger widths (approximately 2.5-5 cm) below the acromion process, not 12.7 cm. Injecting too far below the acromion process could result in an incorrect injection site.

D) Use a 21-gauge needle for the injection: While a 21-gauge needle can be used for IM injections, the gauge of the needle is not the primary focus in this context. The angle of injection is more critical to ensure proper delivery of the medication.

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Correct Answer is C

Explanation

A. Absorption:
Chronic liver failure primarily affects the metabolism of drugs rather than their absorption. While liver disease can impact various bodily functions, the absorption of medications is generally more influenced by gastrointestinal factors and not as directly affected by liver function.

B. Excretion:
Excretion of drugs is primarily managed by the kidneys, not the liver. While liver failure can lead to changes in drug metabolism, it does not directly impair the excretion process, which is largely renal. However, compromised liver function can indirectly affect renal excretion due to altered pharmacokinetics.

C. Metabolism:
Liver failure significantly affects drug metabolism. The liver is the primary site for the metabolism of many medications, converting drugs into more water-soluble compounds for excretion. In chronic liver failure, the liver's ability to metabolize drugs is impaired, leading to potential drug accumulation and increased risk of toxicity. This step of pharmacokinetics is most directly impacted by liver dysfunction.

D. Distribution:
While liver function can affect drug distribution to some extent, it is not as directly impacted as metabolism. Distribution can be influenced by factors such as changes in plasma protein levels and blood flow, but the liver's primary role in drug metabolism is more directly affected by chronic liver failure.

A. Report the incident immediately to your supervisor upon noticing. B. Gather reversal agents to administer to the client C. Notify the client's provider immediately while present with the client. D. Assess the client's vital signs.

Correct Answer is D

Explanation

A) Report the incident immediately to your supervisor upon noticing: Reporting the incident is an important step, but it should come after assessing the client's condition. Immediate assessment of the client's vital signs and overall status takes precedence to address any potential immediate health impacts due to the medication error.

B) Gather reversal agents to administer to the client: Gathering reversal agents is a critical step if the medication administered poses an immediate risk and reversal is necessary. However, this action should follow an initial assessment of the client's condition to determine if reversal is needed.

C) Notify the client's provider immediately while present with the client: Notifying the provider is essential to receive guidance on how to manage the medication error. Nonetheless, the first priority should be to assess the client's condition to provide accurate information to the provider.

D) Assess the client's vital signs: The initial action should be to assess the client’s vital signs and overall condition to determine any immediate effects of the incorrect medication. This assessment helps in identifying if the client is experiencing any adverse reactions or complications, which will guide subsequent actions such as notifying the provider and administering reversal agents if needed.

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A nurse is planning to administer an IM injection into a client's deltoid muscle. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

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