The nurse is administering an iron medication to a client via the Z-track method. Which guidelines/steps are recommended for this procedure? Select all that apply.
Use the Z-track method only in the deltoid site.
Quickly remove the needle after injecting the medication.
Allow the skin to return to its original position slowly while removing the needle.
Do not massage the injection site.
Insert the needle at 90 degrees and inject the medication.
Pinch the skin of the injection site to raise the site.
Correct Answer : B,D,E
A. Use the Z-track method only in the deltoid site: The Z-track method is most often used in the large muscles of the buttock (ventrogluteal) or the thigh (vastus lateralis), not the small deltoid muscle, which can only safely accommodate small volumes.
B. Quickly remove the needle after injecting the medication: After injecting the medication, the needle should be removed quickly and smoothly, and the skin released to allow the muscle layers to slide back over the injection track, effectively sealing the medication within the muscle.
C. Allow the skin to return to its original position slowly while removing the needle: The skin is laterally displaced (pulled) before insertion. It should be held taut until after the needle is removed and the dose is delivered. Releasing it slowly while removing the needle would allow the drug to escape.
D. Do not massage the injection site: Massaging the site is contraindicated as it could force the medication out of the muscle, allowing it to leak into the subcutaneous tissue and negate the benefit of the Z-track seal.
E. Insert the needle at 90 degrees and inject the medication: The Z-track method is for deep intramuscular (IM) injections, which are administered at a 90-degree angle to ensure the medication reaches the muscle tissue.
F. Pinch the skin of the injection site to raise the site: The skin should be pulled or displaced laterally (tautly) rather than pinched, to create the "Z" or zigzag path that locks the medication in place.5 Pinching is used for subcutaneous injections.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Intravenous:While true in a general sense, it is not specific enough. The abbreviation "IVPB" specifies how the intravenous medication is delivered (secondary infusion), making choice D the precise answer.
B. Intravenous Push:IV Push (IVP) implies injecting a concentrated dose directly into the line over a short time (minutes). Piperacillin/tazobactam is an antibiotic that requires intermittent infusion over a longer period (e.g., 30 minutes) to prevent vein irritation and ensure efficacy.
C. Intramuscular:The order specifies "IV," which contradicts the Intramuscular (IM) route.
D. Intravenous Piggyback:The abbreviation IVPB stands for Intravenous Piggyback. This method involves hanging a smaller secondary bag of medication higher than the primary infusion bag, allowing it to infuse through the main line.
Correct Answer is A
Explanation
First, convert the available concentration from ratio to metric units:
- Availability:1 g/1000 mL
- Convert grams (g) to milligrams (mg):1g=1000mg
- Concentration:1000mg/1000ml=1mg/ml
Next, use the concentration to determine the volume needed for the ordered dose:
- Ordered Dose:1.5mg
- Available Concentration:1mg/ml
1.5mg ÷1mg/ml= 1.5ml
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