The nurse is giving an IM corticosteroid injection to a client with rheumatoid arthritis. What type of syringe and needle ward the nurse use for this injection?
1-mL tuberculin syringe with 7-inch bevel
1-to 2-mL syringe with 7-to 1-inch needle
2-to 3-ml syringe with 1-to 11⁄2-inch needle
2-to 3-ml syringe with 1- to 2-inch needle
The Correct Answer is C
A. 1-mL tuberculin syringe with 1-inch bevel: Tuberculin syringes are used for small-volume Intradermal or Subcutaneous injections. They are not suitable for the viscosity or depth required for an IM corticosteroid injection.
B. 1-to 2-mL syringe with 1/2-to 1-inch needle: While a 1-inch needle can be used for the deltoid in some adults, a 1/2-inch needle is too short to reach deep muscle tissue in an average adult, risking subcutaneous deposition (which can cause tissue damage with corticosteroids).
C. 2-to 3-ml syringe with 1-to 1 1/2-inch needle: This is the standard equipment for an adult IM injection. A 3-mL syringe accommodates the medication volume, and a 1 to 1.5-inch needle ensures the medication passes through subcutaneous fat and reaches the deep muscle tissue (Ventrogluteal or Vastus Lateralis).
D. 2-to 3-ml syringe with 1- to 2-inch needle: While the syringe size is correct, a 2-inch needle is typically reserved for patients with obesity who have a larger layer of adipose tissue to penetrate. For an average adult, this may be too long and could strike bone.
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Related Questions
Correct Answer is C
Explanation
A.2.0 mg: This violates the "Trailing Zero" rule. A zero should never be placed after a decimal point for a whole number. If the decimal is missed by the reader, 2.0 mg could be easily misread as 20 mg, leading to a massive overdose.
B.2 mg: This is a mathematical error. 2 mg is a whole number, whereas the prescription is for "two tenths" (0.2) of a milligram. Administering this would result in a ten fold overdose.
C.0.2 mg: This follows the "Leading Zero" rule mandated by the Institute for Safe Medication Practices (ISMP). When a dose is less than a whole number, a zero must be placed before the decimal point. This ensures that if the decimal point is faint or overlooked, the reader will not mistake .2 mg for 2 mg.
D.0.20 mg: While mathematically equivalent to 0.2, this violates the "Trailing Zero" rule. The final zero is unnecessary and increases the risk of the number being misread as 20 or 2 if the decimal is not clearly seen.
Correct Answer is C
Explanation
A. Needle:The needle is the hollow, sharp metal part that pierces the skin or vial stopper. It draws fluid into the syringe, but the needle itself does not hold the medication.
B. Plunger:The plunger is the interior rod that is pushed or pulled to move the fluid. It creates the pressure differential, but the plunger itself does not hold the medication.
C. Barrel:The barrel is the hollow, cylindrical part of the syringe that is marked with measurement calibrations (mL, units, etc.) and is the chamber where the medication is held.
D. Tip:The tip is the end of the barrel where the needle is attached. While fluid passes through the tip, it is not the main storage compartment for the medication.
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