The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select?

A. Rectus femoris: Although accessible, the rectus femoris is not the preferred injection site in infants because it is close to major nerves and blood vessels, and injections here can cause discomfort and inconsistent absorption of medication.

B. Vastus lateralis: This is the safest and most recommended intramuscular injection site for infants under 12 months. It is a large, well-developed muscle located on the anterolateral thigh and free from major nerves or blood vessels, ensuring effective medication absorption and minimal risk of injury.

C. Dorsogluteal muscle: This site should not be used in infants due to the risk of sciatic nerve injury and underdeveloped gluteal muscles, which make proper absorption unreliable. It becomes safer only in older children and adults.

D. Deltoid: The deltoid muscle is too small in infants to safely accommodate an intramuscular injection and has limited muscle mass, increasing the risk of nerve damage. It is typically reserved for children over 18 months, particularly for small-volume vaccines.

A. The child: The physical examination should focus primarily on the child, using a holistic approach that considers both physical and emotional needs. The nurse observes the child’s overall appearance, behavior, and physiological responses, ensuring that the assessment is child-centered and developmentally appropriate.

B. The parents: While parents provide valuable health history and emotional support, they are not the focus of the physical exam. Their role is mainly to comfort the child and supply additional background information during the assessment.

C. Chief complaint: Although addressing the chief complaint is important, the physical exam should not be limited to it. A comprehensive examination ensures that all body systems are assessed, identifying potential issues beyond the presenting concern.

D. Developmental age: Developmental age helps guide the approach to the examination, such as communication style and expected milestones, but it is not the main focus. It informs how the nurse interacts with and evaluates the child rather than being the object of the exam itself.