Which IM injection sites are preferred for the Z-track technique for the administration of medication? (SELECT 2 CORRECT ANSWERS)
Ventrogluteal muscle.
Deltoid muscle.
Dorsogluteal muscle.
Abdomen, 2 inches from umbilicus.
Posterior thigh.
Correct Answer : A,C
Choice A rationale
The ventrogluteal muscle is a preferred site for Z-track injections due to its thick musculature, which minimizes the risk of hitting nerves or blood vessels. Its anatomical location provides a deep, safe space for medication deposition, allowing for effective sealing of the drug within the muscle tissue, preventing leakage and irritation to subcutaneous tissues.
Choice B rationale
The deltoid muscle is generally not preferred for Z-track injections because its smaller muscle mass and proximity to the radial nerve and brachial artery increase the risk of neurovascular injury. While used for some intramuscular injections, the Z-track technique benefits from larger muscle groups to effectively seal the medication.
Choice C rationale
The dorsogluteal muscle, though historically used, is considered less ideal than the ventrogluteal site for Z-track injections due to a higher risk of sciatic nerve injury and penetration of major blood vessels. However, its large muscle mass can still accommodate Z-track injections when alternative sites are contraindicated, if proper landmarks are meticulously observed.
Choice D rationale
The abdomen, 2 inches from the umbilicus, is primarily used for subcutaneous injections, not intramuscular Z-track injections. This area lacks the deep muscle tissue necessary to effectively deposit and seal medication using the Z-track technique, and attempting intramuscular injection here poses a high risk of hitting vital organs.
Choice E rationale
The posterior thigh, specifically the rectus femoris or vastus lateralis, can be used for intramuscular injections, but it is not a primary preferred site for the Z-track technique in adults due to varying muscle thickness and increased potential for discomfort. The ventrogluteal site generally offers a larger and safer muscle mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Assessing the client's skin for breakdown is important in general patient care, especially for immobile patients, but it is not a priority assessment directly related to the immediate physiological effects of administering an opioid analgesic like morphine. Skin integrity issues are typically a long-term complication.
Choice B rationale
Morphine, an opioid agonist, binds to mu-opioid receptors in the central nervous system, including the brainstem respiratory centers. This binding causes dose-dependent respiratory depression by decreasing the sensitivity of these centers to carbon dioxide, leading to reduced respiratory rate and depth. Normal respiratory rate is 12-20 breaths/min.
Choice C rationale
Opioids can cause urinary retention by increasing bladder sphincter tone and reducing detrusor muscle contractility, thereby impairing bladder emptying. While monitoring urinary output is important, respiratory depression is a more immediate and life-threatening adverse effect of opioid administration. Normal urinary output is 30-50 mL/hour.
Choice D rationale
Opioids commonly cause gastrointestinal side effects, including decreased gut motility, leading to constipation and reduced bowel sounds. While assessing abdominal sounds is relevant to monitor for ileus, respiratory depression poses a more acute and significant risk to patient safety following opioid administration.
Correct Answer is C
Explanation
Choice A rationale
Albuterol is a selective beta-2 adrenergic agonist. Its primary action is bronchodilation by stimulating beta-2 receptors in the bronchial smooth muscle, leading to relaxation and widening of the airways. It does not directly suppress the cough reflex, which is a protective mechanism to clear airways. Cough suppression is typically achieved by antitussive medications acting on the central nervous system or peripheral cough receptors.
Choice B rationale
Albuterol is a short-acting beta-agonist (SABA), characterized by a rapid onset of action and relatively short duration (4-6 hours). Therefore, it is used for immediate relief of bronchospasm and acute symptoms of asthma, not for long-term daily maintenance. Long-term maintenance medications include inhaled corticosteroids or long-acting beta-agonists (LABAs) used consistently to control inflammation and prevent exacerbations.
Choice C rationale
Albuterol's rapid onset of action and potent bronchodilatory effects make it the ideal medication for acute relief of bronchospasm in asthma. It is used as a "rescue" inhaler to quickly open airways during an asthma attack or before exercise to prevent exercise-induced bronchospasm. This immediate effect is crucial for alleviating respiratory distress.
Choice D rationale
Post-tussive emesis, or vomiting after coughing, is often a symptom of severe coughing spells. While albuterol can alleviate coughing by reducing bronchospasm, its primary mechanism is not to prevent emesis directly. Emesis is a gastrointestinal reflex; albuterol's action is primarily on the respiratory system. Addressing the underlying cause of severe coughing would indirectly reduce emesis.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.