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
Immediately before menstruation, hormonal fluctuations, particularly increased estrogen levels, can lead to breast swelling and tenderness. This physiological engorgement can obscure subtle lumps or changes, making accurate palpation difficult and potentially leading to false positives or missed abnormalities during self-examination, thereby reducing its efficacy.
Choice B rationale
Days 4-7 of the menstrual cycle, specifically post-menstruation, are optimal for breast self-examination because hormonal influences are at their lowest point. Estrogen and progesterone levels are minimal, resulting in the least breast tenderness and swelling. This makes breast tissue softer and less nodular, facilitating the detection of any new or subtle changes.
Choice C rationale
During ovulation, estrogen levels are elevated, which can cause some degree of breast fullness and tenderness due to glandular changes. This hormonal influence can make it more challenging to distinguish normal breast tissue from suspicious lumps, potentially leading to inaccurate findings and reducing the sensitivity of the self-examination process.
Choice D rationale
While consistency is important, simply choosing any same day of the month without regard to the menstrual cycle can lead to less effective examinations. Hormonal fluctuations throughout the cycle significantly impact breast tissue consistency. A fixed day may coincide with breast swelling or tenderness, hindering accurate assessment and potentially masking abnormalities, thereby reducing detection rates.
Correct Answer is D
Explanation
Choice A rationale
Placing the patch in the same location repeatedly can lead to skin irritation, reduced absorption due to stratum corneum thickening, and localized adverse reactions. Rotation of application sites allows the skin to recover, maintains optimal drug absorption, and prevents cumulative dermal irritation.
Choice B rationale
Transdermal patches often contain significant amounts of medication, including controlled substances or potent drugs. Discarding them in the trash can poses risks of accidental exposure to others, environmental contamination, and diversion. Proper disposal protocols, such as flushing or returning to pharmacy, are crucial.
Choice C rationale
While transdermal patches are designed for systemic absorption, specific sites are recommended to optimize efficacy and minimize adverse effects. Areas with less hair, intact skin, and good circulation are preferred. Improper placement can lead to erratic absorption or local irritation, reducing therapeutic benefit.
Choice D rationale
The nurse should always wear gloves when handling transdermal patches to prevent direct skin contact with the medication. Many transdermal drugs can be absorbed through the nurse's skin, leading to unintended pharmacological effects or sensitization. Gloves provide a crucial barrier against dermal absorption.
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