Skills Lab

Parenteral Administration of Drugs

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Administration of medications by injection

Invasive procedure that is performed using aseptic technique

Procedure
A. Subcutaneous Injection

Rationale
Injection into the tissues just below the dermis of the
skin
Medication absorption is slower. Adipose tissue has
pain receptors.
Assess for factors such as circulatory shock or reduced
local tissue perfusion
Assess adequacy of clients adipose tissue

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P.Chan 2017

Verify patients identity.

Confirm patients identity
Explain procedure to the patient and
provide privacy.
Select appropriate injection site. Rotate
sites according to schedule for repeated
injections using different areas of the
body unless contraindicated.
Don gloves
Clean injection site with alcohol center,
circular motion. Allow to dry before
injecting.
Loosen protective needle sheath
With non-dominant hand, grasp skin
around injection site to elevate
subcutaneous tissue forming a 2.5 fat fold
Hold syringe with dominant hand, insert
loosened needle sheath between 4th and
5th fingers of your other hand while still
pinching the skin round the injection site.
Pull back the syringe with your dominant
hand. Dont touch needle.
Position needle with bevel up.
Tell patient hell feel a needle prick
Insert needle quickly in 45 90 degrees
angle. Release skin.
Pull back plunger slightly. If none
appears, begin injecting drug slowly.
Dont aspirate blood return for insulin or
heparin
After injection, remove needle gently but
quickly at the same angle used for
injection
Cover site with alcohol pad, cotton ball or
a 2 x 2 gauze pad and massage site gently
Remove alcohol pad and check injection
site for bleeding and bruising
Dispose equipment. Dont resheat needle.

If uses barcode, scan.

If blood appears on aspiration, withdraw needle

prepare another syringe and repeat procedure.

Dont massage for heparin or insulin.

Skills Lab

B. Administering Intradermal Injection

Drug injected into the outer layers of the skin in small

volumes (0.5 or less)
Used primarily to produce local effect
Most common site is ventral forearm

19. Tell client where you will be giving the

injection.
20. Instruct patient to sit up and to extend his
arm and support it on a flat surface with
ventral forearm exposed
21. Don gloves
22. With alcohol pad, clean surface of ventral
forearm bout 2 3 fingerbreadths distal
to the antecubital space. Make sure test
site is free from hair and blemishes.
Allow skin to dry before procedure.
23. While holding patients forearm in your
hand, stretch skin with thumb.
24. With free hand, hold needle at 10 15
degree angle, bevel up
25. Insert needle about 1/8inch below
epidermis at site 5 cm apart. Stop when
needles bevel tip is under the skin. Inject
antigen slowly. You should feel resistance
as you do this and a wheal should form.
26. Withdraw angle at same angle. Dont rub
site
27. Circle test site with marking pen. Label.
Instruct patient to refrain from washing
site.
28. Dispose needles.
29. Remove gloves
30. Assess patients response after 30
minutes. Then after 24 48 hours
31. Nursing consideration: In patients who
are hypersensitive to test antigens, severe
anaphylactic shock can occur.
C. Administering Intramuscular Injections
32. Select appropriate injection site. The
general muscles (gluteus medius and
minimus and upper outer corner of
gluteus maximus) are most commonly
used
33. Don gloves. With thumb and index finger
of non-dominant hand, gently stretch skin
of injection site
34. While holding the syringe with dominant
hand, remove needle sheath by sleeping it
between fingers of non-dominant and
then drawing back the syringe
35. Position at 90 degree angle to skin
surface with couple of inches from the
P.Chan 2017

In this case, emergency epinephrine is required.

Skills Lab

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P.Chan 2017

skin. Instruct patient about the prick.

Then quickly and firmly thrust the needle
through the skin, sub-q and into the
muscle
Support syringe with non-dominant hand
and aspirate for blood. If no blood,
continue injecting.
If blood appears, stop withdraw and
prepare a new one.
After injection, remove in the same angle.
Using gloved hand quickly cover site
with alcohol pad or 2x2 gauze pad
Assess for signs of active bleeding or
bruising
Discard all equipment