Question

Place the steps of administering an intradermal injection in the correct order. a. Inject medication slowly. b. Note the presence of a bleb. c. Advance needle through epidermis to \(3 \mathrm{~mm}\). d. Using nondominant hand, stretch skin over site with forefinger. e. Insert needle at a 5- to 15-degree angle into the skin until resistance is felt. f. Cleanse site with antiseptic swab.

Short answer

Cleanse site, stretch skin, insert needle at a shallow angle, advance needle to 3 mm, inject medication slowly, and note the bleb.

Step-by-step solution

Cleanse the Site

Before administering the injection, it's important to cleanse the site with an antiseptic swab to reduce the risk of infection. This prepares the skin for the injection by removing any bacteria.

Stretch the Skin

Use the nondominant hand to stretch the skin over the injection site. This creates a taut surface, making it easier to insert the needle and ensuring that medication is delivered to the correct layer of skin.

Insert Needle at Correct Angle

Gently insert the needle into the skin at a 5- to 15-degree angle until resistance is felt. The shallow angle ensures that the needle remains in the dermis, which is the target layer for intradermal injections.

Advance Needle

Advance the needle through the epidermis to a depth of approximately 3 mm. This ensures that the needle is placed correctly in the intradermal layer.

Inject Medication Slowly

Once the needle is in the correct position, inject the medication slowly. This helps to prevent discomfort and allows for the formation of a small bleb or blister, which is an indicator that the injection is properly placed intradermally.

Observe for Bleb Formation

After the injection, observe the site for the presence of a bleb. The bleb indicates that the medication has been properly administered into the intradermal layer.

Key concepts

Nursing Procedures

Nursing procedures are critical to patient care and cover a broad spectrum of activities, including medication administration via various routes. One such specialized skill is administering an intradermal injection, which is used for allergy tests and tuberculosis screening, among other diagnostic purposes.

For a successful intradermal injection, nurses follow specific steps to ensure that the medication is delivered to the correct anatomical layer of the skin. The steps involve preparing the injection site, precisely inserting the needle, and observing the outcome of the medication administration. It's important to note the details such as stretching the skin to make it taut and using the correct angle for needle insertion that are key for an accurate procedure. When instructing students or healthcare professionals, emphasis is placed on a methodical approach to reducing errors and improving patient comfort and safety.

Medication Administration

Medication administration is a common yet critical process in healthcare settings that requires attention to detail to avoid complications. When administering an intradermal injection, the technique affects the absorption and effectiveness of the medication. A crucial factor in the administration is the injection speed; administering the medication slowly ensures the creation of a bleb and minimizes tissue damage or pain.

Moreover, recognizing the bleb formation signals that the medication has entered the intradermal layer, not subcutaneously or into the muscle. Proper administration contributes to accurate diagnostic results, especially in tests like tuberculin skin tests, where the reaction is read off the skin's response. Real-world scenarios stress the importance of adherence to protocol, as deviations can cause misdiagnosis or unnecessary repeat procedures for patients. Teaching this concept highlights the gravity of precision in every slight adjustment made during the medication delivery process.

Aseptic Technique

Aseptic technique serves as the cornerstone of preventing infection and maintaining patient safety during medical procedures. In the context of intradermal injections, the process begins with thorough hand hygiene and the use of an antiseptic swab to clean the injection site.

This fundamental step reduces the risk of introducing pathogens into the patient's body and should be performed with diligence. Emphasizing the importance of asepsis during medication administration reinforces good clinical practice and patient outcomes. The utilization of aseptic technique is pivotal, not only in injections but across all nursing procedures, to prevent hospital-acquired infections and promote overall health safety.