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dermal

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									    Nursing Skills Laboratory Procedure: Preparing Parenteral Medication from a Vial and
    Administering Via an Intradermal Injection 1

                         ALLENTOWN COLLEGE OF ST. FRANCIS DE SALES
                             DEPARTMENT OF NURSING AND HEALTH

                                               Nursing 204

      Nursing Skills Laboratory Procedure: Preparing Parenteral Medication from a Vial and
                           Administering Via an Intradermal Injection

                           ACTION                            S   U          COMMENTS
     Gather the supplies
     Explain the procedure to the client
     Wash and dry hands carefully
     Determine the necessary needle and syringe size
      needed for administration of the intradermal
      injection to the client
     Review the client’s MAR by determining if each
      medication contains the essential parts of a
      medication order (client’s name, drug name, drug
      dosage, route of drug administration, time for drug
      administration)
     Obtain the appropriate medication vial from the
      medication cart
     Compare the label of the medication vial against
      the MAR by determining if both contain the same
      essential parts of a medication order
     If the label of the medication vial and the MAR do
      not contain the same essential parts of a
      medication order, check the original order in the
      client’s chart
     If the MAR and original order in the client’s chart
      do not contain the same essential parts of a
      medication order, report the discrepancy to the
      nurse in charge and/or physician
     Perform any necessary drug calculations
     Assemble the needle and syringe if not already
      assembled
     Mix the solution in the vial by rotating the vial
      between the palms of your hands
     Place the vial on the medication cart
     Remove the protective metal cap from the vial
     Cleanse the rubber cap of the vial with an alcohol
      swab using a circular motion
     Remove the cap from the needle
     Pull back on the plunger of the syringe to draw into
      the barrel of the syringe the amount of air equal to
      the volume of medication to be withdrawn
     Stabilize the vial on the medication cart with your
      nondominant hand
     Insert the needle into the upright vial through the
      center of the rubber cap
     Push on the plunger of the syringe with your
      dominant hand to inject the air from the barrel of
      the syringe into the vial, keeping the bevel of the
    Nursing Skills Laboratory Procedure: Preparing Parenteral Medication from a Vial and
    Administering Via an Intradermal Injection 2

      needle above the surface of the medication
     Invert the vial, by: 1) holding the vial between the
      index and middle fingers of your nondominant
      hand, 2) holding the barrel of the syringe between
      the thumb and fourth fingers of your nondominant
      hand, and 3) inverting the vial upside down with
      the needle and syringe below it
     Hold the vial at eye level
     Pull back on the plunger of the syringe with your
      dominant hand until the correct dosage of
      medication is withdrawn into the barrel of the
      syringe
     If necessary, tap on the barrel of the syringe to
      dislodge any air bubbles present in the barrel of
      the syringe
     Withdraw the needle from the vial with your
      dominant hand
     Replace the vial on the medication cart
     Replace the cap over the needle utilizing the
      scoop method with your dominant hand
     Take the medication into the client’s room
     Identify the client by comparing the name on the
      client’s MAR with the name on the client’s
      identification bracelet and ask the client his/her full
      name
     Assist the client to a position in which the inner
      lower arms, the upper chest, or the back beneath
      the scapulae can be relaxed, depending on the
      site to be used
     Select a site on the inner lower arm, the upper
      chest, or back beneath the scapulae that is not
      heavily pigmented, covered with hair, free of
      tenderness, hardness, swelling, scarring, itching,
      burning, or localized inflammation, and that has
      not been used frequently
     Don disposable gloves
     Clean the site with an alcohol swab, by: 1) starting
      at the center of the site, 2) cleaning the site in a
      widening circle to about 5 centimeters (2 inches),
      and 3) allowing the site to dry thoroughly
     Place and hold the alcohol swab between the third
      and fourth fingers of your nondominant hand or
      position it on the client’s skin above the cleansed
      site
     Remove the cap from the needle
     Grasp the barrel of the syringe in your dominant
      hand between your thumb and fingers with your
      palm facing upward
     Spread the client’s skin taut at the insertion site
      with your nondominant hand
     Insert the needle, bevel up, at a 15 angle about
      1/8 inch into the dermis with your dominant hand
      so that the bevel of the needle can be seen
      through the skin
    Nursing Skills Laboratory Procedure: Preparing Parenteral Medication from a Vial and
    Administering Via an Intradermal Injection 3

     Move your nondominant hand to the barrel of the
      syringe
     Move your dominant hand to the end of the
      plunger of the syringe
     Push on the plunger of the syringe with your
      dominant hand using slow, even pressure to inject
      the medication while watching for a small wheal or
      blister to appear in the skin
     Pull on the barrel of the syringe with your dominant
      hand to remove the needle
     Lightly wipe the site with an alcohol swab
     Dispose of the supplies in the appropriate
      receptacles
     Wash and dry hands carefully
     Record preparing parenteral medication from a
      vial and administering via an intradermal injection
      on the client’s MAR per agency policy

								
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