ADMINISTERING A INTRAMUSCULAR INJECTION

PROCEDURE CHECKLIST 1 2 3 4 5 PE
1. Assessment:
a. Review the physician’s or qualified
practitioner’s order so that the drug is
administered safely and correctly.
b. Review information regarding the drug
ordered such as action, purpose, time of
onset and peak action, normal dosage,
common side effects and nursing implications
to anticipate the drug’s effects and anticipate
a reaction.
c. Assess the client for factors that may
influence an injection, such as circulatory
shock, reduced local tissue perfusion or
muscle atrophy because reduced tissue
perfusion will interfere with the absorption
and distribution of the drug.
d. Assess the previous intramuscular
injections in order to rotate sites and avoid
repeating a dose in the same site.
e. Assess for the indications for
intramuscular injection because an injection
is preferred for client’s who require that fast
action of the medication, are confused or
unconscious, are unable to swallow a tablet
or have a gastrointestinal disturbance
including the use of nasogastric suction.
2. Wash your hands and put on clean gloves.
3. Close the door or curtains around the bed and
keep the gown or sheet draped over the body.
Identify the client.
4. Select an injection site.
a. Inspect skin for bruises, inflammation,
edema, masses, tenderness, and sites of
previous injections.
b. Use anatomic landmarks.
5. Select the needle size: Assess the size and
weight of the client and site to be used.
6. Assist the client into a comfortable position:
a. For vastus lateralis, lie flat or supine
with the knees slightly flexed.
b. For ventrogluteal, lie on the side of
back with the knee and hip slightly flexed.
c. For dorsogluteal, lie prone with the feet
turned inward or on the side with the upper
knee and hip flexed and placed in front of the
lower leg.
d. For deltoid, stand with the arm relaxed
at the side or sit with the lower arm relaxed
across the abdomen.
e. The client should be told what to
expect when receiving an intramuscular
 injection.
7. Use an antiseptic swab to clean the skin at
the site.
8. While holding the swab between the fingers
of the nondominant hand, pull the cap from the
needle.
9. Administer the injection:
a. Hold the syringe between the thumb
and forefinger of the dominant hand like a
dart.
b. Spread the skin tightly, or pinch a
generous section of tissue firmly – for
cachectic patients.
c. Inject the needle quickly and firmly
(like a dart) at a 90 degree angle.
d. Release the skin.
e. Grasp the lower end of the syringe with
the nondominant hand and position the
dominant hand to the end of the plunger. Do
not move the syringe.
f. Pull back on the plunger to ascertain if
need is in a vein. If no blood appears, slowly
inject the medication.
10.Quickly withdraw the needle while applying
pressure with the antiseptic swab.
11.Gently massage the site.
12.Assist the client to a comfortable position.
The client should be told to report any bleeding,
itching, pain, or other side effects as a result of
the injection.
13.Discard the uncapped needle and syringe in a
safe receptacle.
14.Remove the gloves and wash your hands.
15.Documentation:
Name of medication.
Dosage
Route of administration
Location of injection
Time administered
f. Initials and signature of nurse
administering medication.

TOTAL SCORE

Date of Return Demonstration

Clinical Instructor Signature