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    Intradermal-Injections 2nd Semester 2022-2023!2!1

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    AinaB Manalo
    This document provides information on medication administration via the intradermal route. It defines medication and describes common types of medication orders such as stat, single, standing, and PRN orders. It also outlines the main routes of drug administration including oral, parenteral, intradermal, subcutaneous, intramuscular, intravenous, and intracardiac. The document then focuses on the intradermal route, indicating it is commonly used for diagnostic purposes like tuberculin tests and allergy testing. It provides the dose and explains that intradermal injections are made just below the epidermis. Finally, it outlines the 10 R's of medication administration and provides step-by-step instructions for performing an intradermal

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    Intradermal-Injections 2nd Semester 2022-2023!2!1

    Uploaded by

    AinaB Manalo
    40 views35 pages
    This document provides information on medication administration via the intradermal route. It defines medication and describes common types of medication orders such as stat, single, standing, and PRN orders. It also outlines the main routes of drug administration including oral, parenteral, intradermal, subcutaneous, intramuscular, intravenous, and intracardiac. The document then focuses on the intradermal route, indicating it is commonly used for diagnostic purposes like tuberculin tests and allergy testing. It provides the dose and explains that intradermal injections are made just below the epidermis. Finally, it outlines the 10 R's of medication administration and provides step-by-step instructions for performing an intradermal

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    This document provides information on medication administration via the intradermal route. It defines medication and describes common types of medication orders such as stat, single, standing, and PRN orders. It also outlines the main routes of drug administration including oral, parenteral, intradermal, subcutaneous, intramuscular, intravenous, and intracardiac. The document then focuses on the intradermal route, indicating it is commonly used for diagnostic purposes like tuberculin tests and allergy testing. It provides the dose and explains that intradermal injections are made just below the epidermis. Finally, it outlines the 10 R's of medication administration and provides step-by-step instructions for performing an intradermal

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    40 views35 pages

    Intradermal-Injections 2nd Semester 2022-2023!2!1

    Uploaded by

    AinaB Manalo
    This document provides information on medication administration via the intradermal route. It defines medication and describes common types of medication orders such as stat, single, standing, and PRN orders. It also outlines the main routes of drug administration including oral, parenteral, intradermal, subcutaneous, intramuscular, intravenous, and intracardiac. The document then focuses on the intradermal route, indicating it is commonly used for diagnostic purposes like tuberculin tests and allergy testing. It provides the dose and explains that intradermal injections are made just below the epidermis. Finally, it outlines the 10 R's of medication administration and provides step-by-step instructions for performing an intradermal

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 35

    Medication

    Admnistration
    (INTRADERMAL)
    Lauro N. Linag RN, MAN
    MEDICATION:
    a substance administered for the diagnosis, cure, treatment
    or relief of symptom and prevention of disease.
    TYPES of MEDICATION ORDERS
    STAT to be given immediately, urgent or at once and only given once.
    SINGLE (ONE-TIMEorder)to begivenonceat a specifiedtime.

    STANDING to begivenin a scheduled frequency.Thismaybecar ied


    out indefinitelyor mayhaveterminationdate.

    PRN (asneededorder)maybegivenasneededor asnecessary


    depending on the Doctor’s order or the Nurse’s judgment.
    COMMON ROUTES FORDRUGADMINISTRATION
    1. ORAL ROUTES mostcommonroute,safest,cheapestslowactingthan
    injectables

    a. PerOrem(PO)-medicationis givenbymouth andswalowedfluid.

    b. Sublingual (SL)- drug is placed under the tonguewhere it readily dissolves and
    absorbedbecauseof theoral mucosa’sthinepitheliumandlargevascularsystemwhich
    alowsquickabsorption.

    c. Buccal-drugis placedinsidethemouthorbuccalcavity againstthemucousmembrane of


    the cheek until it dissolvesandabsorbed.
    ORAL ROUTES
    2. PARENTERAL ROUTES-introduction of a medication by any route other than the oral-
    gastrointestinalroute. Absorbedmorequicklythatoralrouteandareir etrievableonce
    injected.

    a. Intradermal: just belowthe epidermis.


    b. Subcutaneous : between the dermis and the muscle layer.
    c. Intramuscular : penetrating into the muscle layer.
    d. Intravenous: Via the vein (directly or via an IVcatheter)
    e. Intracardiac: used only to provide emergency drugs to a patient if other
    approaches would be ineffective
    PARENTERAL ROUTES
    INTRACARDIAC
    INTRAMUSCUL SUBCUTANEO
    AR US

    INTRAVENOUS

    INTRA
    DERMA
    L
    10 Rs of Medication Administration
    # 1: Right Patient
    ● Alwaysverifypatientidentity(viapatient& IDbracelet)
    ● Verifypatient’sallergieswithchart& patient

    # 2: Right Medication
    • Performtriplecheckonmedicationlabel(retrieving,preparing,before
    administering)
    • Check the doctor’s orders
    • Never administer medspreparedby other person/s
    • Never administer unlabeledmeds.
    10 Rs of Medication Administration
    # 3: Right Dose
    ● Compare prepared dose with medication orders.
    ● Triplecheckall medscalculation. (for PEDIA&forADULT)
    ● Checkmedscalculationwithanothernurse.

    # 4: Right Time
    • Verify date and time of meds order.
    • Check the last dose of medication.
    10 Rs of Medication Administration
    # 5: Right Route
    ● Verify routeof administration
    ● Checkif orderedmedsmaybeadministeredviatheroutespecifiedin MDsorders.

    # 6: Right Education
    • Informpatient of the following:
    – Name of thedrug
    – Desired ef ectsof the meds
    – Side ef ectsof themeds
    – Ask for knownallergies to the meds.
    10 Rs of Medication Administration
    # 7: Right to Refuse
    ● Patienthastherightto refuseanymedsat anygiventime.
    ● Informpatient/ SOof theconsequenceof refusingto takemeds.
    ● Verifyif patient / SOunderstandsal theseconsequences.
    ● Notify theAMDof the refusal
    ● Document the refusal.
    10 Rs of Medication Administration
    # 8: Right Assessment
    ● Properlyassesspatient anddetermineif medicationof safe&
    appropriate.
    ● If deemedunsafeor inappropriate,notifytheAMDanddocumentthe
    givingof notification
    ● Document the non-administration of the meds and the reason for the
    misseddose.
    10 Rs of Medication Administration
    (After the meds has been administered…. )
    # 9: Right Evaluation
    ● Assess patient for any adverse ef ects.
    ● Assess for ef ectiveness of the meds.
    ● Compare patient’s prior status with post medication status.
    ● Document patients response to medications.
    10 Rs of Medication Administration
    (After the meds has been administered…. )
    # 10: Right Documentation
    ● Never document before medication is administered.
    ● Document the folowing:

    ○ Nameof meds

    ○ Dosage

    ○ Route

    ○ Date andTime

    ○ Signature& credentials
    INTRADERMAL
    INJECTIONS
    Commonlyusedfor diagnosticpurposes:
     tuberculin test
     allergytesting- sensitivitytest (ANST)

    Dose (.05ml - .1ml)


    • Intradermal injections are made into the dermal layer of the skin
    just below the epidermis.

    • The absorption from intradermal sites is slow, making it the route


    of choice for allergy tests, desensitization injections, local
    anesthetics and vaccinations.
    or wheal
    ANATOMY OF A SYRINGE

    TUBERCULIN SYRINGE
    Steps # 1
    1. Assemble the equipment.
    Steps # 2 - 4

    2. Check Physician or
    Doctor’s Order Sheet (MAR)
    3. Perform hand hygiene.
    4.Prepare the medication from the vials or ampule for
    drug withdrawal. (done at the nurse’s station)
    Opening and aspirating from
    ampules
    Reconstituting vials in powdered form
    Opening and extracting from vials

    9 10 11 12

    13 14 15
    WATER FOR Drug
    INJECTION for skin
    (0.9ml) testing
    (0.1ml)

    Extract 0.9ml of diluent FIRST, then 0.1ml


    drug LAST
    Steps # 5 - 9
    5. Introduce yourself.
    6. Preparetheclient- checktheclient identificationband.
    7. Explain the procedure.
    8. Provide for client privacy.
    9. Select the most appropriate site
    A common site for an intradermal injection is the inner aspect of the forearm.
    Other areas that may be used are the back and upper chest.
    Steps # 10 - 12
    10. Cleanse the site using firm, circular motion
    starting at the center widening the circle
    outward.
    11. Allow the area to dry thoroughly

    12. Remove the needle cap while waiting for the


    antiseptic to dry.
    Steps # 13 - 15

    13.Remove the needle cap and expel any


    air bubbles from the syringe. Smal amount of air
    can harmthe tissues.

    14.Grasp the syringe with your dominant


    hand, close to the hub, holding it between the
    thumb and forefinger.

    15.Hold the needle almost paralel to the skin


    surface, with thebevel of the needle up.
    Steps # 16 - 18
    16.With the non dominant hand, pull the skin
    at the site until it is taut.

    17.Insert the tip of the needle far enough to


    placethebevelthroughtheepidermisandinto
    thedermis.

    18.The outline of the bevel should be visible


    under skin surface.
    Steps # 19 - 21

    19. Stabilize the syringe and needle


    quickly at the same angle at which it
    was inserted.
    20. Inject 0.1ml to produce a wheal
    (bleb).
    21. Withdraw the needle quickly at the
    same angle at which it was inserted.
    (Do not massage the area! !
    Massage can disperse the medication
    into the tissue)
    Steps # 22
    22. Disposethesyringeandneedlesafely.Donotrecaptheneedlein orderto
    prevent needle stick injuries.
    Steps # 23 - 25

    23. Encircle the wheal or bleb using a black inked


    balpoint pen
    24. Label the marked area with the name of the
    drug, the time that the bleb is supposed to be
    checked for any reaction (after 30 mins.) and
    the nurse’s signature.
    25. Document al relevant information on the
    patient’s chart.
    • Reddening of the site
    accompanied with marked
    ANST elevation of the bleb or
    + wheal

    ANST • Increase circumference of


    + the bleb or wheal

    ANS • Itchiness on the site


    T
    -
    Instructional Videos
    ● https://www.youtube.com/watch?v=JEiHJoC6ChY
    ● https://www.youtube.com/watch?v=f3w-MlDAdg0
    ● https://www.youtube.com/watch?v=7i6YNqizxwk
    Do you have questions?

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