A primary health care provider prescribes a deep intramuscular injection of iron dextran for an adult client with severe anemia. To prevent superficial tissue irritation and skin staining, the practical nurse must utilize the Z-track technique. Arrange the following procedural steps for preparing and administering this medication in the correct chronological order.
- 1Draw the prescribed medication into the syringe and replace the needle with a new, sterile one.
- 2Cleanse the ventrogluteal site and pull the overlying skin and subcutaneous tissue laterally by 1 to 1.5 inches.
- 3Insert the needle firmly at a 90-degree angle into the muscle while maintaining traction on the skin.
- 4Depress the plunger slowly to inject the medication into the deep muscle tissue.
- 5Keep the needle inserted in the muscle for 10 seconds after the injection is complete.
- 6Withdraw the needle smoothly and immediately release the traction on the skin.
Answer
The correct sequence is: draw the medication and replace the needle, displace the skin laterally, insert the needle at 90 degrees, inject slowly, wait 10 seconds, and finally withdraw the needle while releasing the skin.
The Z-track method is meticulously designed to seal highly irritating or staining medications (such as iron dextran) deep within the muscle tissue. The process begins with drawing up the medication and strictly changing the needle to ensure no residue is on the needle shaft. Next, the skin is pulled laterally to displace the tissue layers. The needle is then inserted at a 90-degree angle, and the medication is injected slowly. The nurse must wait 10 seconds before withdrawing the needle to allow the fluid to disperse and prevent backflow. Finally, withdrawing the needle and immediately releasing the skin creates a staggered track, effectively trapping the medication in the muscle layer and preventing superficial damage.
Step-by-Step Solution
Key Concept
Safe Administration of Intramuscular Medications utilizing the Z-Track Method