A licensed practical nurse is tasked with giving a prescribed dose of iron dextran via intramuscular injection using the Z-track method. To ensure client safety and proper medication delivery, in what chronological order should the nurse perform the following procedural steps?
- 1Pull the skin and subcutaneous tissue laterally 1 to 1.5 inches from the injection site.
- 2Insert the needle at a 90-degree angle to penetrate the deep muscle layer.
- 3Depress the plunger slowly to instill the medication.
- 4Maintain the needle in the muscle for 10 seconds.
- 5Withdraw the needle smoothly and immediately release the displaced skin.
Answer
The correct sequence is: pull the skin laterally, insert the needle at a 90-degree angle, slowly depress the plunger to instill the medication, wait 10 seconds, and finally withdraw the needle while releasing the skin.
The Z-track method is specifically utilized for intramuscular administration of highly irritating or staining medications, such as iron dextran. The technique physically misaligns the tissue layers by pulling the skin and subcutaneous tissue to the side before insertion. The needle is inserted at a 90-degree angle, followed by slow instillation of the drug. Crucially, the nurse must wait 10 seconds before removing the needle to allow tissue accommodation. Finally, withdrawing the needle and releasing the skin simultaneously creates a broken, zigzag pathway that securely traps the medication deeply within the muscle, preventing tracking into the subcutaneous layer.
Step-by-Step Solution
Key Concept
Z-track method for intramuscular injections