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Zorluk: OrtaPharmacological Therapies

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?

  1. 1Pull the skin and subcutaneous tissue laterally 1 to 1.5 inches from the injection site.
  2. 2Insert the needle at a 90-degree angle to penetrate the deep muscle layer.
  3. 3Depress the plunger slowly to instill the medication.
  4. 4Maintain the needle in the muscle for 10 seconds.
  5. 5Withdraw the needle smoothly and immediately release the displaced skin.

Cevap

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.

Adım Adım Çözüm

1
Identify the first distinct step of the Z-track method prior to needle insertion.
Pull the skin and subcutaneous tissue laterally 1 to 1.5 inches from the injection site.
Displacing the tissue is the defining first physical manipulation of the Z-track technique, setting up the shifted pathway.
2
Determine the correct needle insertion technique once the skin is displaced.
Insert the needle at a 90-degree angle to penetrate the deep muscle layer.
The needle must be inserted perpendicularly while the non-dominant hand maintains the tissue displacement.
3
Identify the action for actual drug delivery.
Depress the plunger slowly to instill the medication.
Slow injection minimizes tissue trauma and promotes gradual absorption.
4
Determine the necessary pause before needle removal.
Maintain the needle in the muscle for 10 seconds.
This dwell time provides an opportunity for the medication to disperse locally rather than forcing its way back up the needle track.
5
Identify the final coordinated step to seal the track.
Withdraw the needle smoothly and immediately release the displaced skin.
Releasing the tissue shifts the superficial puncture site away from the muscle puncture site, locking the medication deep within the tissue.

Anahtar Kavram

Z-track method for intramuscular injections
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