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Zorluk: ZorPharmacological Therapies

A practical nurse (PN) is preparing to administer an intramuscular injection of prescribed iron dextran to an adult client using the Z-track method. In what order should the PN perform the following steps to ensure safe administration? Arrange the actions in the correct chronological sequence.

  1. 1Replace the needle used to draw up the medication with a new sterile administration needle.
  2. 2Retract the skin and subcutaneous tissue 1 to 1.5 inches laterally or downward.
  3. 3Insert the needle swiftly at a 90-degree angle into the selected muscle.
  4. 4Depress the plunger slowly to inject the medication and wait for 10 seconds.
  5. 5Withdraw the needle smoothly and simultaneously release the displaced skin.

Cevap

The correct sequence is to first change the drawing-up needle, then retract the skin and subcutaneous tissue, insert the needle at a 90-degree angle, inject the medication while pausing for 10 seconds, and finally withdraw the needle while simultaneously releasing the skin.
The Z-track method requires strict adherence to a specific sequence to prevent tissue damage. First, a new needle must be attached to ensure the outside is free of irritating medication. Next, the skin is retracted to displace the tissue layers. The needle is then inserted at 90 degrees. After injecting slowly, a 10-second pause is necessary for medication dispersion. Finally, withdrawing the needle and releasing the skin simultaneously seals the track, trapping the medication in the muscle.

Adım Adım Çözüm

1
Change the drawing-up needle to a new, sterile administration needle.
Ensures the exterior of the needle shaft is free of medication.
Iron dextran can cause permanent tissue staining and severe irritation if deposited in the subcutaneous layers during insertion.
2
Retract the skin and subcutaneous tissue 1 to 1.5 inches laterally.
Moves the superficial tissues out of alignment with the underlying muscle.
This is the core principle of the Z-track method, preparing the 'zigzag' path that will lock the medication in the muscle.
3
Insert the needle at a 90-degree angle.
Penetrates through the displaced tissue directly into the muscle belly.
A 90-degree angle is required for intramuscular injections to ensure the medication reaches deep muscle tissue.
4
Inject the medication slowly and maintain the needle's position for 10 seconds.
Deposits the medication and allows it to begin diffusing into the surrounding muscle fibers.
Slow injection minimizes discomfort, and the 10-second pause prevents the medication from immediately welling up the injection track.
5
Withdraw the needle and release the retracted skin simultaneously.
The tissue layers slide back into their original positions, breaking the needle track alignment.
This seals the track, effectively trapping the irritating medication deep within the muscle and preventing seepage to the surface.

Anahtar Kavram

The Z-track method for intramuscular injections is used to prevent highly irritating or staining medications from leaking back into the subcutaneous tissue by displacing tissue layers before injection.
Tahmini Süre:1m 30s
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