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Nursing Skills Laboratory Procedure


Preparing Parenteral Medication From a Vial and Administering Via an Intradermal Injection

Achievement of SATISFACTORY in all categories is necessary

Student's Name: ____________________

Grade (circle one):

P = achieved 3 or above in all categories

F = achieved 2 or below in one or more categories

The following scale is utilized:

1 = Failing 2 = Unsatisfactory 3 = Satisfactory 4 = Good 5 = Superior

ACTION
S
G SA U
F
  • Gather the supplies
5 4 3 2 1
  • Explain the procedure to the patient
5 4 3 2 1
  • Wash and dry hands carefully
5 4 3 2 1
  • Determine the necessary needle and syringe size needed for administration of the intradermal injection to the patient
5 4 3 2 1
  • Arrange the patient's MAR next to or on the medication cart
5 4 3 2 1
  • Review the patient's MAR by determining if each contains the essential parts of a medication order (patient's name, drug name, drug dosage, route of drug administration, time for drug administration)
5 4 3 2 1
  • Obtain the appropriate medication vial from the patient's medication drawer in the medication cart or other storage area
5 4 3 2 1
  • Compare the label on the medication vial against the MAR by determining if both contain the essential parts of a medication order (patient's name, drug name, drug dosage, route of drug administration, time for drug administration)
5 4 3 2 1
  • If the label on the medication vial and the patient's MAR do not contain the same essential parts of a medication order, check the original order in the patient's chart
5 4 3 2 1
  • If the MAR and the original order in the patient's chart do not contain the same essential parts of a medication order, report the discrepancy to the nurse in charge and/or physician
5 4 3 2 1
  • Perform any necessary drug calculations
5 4 3 2 1
  • Assemble the needle and syringe if not already assembled
5 4 3 2 1
  • Mix the solution in the vial by rotating it between the palms of your hands
5 4 3 2 1
  • Place vial on the medication cart
5 4 3 2 1
  • Remove the protective metal cap from the vial
5 4 3 2 1
  • Cleanse the rubber cap of vial with an alcohol swab using a circular motion
5 4 3 2 1
  • Remove the cap from the needle
5 4 3 2 1
  • Pull back on the plunger of the syringe to draw into the barrel of the syringe the amount of air equal to the volume of medication to be withdrawn from the vial
5 4 3 2 1
  • Stabilize the vial on the medication cart with your nondominant hand
5 4 3 2 1
  • Insert the needle into the upright vial through the center of the rubber cap
5 4 3 2 1
  • Push on the plunger of the syringe with your dominant hand to inject the air from the barrel of the syringe into the vial, keeping the bevel of the needle above the surface of the medication
5 4 3 2 1
  • Invert the vial, by 1) holding the vial between the index and middle fingers of your nondominant hand, 2) holding the barrel of the syringe between the thumb and fourth finger of your nondominant hand, and 3) inverting the vial upside down with the needle and syringe below it
5 4 3 2 1
  • Hold the vial at eye level
5 4 3 2 1
  • Pull back on the plunger of the syringe with your dominant hand until the correct dosage of medication is withdrawn into the barrel of the syringe
5 4 3 2 1
  • If necessary, tap on the barrel of the syringe to dislodge any air bubbles present in the barrel of the syringe
5 4 3 2 1
  • Withdraw the needle from the vial with your dominant hand
5 4 3 2 1
  • Replace the vial on the medication cart
5 4 3 2 1
  • Replace the cap over the needle utilizing the single-handed scoop method with your dominant hand
5 4 3 2 1
  • Take the medication into the patient's room
5 4 3 2 1
  • Identify the patient by comparing the name on the patient's MAR with the name on his/her identification bracelet and ask him/her to state his/her full name
5 4 3 2 1
  • Lock the wheels of the bed
5 4 3 2 1
  • Raise the bed to waist level
5 4 3 2 1
  • Lower the siderail nearest you
5 4 3 2 1
  • Assist the patient in assuming a position in which his/her inner lower arms, upper chest, or back beneath his/her scapulae can be relaxed, depending on the site to be used
5 4 3 2 1
  • Select a site on the patient's inner lower arms, upper chest, or back beneath his/her scapulae that is not heavily pigmented, covered with hair, free of tenderness, hardness, swelling, scarring, itching, burning, or localized inflammation, and that has not been used frequently
5 4 3 2 1
  • Don disposable gloves
5 4 3 2 1
  • Clean the site with an alcohol swab, by 1) starting at the center of the site, 2) cleaning the site in a widening circle to about 5 centimeters (2 inches), and 3 allowing the site to dry thoroughly
5 4 3 2 1
  • Place and hold the alcohol swab between the third and fourth fingers of your nondominant hand or position it on the patient's skin above the cleansed site
5 4 3 2 1
  • Remove the needle cap from the needle
5 4 3 2 1
  • Grasp the syringe and hold it in your dominant hand between your thumb and fingers with your palm facing upward
5 4 3 2 1
  • Spread the patient's skin at the insertion site with your nondominant hand
5 4 3 2 1
  • Insert the needle, bevel up, at a 15 degree angle into the dermis with your dominant hand so that the bevel of the needle can be seen through the skin
5 4 3 2 1
  • Move your nondominant hand to the barrel of the syringe
5 4 3 2 1
  • Move your dominant hand to the end of the plunger of the syringe
5 4 3 2 1
  • Push on the plunger of the syringe with your dominant hand using slow, even pressure to inject the medication while watching for a small wheal or blister to appear in the skin
5 4 3 2 1
  • Pull on the barrel of the syringe with your dominant hand to remove the needle
5 4 3 2 1
  • Lightly wipe the site with an alcohol swab
5 4 3 2 1
  • Assist the patient in returning to a comfortable position
5 4 3 2 1
  • Lower the bed to the lowest level
5 4 3 2 1
  • Raise the siderail nearest you
5 4 3 2 1
  • Assure that the patient's call light is readily available
5 4 3 2 1
  • DIspose of soiled supplies in an appropriate receptacle
5 4 3 2 1
  • Wash and dry hands carefully
5 4 3 2 1
  • Record preparing parenteral medication from a vial and administering via an intradermal injection on the patient's MAR per agency policy
5 4 3 2 1
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This page was last modified on 6/1/01