1. An older, frail patient is prescribed a flu vaccine that is an aqueous or water-based solution. The patient’s deltoid muscle is not very prominent, and the patient has very little fat over the deltoid. The needles available are 23 G 5⁄8 inch, 22 G 1 inch, and 20 G 1 1⁄2 inch.
- What needle size/length would work best for this particular medication and patient? Give the reason for your selection.
2. A patient is hospitalized on the surgical floor. Pain medication is prescribed to be given by intramuscular route. After calculating, the volume to be administered is 2 mL. The patient has a large amount of adipose tissue around her hips and buttocks region and weighs 253 pounds. The needle sizes available include 27 G 3⁄8 inch, 25 G 5⁄8 inch, 22 G 1 inch, 21 G 1 1⁄2 inch, and 20 G 2 inches.
- What needle size/length and injection site would work best for this particular medication and patient? Give the reason for your selection.
3. The nurse is teaching a patient how to mix 5 units of regular insulin and 15 units of NPH insulin in the same syringe. The nurse determines further instruction is needed if the patient does which of the following?
- Injects 5 units of air into the regular insulin vial first and withdraws 5 units of regular insulin
- Injects 15 units of air into the NPH insulin vial but does not withdraw the medication
- Withdraws 5 units of regular insulin before withdrawing 15 units of NPH insulin
- Calculates the combined total insulin dose as 20 units after withdrawing the regular insulin from the vial