Unit 9 Intradermic injection（皮內(nèi)注射)
Objectives and injection sites
1. Hypersensitivitytest（藥物過敏試驗(yàn))------- inner aspect offorearm
2. Vaccination（預(yù)防接種) ------- lateral and posterioraspects of upper arm
3. Topicalanaesthesia(局部麻醉)
Equipment
Basic therapeutic tray(基礎(chǔ)治療盤)
Syringes (1ml and 5ml)
Needle (4 – 41/2)
Adrenalin(腎上腺素)
Procedure
1. Take equipment to client’s room.
2. Identi國家醫(yī)學(xué)考試網(wǎng)fy the client and medication. ask client to statename.
3. Explain action of medication and procedure ofadministration. History of anaphylaxis(過敏反應(yīng)) must be know inside out.
4. Select site for injection and wash your hands. Cleanse areawith alcohol swab.
5. Check medication and client again.
6. Expel all air bubbles from syringe.
7. Gently pull the skin taut（緊)on ventral(腹側(cè)的)forearm.
8. Insert needle at a 5。 angle with the bevel（斜面) of the needle facing up.
9. After the whole bevel goes into skin, fix the syringefirmly.
10. Inject 0.1ml medicationslowly. Observe for signs of wheal（皮丘) formation and blanching at the site.
11. Withdraw needle. Do notmassage area.
12. Record time and disposeof equipment.
13. Wash hands, and recheckagainst the client’s medication record.
14. Tell client do not pressor scratch the area. If has any discomfort, tell nurse as soon as possible.
15. 15—20’ later, observe and record result.
Intravenous injection（靜脈注射)
Objectives
1. To promote rapid absorption of the drug
2. When drug is irritating to tissues or can’t be taken orally.
Venipuncture sites
1. Inspect both of client's arms, palpating(觸診) and visualizing（觀察) the course of the veins.
2. Vein should be superficial, easily palpated, and largeenough for needle insertion and advancement.
3. Area should be free of lesions or scars and away fromjoints.
4. Distal end of vein should be selected first, reserving moreproximal sites for future IV therapy.
1. Select larger veins for hypertonic（高滲) solutions, blood, and viscous （粘滯的)fluids.
2. Avoid using veins in affected arm following mastectomy（乳房切除術(shù)).
3. Lower extremity sites are associated with complications(e.g., thrombosis 血栓癥)and should be used ONLY if necessary.
4. If possible, select a vein on client's nondominant（非優(yōu)勢的) arm.
venipunctureSites in common use
Dorsal Venous Network 手背靜脈網(wǎng)
Dorsal Plexus 足背靜脈叢
Dorsal Arch 足背靜脈弓
Basilic Vein 貴要靜脈
Dorsal Metacarpal Veins 掌骨靜脈
Cephalic Vein 頭靜脈
Radial Vein 徑脈
Median Cubital Vein 肘正中靜脈
Ulnar Vein 肘脈
Greater Saphenous Vein 大隱靜脈
u Equipment
Basic therapeutic tray(基礎(chǔ)治療盤)
Syringes and needle
Tourniquet（止血帶)
Protective pad（治療巾)
u Procedure
1. Take equipment to client’s room.
2. Identify the client and medication. Have client state name.
3. Explain the procedure to client.
4. Select site for injection and set the protective wrap underarm.
5. Wash your hands. Apply iodophor(碘伏) to selected venipuncture site and dry.
6. Apply tourniquet 6cmabove selected site to distend vein.
7. Check medication and client again. Ask client to clospayment-defi.com/jianyan/e fist.
8. Expel all air bubbles from syringe.
9. With needle bevel up, enter client’s skin at a 20-25。angle. Flatten angle once needle isunder skin and then enter vein.
10. Observe for flashback ofblood.
11. Carefully advance needleup course of the vein.
12. Release tourniquet andfist.
13. Inject medication slowly.Observe client’s situation.
14. Withdraw needle, and quicklypress sterile swab over venipuncture site. Hold firmly until bleeding stops.
15. Dispose of equipment.
16. Wash hands, and recheck against the client’s medicationrecord.
a.
