65. A nurse prepares to administer 0.3 mL of a medication intramuscularly to a 4-month-old infant. Which equipment should the nurse collect? Select all that apply and place in sequential order.
65. A nurse prepares to administer 0.3 mL of a medication intramuscularly to a 4-month-old infant. Which equipment should the nurse collect? Select all that apply and place in sequential order.
. 3-mL syringe with a 23-gauge needle.
. 1-mL syringe with a 25-gauge needle.
. Alcohol pad.
. Cotton ball and bandage.
Test-Taking Tip
The nurse should always select the smallest gauge of syringe and needle possible for use in infants; the larger the number, the smaller the gauge. Think "organization" (i.e., sequence of steps) to give the medication, to cleanse the skin, and to apply pressure and to cover.
Content Area: Child Health, Medication Administration; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Safe, Effective Care Environment/Safety and Infection Control/Safe Use of Equipment
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Answer 1 is incorrect because a 3-mL syringe does not allow for precise measurement of the small amount of medication that the infant is to receive. In addition, a 23-gauge needle could cause injury as well as unnecessary discomfort to the infant. Answer 2 is correct because a 1-mL syringe does allow for precise measurement of the small amount of medication that the infant is to receive. In addition, a 25-gauge needle will provide a degree of safety as well as comfort for the infant. Selection of the most appropriate syringe and needle is the first action that the nurse should take. Answer 3 is correct because the nurse must cleanse the infant's skin prior to the injection. Working in an organized fashion and visualizing what steps must be performed and in what order to administer the injection makes this the nurse's second action. Answer 4 is correct because the nurse must apply pressure and then cover the injection site after administration of the injection. Working in an organized fashion and visualizing what steps must be performed and in what order to complete the injection makes this the nurse's third action.