Mountain View College

School of Nursing

PHARMACOLOGY
First Semester, AY 2023-2024

INTRADERMAL INJECTION

Criteria for Evaluation:

3 – Able to perform the procedure properly without coaching.
2 – Abot to perform the procedure but needs coaching and assistance sometimes.
1 – Able to perform the procedure but needs coaching and assistance at all times.

STEPS PERFORMANCE
3 2 1 Remarks
Check the medication card against the physician’s written orders.
Check the client’s identification band. Explain the procedure to the client.
Check for the client and the chart for any known allergies.
Wash hands.
Follow the Ten Rights of Drug Administration.
Prepare needed equipment and supplies: 1 mL tuberculin syringe, G-26-27 needle, antiseptic
swab, gloves, medication ampule, medication card, sterile water for injection (diluent), pen.
Check medication order again. (Three checks promote safety.)
Prepare correct volume of sterile water from the vial.
 Wipe off surfaced of rubber seal if vial has been previously opened.
 Inject 0.9 mL of air into the vial and aspirate the same amount of the diluent.
Prepare correct medication dose from an ampule.
 Draw up 0.1 mL of medication quickly. Hold ampule upside down or set it on a flat
surface. Insert syringe needle into the center of ampule openly. Do not allow needle
tip or shaft to touch the rim of ampule. Keep needle tip below the surface of the
liquid.
Gently tap the syringe to mix the solution properly.
Cover needle with cap. Change needle on syringe.
Once again, check for the right client and the right drug to be administered.
Assist patient to comfortable position. Have patient extend elbow and support it and forearm
on flat surface.
Don sterile gloves.
Select appropriate injection site. Inspect skin surfaces over sites for bruises inflammation, or
edema. Note lesions or discolorations of forearm.
Relocate site using anatomic landmarks.
Cleanse site with antiseptic swab. Apply swab at center of site and rotate outward in circular
direction for about 5 cm (2 inches).
Hold swab between third and fourth fingers of non-dominant hand.
Remove cap from needle by pulling it straight off.
Hold syringe correctly between thumb and forefinger of dominant hand. Hold bevel of needle
pointing up.
Administer injection.
 With non-dominant hand, stretch skin over site with forefinger or thumb.
 With needle almost against client’s skin, insert it slowly at 5 to 15 degree angle until
resistance is felt. Then advance needle through epidermis to approximately 3 mm
(1/8 inch) below surface. Needle tip can be seen through skin.
Inject medication slowly. It is normal to feel resistance; if not, needle is too deep.
Note formation of a small bleb on skin’s surface.
Withdraw needle while applying alcohol swab gently above or over injection site.
OPTIONAL: Apply bandage. Do not massage site.
Draw circle around perimeter of injection site with skin pencil or pen.
Assist patient to comfortable position.
Discard unsheathed needle and attached syringe into appropriately labeled receptables.
Remove disposable gloves. Wash hands.
Record areas of injection, amount and type of testing substance, and date and time on
medication record.
SUBTOTAL

Signature of Supervising Clinical Instructor: _______________________________________________ Total Score: _____________ Grade: ________________
 Mountain View College
School of Nursing

PHARMACOLOGY
First Semester, AY 2023-2024

INTRAMUSCULAR INJECTION

Criteria for Evaluation:

3 – Able to perform the procedure properly without coaching.
2 – Abot to perform the procedure but needs coaching and assistance sometimes.
1 – Able to perform the procedure but needs coaching and assistance at all times.

STEPS PERFORMANCE
3 2 1 Remarks
Check the medication card against the physician’s written orders to ensure accuracy in the
medication administration.
Check the client’s identification band and explain the procedure to the client.
Check for the client and the chart for any known allergies.
Wash hands.
Follow the Ten Rights to Drug Administration.
Prepare needed equipment and supplies; syringe (2-3 mL for adult, 1-2 mL for pedia),
antiseptic swab, disposable gloves, medication ampule or vial, medication card.
Check medication order again. (Three checks promote safety.)
Prepare the medication from a vial.
 Wipe off surface of rubber seal with alcohol swab if vial has been previously opened.
 Inject air (same volume of the drug to be aspirated from the vial) not the vial, holding
unto plunger.
 Hold vial between thumb and forefinger of dominant hand.
Once again, check fluid level in syringe and compare with desired dose.
Place the client in an appropriate position to expose the site (deltoid-sitting; ventrogluteal-
lateral, dorsogluteal-prone).
Don sterile gloves.
Select and clean the site.
 Assess the client’s skin for redness, break in the skin.
 Select site using the anatomic landmarks (dorsogluteal-imaginary diagonal line
extending from the posterior superior iliac spine to the greater trochanter).
 Cleanse the area with an alcohol swab. Using friction, cleanse from center, rotate
outward in circular motion for about 5 cm (2 inches): wait 30 seconds to allow site
to dry.
Prepare for injection.
 Hold swab between 3rd and 4th fingers of non-dominant hand.
 Remove the needle cap by pulling it straight off, and expel any air bubbles from the
syringe.
 Spread skin tightly (pull the skin down or to one side for Z-track) with non-dominant
hand. I muscle mass is small, grasp body of muscle between thumb and other
fingers.
Administer the injection.
 Hold syringe correctly between thumb and forefinger of dominant hand. Quickly
insert the needle using a dart-like motion and steady pressure at a 90 degree angle.
 While maintaining traction on the skin, insert the needle deeply. Aspirate with the
dominant hand.
 If blood appears, remove the needle and discard; if none, inject the medication
slowly at about 10 sec/mL.
 Withdraw needle while applying gentle pressure at the site with a dry swab.
 Massage skin lightly. (DO NOT massage with SC and Z-track methods.)
 Discard the needle and syringe in a safe sharp container. DO NOT recap the needle.
Position the client for comfort.
Remove gloves, wash hands to prevent transmission of microbes.
Document the medication: dosage, route, site used, date and time
SUBTOTAL

Signature of Supervising Clinical Instructor: _______________________________________________ Total Score: _____________ Grade: ________________