NCLEX-PN® ExaminationPharmacological TherapiesMedium
An LPN is preparing to administer an intramuscular (IM) injection of an opioid analgesic to an adult client. The client is of average build. Which site and needle gauge/length combination is most appropriate for this injection?
- ADorsogluteal site, 23-gauge, 1-inch needle.
- BVentrogluteal site, 21-gauge, 1.5-inch needle.
- CDeltoid muscle, 25-gauge, 5/8-inch needle.
- DVastus lateralis, 20-gauge, 1-inch needle.
Show answer & explanationAnswer & explanation
Correct answer: B. Ventrogluteal site, 21-gauge, 1.5-inch needle.
The ventrogluteal site is the preferred IM injection site for adults due to its large muscle mass, distance from major nerves and blood vessels, and thinner subcutaneous tissue. A 21-gauge, 1.5-inch needle is appropriate for an average adult to reach the muscle tissue and ensure proper absorption of the medication.
Why the other options are wrong
- A. The dorsogluteal site is associated with a higher risk of sciatic nerve damage and is generally avoided. A 1-inch needle might be too short for some adults in this site.
- C. The deltoid is often too small for opioid analgesics (which can be a larger volume) and a 5/8-inch needle is generally too short for IM injection in an average adult.
- D. While the vastus lateralis is an acceptable site, a 20-gauge needle is larger than typically necessary for an opioid analgesic and may cause more discomfort. A 1-inch needle might be too short for an average adult in this site.
IM Injection Site Selection
Selecting the appropriate intramuscular (IM) injection site and needle based on client age, muscle mass, medication volume, and medication type to ensure safety and efficacy.
- Ventrogluteal is preferred for adults.
- Avoid dorsogluteal due to sciatic nerve risk.
- Needle length depends on site, client size, and muscle mass.
- Gauge depends on medication viscosity.
Memory trick: IM: Inject Muscle Safely