The nurse is giving an intramuscular injection of an antibiotic to a 16-month-old toddler with pneumonia. The toddler does not have any known allergies and has been walking without assistance for one month.
Which technique should the nurse select for administration?
A.
Give in the arm, one to 2 inches (2.5 to 5.0 cm) below the acromion process.
B.
Use a needle length of 1/2 inch (1.25 cm) to avoid deep tissue damage.
C.
Administer the injection into the middle of the lateral aspect of the thigh.
D.
Divide the gluteal area into quarters and give IM into the upper outer quadrant.
The Correct Answer and Explanation is:
The correct answer is:
C. Administer the injection into the middle of the lateral aspect of the thigh.
Explanation:
When administering an intramuscular (IM) injection to a 16-month-old toddler, the choice of injection site is crucial to ensure safety and efficacy. Here’s why the selected option is the most appropriate:
1. Anatomy of Toddlers:
For toddlers, the vastus lateralis muscle, located on the lateral aspect of the thigh, is the preferred site for IM injections. This muscle is well-developed even in young children and is away from major nerves and blood vessels, making it safer and more suitable for IM injections. The middle of the lateral aspect of the thigh provides a large muscle mass with adequate depth for the injection, reducing the risk of injury and ensuring proper medication absorption.
2. Why Not the Arm (Option A)?
In infants and toddlers, the deltoid muscle in the arm is not sufficiently developed to handle IM injections. Administering an injection into the arm, particularly one to 1 to 2 inches below the acromion process, could result in discomfort and potential damage due to the small muscle mass and proximity to major structures. It is generally reserved for older children and adults.
3. Needle Length (Option B):
The choice of a 1/2 inch needle is inadequate for IM injections in toddlers. A longer needle is necessary to ensure that the medication is delivered deep into the muscle tissue. A needle length of 1 inch (2.5 cm) is typically recommended for toddlers to reach the muscle tissue effectively.
4. Gluteal Area (Option D):
Using the gluteal area for IM injections is not recommended in infants and young children. The risk of damaging the sciatic nerve and major blood vessels in this area is higher. Furthermore, the gluteal muscle is less developed in toddlers compared to the vastus lateralis, making it a less ideal site for injections.
In summary, option C, which involves administering the injection into the middle of the lateral aspect of the thigh, is the safest and most effective technique for an intramuscular injection in a 16-month-old toddler. This site provides a large, well-developed muscle with reduced risk of injury and optimal medication absorption.