A nurse is administering an intradermal injection to a patient. Which statements are correct? Select all that apply.
A.
A depressed area around the injection sites indicates a positive reaction.
B.
After the insertion of the needle, a healthcare provider should aspirate for a blood return.
C.
The needle is inserted with the bevel of the needle upward at a 10- to 15-degree angle.
D.
The inner arm or upper back are the preferred sites.
The correct answer and Explanation is :
The correct answers are C and D.
Explanation:
Administering an intradermal injection is a specialized procedure used primarily for diagnostic purposes, such as tuberculosis (TB) testing or allergy testing. The nurse must be familiar with the correct technique and injection sites to ensure accuracy and minimize complications.
- Option C: “The needle is inserted with the bevel of the needle upward at a 10- to 15-degree angle.”
- This is correct. Intradermal injections require the needle to be inserted just below the surface of the skin (into the dermis layer), and the bevel should always face upward to create a small wheal (or raised area). The shallow 10- to 15-degree angle is crucial for ensuring the medication is injected into the correct layer. If the angle is too steep, the medication might enter the subcutaneous tissue, rendering the test inaccurate.
- Option D: “The inner arm or upper back are the preferred sites.”
- This is also correct. The inner aspect of the forearm and the upper back (below the scapula) are ideal because the skin in these areas is relatively thin, making it easier to inject the solution into the dermis. Moreover, these areas are not heavily used or exposed to friction, which helps prevent irritation and improves the visibility of any reaction.
Incorrect Options:
- Option A: “A depressed area around the injection site indicates a positive reaction.”
- This is incorrect. A positive reaction to an intradermal injection, such as for a TB skin test, usually results in induration (a raised, firm area) at the injection site, not a depression.
- Option B: “A healthcare provider should aspirate for a blood return.”
- This is also incorrect. Aspiration (pulling back on the plunger to check for blood) is not performed with intradermal injections, as the goal is to deliver the medication into the dermis, and there is minimal risk of injecting into a blood vessel in this layer.