Injections
Preparing Injections from an Ampule
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- » Preparing Injections from an Ampule
- » Preparing Injections from a Vial
- » Preparing and Administering Insulin
- » Drawing up More Than One Type of Insulin
- » Administering Intradermal Injections
- » Administering Subcutaneous Injections
- » Administering Intramuscular Injections
Take the Review Test:
Safety
- Ensure that the Six Rights of Medication Administration are followed: right medication, right dose, right patient, right route, right time, and right documentation.
- To protect your fingers, place a small gauze pad or unopened foil-wrapped alcohol swab around the neck of the ampule when snapping it open. Do not use an opened alcohol swab to wrap the top of an ampule, because alcohol may leak into the ampule.
- Use a filter needle or filter straw to withdraw medication from an ampule, so that glass particles cannot enter the syringe.
- When using a filter needle/straw, remove or replace it with a needle of the appropriate gauge and length for the injection.
- Use strict asepsis when preparing an injection from an ampule.
- Establish a “No Interruption Zone” when preparing medications.
Equipment
(Roll cursor over items to see labels)
Syringe
Filter needle or filter straw
Alcohol swab
SESIP safety needle for injection
Medication in ampule
Tape for labeling syringe
PrintableDelegation
The skill of preparing an injection from an ampule or vial may not be delegated to nursing assistive personnel (NAP).
Preparation
- Check the accuracy and completeness of each medication administration record (MAR) against the health care provider’s medication orders. Confirm the patient’s name, medication name, dosage, route of administration, and time of administration. Clarify incomplete or unclear orders with the health care provider. Note if the patient has allergies.
- Observe the Six Rights of Medication Administration: right medication, right dose, right patient, right route, right time, and right documentation. (For details, see the Video Skill “Ensuring the Six Rights of Medication Administration.”)
- When drawing up medication for injection away from the patient’s bedside, be sure to label the syringe with the name of the medication and the amount it contains.
- Review the medication reference information for action, purpose, side effects, and nursing implications.
- Assess the patient’s body build, muscle size, and weight if giving subcutaneous or intramuscular medication.
Follow-up
- Just before administering the drug to the patient, compare the MAR with the label of the prepared drug, and compare the dose in the syringe with the desired dose.
Documentation
Record medication administration after giving the drug. It is not necessary to document medication preparation from an ampule separately.
Review Questions
1. When preparing an injection from an ampule, what will the nurse do if liquid is trapped in the neck of the ampule?
Check the medication cabinet for an extra ampule of the medication.
Notify the pharmacy that an additional ampule of medication will be needed.- Use quick, light finger taps on the top of the ampule to move the liquid.
- Shake the medication out of the neck of the ampule.
CORRECT. Although some of the liquid is trapped, the ampule is usable and need not be replaced with another if the proper technique is followed.
INCORRECT. The ampule is usable, and the pharmacy need not supply another one.
INCORRECT. Tapping the ampule will move the trapped fluid out of the neck of the ampule.
INCORRECT. Shaking the ampule to move the fluid out of the neck of the ampule is not recommended.
2. What is the greatest safety concern when withdrawing medication from an ampule?
- Not wearing gloves when preparing medication
- Selecting an inappropriate needle size
- Withdrawing glass particles into the syringe
- Withdrawing bubbles into the syringe
INCORRECT. It is not necessary to wear clean gloves when preparing medication.
INCORRECT. Appropriate needle size is not the greatest safety concern when withdrawing medication from an ampule.
CORRECT. Measures must be taken to prevent glass particles from being drawn into the syringe when aspirating medication from an ampule.
INCORRECT. Bubbles can be easily removed from a syringe.
3. How does the nurse minimize the risk of patient infection when preparing medication from an ampule?
- Using a filter needle to draw up the medication
- Preparing the medication in the patient’s room
- Applying clean gloves while preparing the medication
- Preserving the sterility of the needle while preparing the medication
INCORRECT. Using a filter needle is required, but the purpose is not to minimize the patient’s risk for infection.
INCORRECT. Preparing medication in the patient’s room will not minimize the patient’s risk for infection.
INCORRECT. Wearing gloves is not necessary while preparing the medication from an ampule.
CORRECT. Maintaining the sterility of the needle is the primary method of minimizing the patient’s risk for infection while preparing medication from an ampule.
4. Which action minimizes the risk of introducing glass particles into the syringe when drawing medication from an ampule?
- Using minimal force to snap the neck of the ampule
- Using gauze to cover the top of the ampule when snapping it
- Using a filter needle or straw to draw the medication from the ampule
- Allowing the medication to settle after the ampule has been snapped open
INCORRECT. Reducing the force used to snap the neck of the ampule will not reduce the risk of introducing glass particles into the medication drawn from an ampule.
INCORRECT. Covering the top of the ampule with gauze will not reduce the risk of introducing glass particles into the medication drawn from an ampule.
CORRECT. Filter needles are designed to prevent glass particles in the ampule from entering the syringe.
INCORRECT. Allowing the medication to settle will not reduce the risk of introducing glass particles into the medication drawn from an ampule.
5. Which action might the nurse take when drawing up medication from an ampule?
- Hold the ampule upside down while inserting the filter needle.
- Inject air into the ampule before withdrawing the medication.
- Hold the ampule horizontally while inserting the filter needle.
- Expel air bubbles from the syringe while the filter needle is still inside the ampule.
CORRECT. The ampule is either held upside down or placed on a flat surface to withdraw medication.
INCORRECT. Injecting air into the ampule would force medication to be expelled from it.
INCORRECT. The ampule is not held horizontally.
INCORRECT. Expelling air bubbles from the syringe while the filter needle is still in the ampule would force medication out of the ampule.
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