Injection CJ Quiz

What are the six steps of the Clinical Judgment Model (Caputi 2023)

Recognize cues → Analyze cues → Prioritize hypotheses → Generate solutions → Take action → Evaluate outcome

What does Caputi emphasize in the Clinical Judgment Model?

Reflection and metacognition — think about what went well and what needs improvement

What are the Seven Rights of Medication Administration?

Right patient, right medication, right dose, right time, right route, right documentation, right indication

What are the Three Checks for safe medication administration?

When removing from storage

When preparing

At bedside before administration

What are key safety practices for med administration?

Use two identifiers

What are the four parenteral routes?

Intradermal (ID)

What is the typical volume range for subcutaneous injections?

0.5–1.5 mL (max 2 mL)

What are common subcutaneous injection sites?

Abdomen

What are the needle gauge and length for insulin injections?

28–31 gauge

What are the needle gauge and length for heparin or LMWH injections?

25–27 gauge

What are the needle gauge and length for subcutaneous immunizations?

23–25 gauge

What is the angle of subcutaneous injection?

45° or 90°

What is the rule for pinching skin during subcutaneous injections?

Pinch 2 inches → 90° angle; Pinch 1 inch → 45° angle

What are common subcutaneous medications?

Insulin

What is the mixing order for insulins (NPH and Regular)?

Inject air into NPH → air into Regular → draw Regular → draw NPH (Clear before Cloudy; “Nancy Reagan RN”)

What is the typical volume range for intramuscular injections?

Up to 2–3 mL depending on site

What gauge and length are used for IM injections?

20–25 gauge; 1–1½ inch

What are the three main IM injection sites?

Ventrogluteal

What is the angle of IM injection?

90°

Which IM site is safest for large-volume injections?

Ventrogluteal site

Which IM site is preferred for infants and children?

Vastus Lateralis

Which IM site is common for adult immunizations?

Deltoid

What is the purpose of the Z-Track method for IM injections?

Prevents medication leakage and irritation by sealing the injection track

Should aspiration be performed before IM injection?

Follow agency policy; not recommended for vaccines or deltoid site per CDC

What is the angle and volume for intradermal injections?

5–15° angle; 0.01–0.1 mL volume

What is the typical needle gauge and length for intradermal injections?

25–27 gauge; 3/8–5/8 inch

What are common sites for intradermal injections?

Inner forearm and upper back

What should you see when giving an intradermal injection correctly?

A small bleb or bubble forms; resistance felt during injection

When should a PPD test be read?

48–72 hours after injection

What is measured on a positive PPD test?

The area of induration (firm bump)

What infection prevention steps apply to injections?

Hand hygiene

What is the dosage calculation formula?

(Desired ÷ Have) × Quantity = Dose to give

Example: Order 500 mg

Have 250 mg/tab — how many tablets?

Sliding scale insulin: glucose 151–200 mg/dL — how many units?

4 units Regular insulin subcut

Sliding scale insulin: glucose 201–250 mg/dL — how many units?

8 units Regular insulin subcut

Sliding scale insulin: glucose 251–300 mg/dL — how many units?

12 units Regular insulin subcut

What are the six actions in Caputi’s clinical reasoning example?

Recognize cues

Example: Patient with BG 189 mg/dL — what action is taken?

Administer 4 units Regular insulin subcut and reassess in 2 hours

What are the nurse’s infection control priorities during injections?

Maintain aseptic technique

What is the goal of the clinical judgment model?

Promote safe