A pregnant woman non-compliant with oral iron therapy is prescribed an intramuscular iron injection. Which technique should the nurse employ to prevent medication leakage into the subcutaneous tissue and avoid skin staining?

Appeared in: NORCET-11 Prelims

Explanation

The Z-track technique is recommended for IM injections of irritating medications like iron.
Pulling the skin laterally before injection and releasing it after withdrawal seals the medication in the muscle.
This method prevents leakage into subcutaneous tissue and avoids skin staining.

Option A: A 45-degree angle is used for subcutaneous injections, not intramuscular. IM injections require a 90-degree angle.
Option B: The dorsogluteal site is outdated and not recommended due to risk of sciatic nerve injury. It does not prevent leakage or staining.
Option D: Massaging the site after IM iron injection can cause medication to leak into subcutaneous tissue and worsen skin staining.

Clinical Relevance

Nursing practice connection: Use the key finding related to Z-track technique for intramuscular iron injection to prevent leakage and skin staining to guide bedside assessment, documentation, and the next nursing action.
Prevents iron staining and tissue irritation, improving patient comfort and satisfaction.
Essential for safe administration of IM iron, especially in pregnant women who may require repeated injections.
What if? If the Z-track method is not used, the patient may develop permanent skin discoloration and tissue irritation.

How to Approach the Question

Identify the medication and its risk for tissue irritation or staining (iron dextran).
Recall the recommended technique for IM injections of irritating substances.
Eliminate options that do not match standard IM injection protocols (e.g., incorrect angle, outdated sites, or unsafe aftercare).
Select the option that describes the Z-track method, as it is the evidence-based standard for this scenario.

Concept Tested & Keywords

Concept Tested: Z-track technique for intramuscular iron injection to prevent leakage and skin staining
Stem keywords: pregnant woman, non-compliant with oral iron, intramuscular iron injection, prevent medication leakage, avoid skin staining
Lead-in keywords: should the nurse employ, prevent, avoid
Clinical cues: Pregnancy increases risk of iron deficiency; IM iron is irritating and stains tissue

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E6 Nursing Fundamentals Taylor p. 862-864

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 174-176

E6 Pharmacology Nursing Lilley 11e Part 1 p. 137-139

Practise the full NORCET-11 Prelims

Attempt every question from this paper in a timed mock, then review the full solution for each one.