For a 10-month-old child, an IM injection can be given in?

NHM UP Staff Nurse - 2016

Child Health Nursing (Pediatrics)

Easy

Appeared in: NHM UP Staff Nurse - 2016

Explanation

The anterolateral thigh contains the vastus lateralis muscle, which is the recommended site for IM injections in infants under 12 months of age.
This muscle is the largest and most well-developed in infants, which allows for the safe administration and effective absorption of medication.
The vastus lateralis site is considered the safest for this age group because it is not close to any major nerves (like the sciatic nerve) or large blood vessels.

Option A: The deltoid muscle is small and not sufficiently developed in a 10-month-old infant to safely receive an IM injection. Using this site increases the risk of injury to underlying nerves and bone.
Option C: The buttock, specifically the dorsogluteal site, is strictly avoided for IM injections in infants and young children. There is a significant risk of injuring the sciatic nerve, which can lead to permanent or temporary paralysis of the leg.
Option D: The abdomen is a primary site for subcutaneous (Sub-Q) injections, such as insulin or heparin. It is not used for intramuscular (IM) injections as the needle would not reach deep muscle tissue.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric Intramuscular (IM) Injection Site Selection as background academic context rather than a clinical decision trigger.
Selecting the correct injection site is a critical nursing responsibility to ensure patient safety, prevent complications like nerve damage or abscesses, and guarantee the medication is absorbed effectively.
A nurse must always assess the muscle mass and integrity before an injection, even at a recommended site, and choose the appropriate needle length for the child's size.
What if? If the child were 4 years old, the deltoid muscle would be an appropriate and common site for routine immunizations (up to 1-2 mL), in addition to the vastus lateralis.

How to Approach the Question

First, identify the key patient information in the question: the patient is a '10-month-old child'.
Next, identify the procedure: 'IM injection'.
Recall the standard guidelines for pediatric IM injection sites based on age.
For infants (birth to 12 months), the primary recommended site is the vastus lateralis muscle, located on the anterolateral thigh.
Evaluate the options provided. 'Anterolateral Thigh' directly corresponds to the recommended site.
Eliminate the other options based on safety and anatomical contraindications for this age group: the deltoid is underdeveloped, the buttock poses a risk to the sciatic nerve, and the abdomen is for subcutaneous injections.

Concept Tested & Keywords

Concept Tested: Pediatric Intramuscular (IM) Injection Site Selection
Stem keywords: 10-month-old child, IM injection
Lead-in keywords: can be given in
Clinical cues: Patient age (10-month-old) is the critical factor for determining the appropriate injection site.

Qo7bHdlQIcA8K-gFEzO5Gm

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 175-177

E6 Nursing Fundamentals Taylor p. 861-863

E6 Pharmacology Nursing Lilley 11e Part 1 p. 138-140