The site selected by a nurse to administer an intramuscular injection to a 6-month infant is?

SCTIMST Staff Nurse - 2015 (Set-A)

Pediatric Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

The vastus lateralis is the largest and most well-developed muscle in an infant up to 12 months old, making it the ideal site for intramuscular injections.
This site is located on the anterolateral thigh and is distant from major nerves (like the sciatic nerve) and blood vessels, which minimizes the risk of injury during injection.
It is the universally recommended site by pediatric and immunization guidelines for infants.
The muscle can safely accommodate the typical injection volume for an infant, which is generally up to 1 mL.

Option B: The ventro-gluteal muscle is not sufficiently developed in a 6-month-old infant. While it is a very safe site, it is generally recommended for use in children older than 7-12 months who have been walking and have developed more muscle mass in this area.
Option C: The dorso-gluteal site is strictly contraindicated for infants and young children. The site's proximity to the sciatic nerve creates a high risk of permanent nerve damage and subsequent leg paralysis.
Option D: The deltoid muscle in a 6-month-old infant is far too small and underdeveloped to safely receive an intramuscular injection. Using this site risks injecting into subcutaneous tissue or causing injury to the radial nerve.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pediatric Intramuscular Injection Sites to guide bedside assessment, documentation, and the next nursing action.
Selecting the correct injection site is a critical nursing responsibility to ensure patient safety and medication efficacy. Using the wrong site can lead to nerve damage, poor drug absorption, pain, and abscess formation.
Always stabilize the infant's leg firmly but gently before and during the injection to prevent sudden movement that could cause injury.
What if? If the patient were a 4-year-old child receiving a routine vaccine, the deltoid muscle would likely be the preferred site, assuming it has adequate mass. For a walking child, the deltoid is often less painful and more easily accessed than the thigh.

How to Approach the Question

First, identify the key information in the question: the procedure is an intramuscular injection, and the patient is a 6-month-old infant.
Recall the principles of selecting IM injection sites, which are based on the patient's age, muscle development, and the location of underlying nerves and blood vessels.
Systematically evaluate each option based on the patient's age.
Eliminate the deltoid site because the muscle is too small in an infant.
Eliminate the dorso-gluteal site because it is contraindicated due to the risk of sciatic nerve injury.
Compare the vastus lateralis and ventro-gluteal sites. Recognize that the vastus lateralis is the most developed muscle at 6 months and is therefore the recommended primary site.

Concept Tested & Keywords

Concept Tested: Pediatric Intramuscular Injection Sites
Stem keywords: intramuscular injection, 6-month infant, site
Lead-in keywords: selected by a nurse
Clinical cues: Patient age of 6 months is the critical factor for determining the correct muscle site.

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