Uttarakhand CHO - 2021
Child Health Nursing (Pediatrics)
Easy
Which muscle (muscles) is used for IM injection in infants (Infants)?
Appeared in: Uttarakhand CHO - 2021
Explanation
- The vastus lateralis muscle is the recommended site for intramuscular (IM) injections in infants (birth to 12 months).
- This muscle is the most developed and largest in an infant's body, providing a safe and adequate location for medication administration.
- It is located on the anterolateral (outer-middle) aspect of the thigh and is free from major nerves and blood vessels, reducing the risk of complications like nerve damage.
- The recommended volume for injection in this site for infants is typically up to 1 mL (and not more than 0.5 mL for smaller infants).
Why Other Options Were Wrong
- Option B: The gluteal muscles (both ventrogluteal and especially dorsogluteal) are underdeveloped in infants and are not recommended. The dorsogluteal site carries a high risk of injuring the sciatic nerve.
- Option C: The rectus femoris muscle, also on the anterior thigh, can be used but is generally avoided because injections here are more painful and can cause significant discomfort for the infant.
- Option D: The deltoid muscle in the upper arm is very small and underdeveloped in infants. It cannot accommodate the required medication volume and has a higher risk of injury to the radial nerve.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Intramuscular (IM) injection sites in infants as background academic context rather than a clinical decision trigger.
- Proper site selection is a critical nursing skill to ensure patient safety, medication effectiveness, and minimize pain. Using the wrong site in an infant can lead to serious, permanent nerve damage (e.g., sciatic nerve injury causing foot drop).
- Nurses must always assess the muscle mass and integrity before injection. If a child is emaciated or has muscle atrophy, the site may not be suitable, and an alternative site or medication route should be considered in consultation with the provider.
- What if? If an infant required frequent IM injections, the nurse should rotate between the left and right vastus lateralis muscles to prevent tissue damage, induration, and impaired medication absorption.
How to Approach the Question
- First, identify the core question: It asks for the correct IM injection site for a specific patient population, which is 'infants'.
- Recall the principles of pediatric medication administration. Key factors include the patient's age, muscle development, and the volume of medication.
- Evaluate each option based on these principles. Consider the development and safety of each muscle group in an infant.
- Eliminate options known to be unsafe or underdeveloped in infants. The gluteal and deltoid muscles are poor choices due to nerve proximity and small size, respectively.
- Compare the remaining thigh muscles. The vastus lateralis is explicitly recommended over the rectus femoris due to being less painful and safer.
- Conclude that the vastus lateralis is the best and most recommended site for IM injections in infants.
Concept Tested & Keywords
- Concept Tested: Intramuscular (IM) injection sites in infants
- Stem keywords: IM injection, infants, muscle
- Lead-in keywords: Which
- Clinical cues: Patient population is infants, which is a key determinant for selecting the injection site.
Question ID
Q_Lb_0W3fwvKp19jCWQd0U
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 175-177
E6 Anatomy Applied Ashalatha 4e p. 345-347
Practise the full Uttarakhand CHO - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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