Which of the following actions is accurate or safe when administering a medication using the Z - track method?

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

The core principle of the Z-track method is the lateral displacement of the skin and subcutaneous tissue before needle insertion.
This action creates a zigzag path when the skin is released after the injection, which effectively seals the medication within the muscle.
Sealing the medication prevents it from leaking back into the subcutaneous tissue, thereby minimizing skin irritation, pain, and discoloration.

Option B: Injecting without aspiration is not universally safe for all Z-track injections. Aspiration is often recommended for irritating medications to ensure the needle is not in a blood vessel.
Option C: A 26-gauge needle is generally too thin and short for an adult intramuscular injection. It may not reach the deep muscle tissue.
Option D: A volume of 0.3 to 0.5 mL of air is excessive for the 'air lock' technique. The standard is a much smaller bubble.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Z-Track Intramuscular Injection Technique as background academic context rather than a clinical decision trigger.
The Z-track method is a critical skill for nurses to prevent patient discomfort and complications when administering medications that are known to be irritating, viscous, or staining to the skin, such as iron dextran or haloperidol.
Proper site selection (e.g., ventrogluteal muscle) and technique are essential for patient safety and medication efficacy.
What if the patient is very thin or emaciated? The nurse would need to adjust the technique. Instead of pulling the skin flat, it might be necessary to grasp or 'bunch' the muscle mass to ensure the injection is intramuscular, and a shorter needle might be required.

How to Approach the Question

First, identify the core nursing procedure in the question, which is the 'Z-track method' for injections.
Recall the defining steps and principles of this specific technique. The name 'Z-track' itself is a clue to the mechanism.
Evaluate each option against the standard procedure for an IM Z-track injection.
Option A describes the hallmark of the technique: displacing the skin. This is a strong candidate.
Analyze the other options for inaccuracies. Consider standard practices for needle gauge, aspiration, and air-lock volumes for IM injections.
Eliminate options that describe incorrect parameters (wrong needle size, excessive air) or actions that are not universally safe for this method (no aspiration for irritating drugs).

Concept Tested & Keywords

Qds8F2PpyjAtRUlCnaGr4G

E6 Nursing Fundamentals Potter Perry 12e Part 3 pp. 203-205, 174-176

E6 Nursing Fundamentals Taylor p. 897-899

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