Skip to content
View in the app

A better way to browse. Learn more.
allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

Am I doing something wrong?

Hello, I recently started working in outpatient psych, and regularly give Haldol and Prolixin Decanoate injections, as well as Invega Sustenna and Risperdal Consta. So far, I have been able to give the injections effectively, without any site reactions or decompensation. Sometimes though, I get nervous that I am not administering the injection correctly. I have noticed every once in a while the Prolixin oozes out a little, but I started using larger needles to prevent this. Also, I have one client who receives the Invega injection in the deltoid, and has been having issues. The first injection apaprently I gave too far down, and caused a hardened area under the skin and pain. I felt horrible, and he was afraid to come back to me. I finally got him to come in again, and administered the injection again in the deltoid (per request) and he explained it was great and didn't hurt at all. I just called him today a month later and is now complaining of hardness and pain under the skin at that site too! I feel so stupid and that I am doing something terribly wrong. He has never had this issue before. I give at least 20 other people Invega and they have no problems. Can someone help me understand or give me advice as to prevent this from occurring?! Feeling helpless. P.S-I either pinch up the skin and insert fast at a 90 degree angle or use the z-track if they are larger.

  • Quote

    • Featured Replies

    Hi depending on the weight of the should consider whether deltoid is the best option. I would leave the needle in for at least 10 sec after giving it to stop the ooze and use the z track. :)

  • Quote

    I am not sure about this particular injection, but I learned you use the Z track method for IM and do not pinch the skin. Pinching the skin in an SQ shot helps make sure you are not going into the muscle tissue. I also leave the syringe in for a short period of time if it's a medication I know carries additional risks (i.e. phenergan) if it leaks into the SQ at all when I take the needle out. That gives it a little time to start getting absorbed.

  • Quote
    • Experts

    The Z-track should settle any oozing problems, though if it's a very large amount of medication injected and/or a small muscle,you might still get a trace of oozing anyway.

    As for why your patient's arm site is hurting, did you use the correct needle size?

  • Quote

    I don't like giving invega in the arm always have complaints of pain. I always go for bigger muscle groups and rotate sites because of the sheer amount these patients usually get way too hard on their bodies. I have one patient who has gotten injections for 18 years and her arms are a train wreck.

  • Quote

    I used to have a pt that had injections with the same result no matter who did the IM. The doctor finally had to switch meds because it was a reaction. I would give in the gluteal though and see if it's the same result.

  • Quote
    • Author

    Thank you for all of the feedback. I saw the client today, and he stated he was only sore for a few days which is expected. Over the phone he made it seem as though his arm was swollen and tender which was not the case. I do give many of these in the gluteal, but in this case hes a young male and I am 22 and he does not like the idea of this. I have noticed I no longer have an issue with oozing, because I do not remove until at least 10 seconds and use the 11/2 needle on all clients unless they do not have much body fat. So far so good. I find the men to be bigger babies when it comes to the shots than the women haha. Good suggestions everyone!

  • Quote

    • Join the conversation

    You can post now and register later. If you have an account, sign in now to post with your account.

    Guest
    Add a Comment
    Go to topic listing

    Currently Reading 0

    • No registered users viewing this page.

    Account

    Navigation

    Search

    Search

    Configure browser push notifications
    Chrome (Android)
    1. Tap the lock icon next to the address bar.
    2. Tap Permissions → Notifications.
    3. Adjust your preference.
    Chrome (Desktop)
    1. Click the padlock icon in the address bar.
    2. Select Site settings.
    3. Find Notifications and adjust your preference.