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Discussion

IM injection doubt..Please help.

As a new grad nurse, I administered an intramuscular injection of fulvestrant, a hormonal therapy used to block estrogen receptors in breast cancer patients. The patient receives this injection monthly on both gluteal sites. During my first independent administration on the second gluteal site, I observed blood in the syringe upon needle removal. The patient suggested that the injection might have been mistakenly administered in the waist instead of the hip due to inaccurate landmarks. However, she reported feeling fine and left the facility.

Two days later, I followed up with the patient, and she reported experiencing nausea and diarrhea since the injection. She attributed these symptoms to the injection being administered in the waist instead of the hip. Even after two days, she continues to experience nausea. As a new grad nurse, I am concerned about the possibility of hitting a vessel or misplacement of the injection due to inaccurate landmarks. Could these symptoms be related to such issues?

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    • Admin

    Hello, @Manjeet, it appears based on your posting history that you have several concerns about IM injections. Have you reached out to your educator, supervisor, or a trusted coworker to discuss your concerns?

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    [...]

    ... As a new grad nurse, I am concerned about the possibility of hitting a vessel or misplacement of the injection due to inaccurate landmarks.  Could these symptoms be related to such issues?

    Have you addressed this, as well the other issues you've posted with your unit's educator or preceptor?  If not, you should as he or she would be best positioned to help you.

    Best wishes.

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    • Author

    Yes I discussed it with my preceptor. She said patients cannot experience diarrhea even if you missed the muscle while giving an IM injection. I showed her exactly where I gave the injection. She said I might have hit a small blood vessel while giving the injection, which is why I saw blood after taking out the needle. It's just me overthinking because the patient told me three days later that she is feeling nauseous and has some diarrhea after that injection. Additionally, diarrhea and nausea are common side effects of that medication. I also feel very guilty about the situation. The patient mentioned I gave the injection on her waist instead of her hip, but I explained to her that it doesn't matter because I could feel the muscle in that area while landmarking.

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