IM Progesterone Injection

  1. Hi everyone,

    My wife is starting on IM progesterone (in oil) tommorrow. The nurses at the fertility clinic have said it's a difficult and painful injection and I'm wondering if anyone has any pointers on how to minimize the discomfort before and/or after the injection. I'm usually quite good with my injections but I want to make this as easy on my wife as possible. Thanks in advance for any help or advice!
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    About bigjay

    Joined: Mar '00; Posts: 94; Likes: 14
    Oncology Nurse


  3. by   anitame
    A very smart and well respected CNM I work with recently gave me this tip. I tried it with my last two injections and it seemed to work. From the time you inject the needle until you remove it, use the tip of the index finger on your dominant hand to scratch the patient's skin directly beside the injection site. Apparently it "confuses" the nerve endings to feel the scratching (which probably actually feels like rubbing with gloves on) instead of the pain from the injection.
    I did this the other day to a woman receiving her second Betamethasone injection (painful). She said she couldn't believe how different it felt from her first shot. Said she kept thinking "I hope you don't stop scratching that spot" She said she was amazed at the difference in the pain level from the injection the previous day.
    Made a believer out of me! Definitely can't hurt, worth a try. Best of luck to you and your wife.
  4. by   mark_LD_RN
    that technique workswell anitame i have used it for yrs. I also frequently use z track method for injections like that helps stop the irrritation of meds leaking out through puncture
  5. by   SmilingBluEyes
    Here is a simple thing you can do w/o changing a thing about injection technique: have patient either lie sideways (laterally) and put the "shot" leg forward, knee bent, resting in infront of the other leg. This makes it harder to tense up the buttock/hip area you are giving the shot to. Or if standing, have them put the "shot" leg forward, knee bent, resting the weight on opposite side (straight leg). You always administer the injection on the BENT KNEE side. Both positions make it difficult to tense the affected muscles, a major reason for the pain during and after IM injections. I had to have steroids and other painful injections during my pregnancy w/Katie so I KNOW THIS WORKS!.

    ALSO: make sure the needle with which you inject her is NOT the needle you used to draw up the medication! This reduces the "sting" with the insertion of the med! (old nursing school memories). I do this w/each and every patient I care for!

    t's a simple technique my patients SWEAR makes it so much better! Good luck.
  6. by   Ortho_RN
    A friend of mine was taking those shot, well I was giving them to her.. And her doctor sent her home with some Lidocaine cream for her to put on 1hr prior to injection and she never felt a thing..
  7. by   SmilingBluEyes
    yes yes!!! EMLA cream. Wonderful suggestion! My son had it prior to some major blood work a while back.....(sticks in both arms)...he never felt anything and came out smiling. GOOD IDEA!
  8. by   mark_LD_RN
    good point about changing needles, i always do that ,just habit so i forgot to mention it. thanks debbie
  9. by   anitame
    Lots of good points. I always change needles too.
    My four year old had to have blood work, we used the EMLA and she watched the whole thing. Didn't even flinch. The lab tech was absolutely blown away. Said he'd NEVER had a child that young just watch.
  10. by   bigjay
    Thanks for all the advice. The shot itself went fine, she said she didn't even feel it. I will try z-tracking it next time though to prevent the leakage...

    However, she is complaining of a fair bit of pain today though which the clinic nurses said is usual. All in all, we're pretty relieved at how well it went so far...
  11. by   Jolie
    I presume this is in relation to in-vitro fertilization. Best of luck to you and your wife! May you be blessed with a healthy pregnancy and baby!