Nursing Procedures: Brain Anatomy, Injections, and Catheterization

Posted on May 10, 2024 in Medicine & Health

Brain Anatomy

Frontal Lobe: Movement, problem-solving, concentration, thinking, behavior, personality, mood

Motor Cortex: Movement of voluntary muscles

Sensory Cortex: Skin sensations (temperature, pain, pressure)

Temporal Lobe: Hearing, language, memory

Brain Stem: Consciousness, breathing, heart rate

Parietal Lobe: Sensations, language, perception, body awareness, attention

Occipital Lobe: Vision, perception

Cerebellum: Posture, balance, coordination of movement

Broca’s Area: Production of speech

Wernicke’s Area: Understanding speech (language comprehension)

Injection Procedures

General Guidelines

  • Do check before removal of medication, when putting it in the syringe, and before administering.
  • Check name, date of birth, and allergies (check against MAR).
  • Inform the patient why they are getting this injection.
  • Practice hand hygiene and wear gloves.
  • Clean the injection site in a circular motion.
  • Maintain patient privacy and comfort during and after the injection.
  • Reassess the injection site after administration.
  • Document medication, patient, dose, route, site, time, and signature.

Intramuscular (IM) Injections

  • Hold the syringe like a dart, at a 90-degree angle.
  • Wait 10 seconds, then withdraw the needle.
  • Release the skin and place a swab over the site.
  • Apply gentle pressure – do not massage.
  • Ensure needle safety and discard properly.

IM Injection Sites and Needle Sizes

  • Ventrogluteal: Up to 3 mL of medication (25 gauge needle), 1 to 1 1/5 inch needle length
  • Vastus Lateralis: Up to 3 mL of medication (25 gauge to 38 gauge needle), 1 to 1 1/2 inch needle length
  • Deltoid: 1 mL or less (25 gauge needle), 1 to 1 1/2 inch needle length

Subcutaneous (SubQ) Injections

  • Needle size: 25-31 gauge
  • Needle length: 1/2 inch to 5/8 inch
  • No more than 1 mL injection volume
  • For high-risk medications, get verification from another nurse on dosage.
  • Pinch the skin, insert the needle quickly at a 45-degree angle.
  • Inject slowly and withdraw the needle at the same angle.
  • Place a swab over the site – do not massage or touch.

SubQ Injection Site

Abdomen: From below the costal margin to the iliac crest and more than 2 inches from the umbilicus.

Z-Track Method

  • Vastus Lateralis: (Refer to IM injection guidelines)
  • Ventrogluteal: Place the patient on their side. Place your thumb/palm on the greater trochanter, middle finger pointing at the iliac crest, and index finger toward the anterior superior iliac spine. Inject between the V of your fingers, close to the middle one.

Vastus lateralis intramuscular injection

Urinary Catheterization

General Guidelines

  • Adhere to safety and quality components as defined in the syllabus.
  • Verbalize verification of the order.
  • Identify the patient using two identifiers.
  • Ask for patient allergies.
  • Explain the procedure to the patient.
  • Verbalize maintenance of patient privacy.
  • Position the patient, bed, and environment for the procedure.
  • Establish and maintain a sterile field for the procedure.
  • Prepare the tray, cleansing materials, lubricant, and catheter for insertion.

Female Patient

  1. Separate labia with fingers of nondominant hand and maintain position throughout the procedure.
  2. Clean the far labial fold, near labial fold, and over the center of the urethral meatus, moving from clitoris toward anus and using a new cotton ball/swab for each area.
  3. Insert catheter into the urethra approximately 2-3 inches, verbalize observing for return of urine, then advance the catheter another 1-2 inches.
  4. Inflate the balloon with the correct amount of sterile water.
  5. Retract the catheter gently until resistance is met.
  6. Secure the catheter properly.
  7. Place the drainage bag on the bed frame, below the level of the bladder.
  8. Document the size of the catheter inserted, the amount of fluid used to inflate the balloon, the clarity and color of urine, and the patient’s response to the procedure.

Male Patient

  1. Hold the penis at a right angle to the body with the nondominant hand.
  2. Clean the meatus a total of three times with a cotton ball or swab, moving in a circular motion away from the meatus outward and using a new cotton ball/swab each time.
  3. Insert the catheter to the bifurcation, maintaining the penis at a right angle with slight traction applied.
  4. Inflate the balloon with the correct amount of sterile water.
  5. Retract the catheter gently until resistance is met.
  6. Secure the catheter properly.
  7. Place the drainage bag on the bed frame, below the level of the bladder.
  8. Document the size of the catheter inserted, the amount of fluid used to inflate the balloon, the clarity and color of urine, and the patient’s response to the procedure.