The nurse is preparing to administer an IM immunization to a 6-month-old infant. Which needle length and injection site would be the most appropriate to minimize a local reaction to the vaccine components? A)3⁄8-in (9-mm) needle in the anterolateral thigh B)5⁄8-in (16-mm) needle in the ventrogluteal muscle C)1-in (25-mm) needle in the anterolateral thigh D)1½-in (38-mm) needle in the ventrogluteal muscle

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11ecbb05_cb43_51c3_b433_1795ce1c13b9_MD0009_00 The needle length and injection site for IM injections are dependent on a client's age and muscle mass. The vastus lateralis muscle in the anterolateral middle portion of the thigh is the preferred IM injection site for newborns (age <1 month) and infants (age 1-12 months). Selection of the most appropriate needle length is an important factor in ensuring immunization success and minimizing local reactions to vaccine components. If the needle is too short, the IM vaccine is injected into subcutaneous fat, resulting in vaccine failure due to poor mobilization of the antigen within adipose tissue. Infants typically require a 1-in (25-mm) needle for IM injections (Option C). (Option A) A 3⁄8-in (9-mm) needle is too short to penetrate the deep vastus lateralis muscle of the thigh. (Options B and D) The ventrogluteal area in an infant does not have enough muscle mass for use and is not recommended until at least age 3. A 5⁄8-in (16-mm) needle is too short and does not penetrate the deep muscle. A 1½-in (38 mm) length is too long and is normally used on older children and adults with sufficient muscle mass. Educational objective: Appropriate needle length and injection site are essential for proper administration of IM immunizations. For infants, use of a 1-in (25-mm) needle to administer medication in the vastus lateralis muscle is recommended to reach the IM tissue and minimize local reactions.

The Nurse Is Preparing to Administer an IM Immunization to a 6-Month-Old