During intramuscular injection in the deltoid, which action by the student requires follow-up?

• A. Depresses the plunger of the syringe during the insertion of the needle
• B. Locates the injection site 3 finger widths below the acromion process
• C. Positions the client either lying or sitting
• D. Dons clean gloves before administering the injection

Answer: (A)

In an intramuscular injection to the deltoid, the medication should be delivered only after the needle tip is fully in the muscle and you’re ready to inject. Depressing the plunger during needle insertion is unsafe because it starts delivering the drug before proper tissue placement is confirmed, which can lead to the medication being deposited in subcutaneous tissue or, in some cases, causing damage to surrounding tissue. The goal is precise intramuscular delivery, so you insert the needle, verify you’re in the muscle, then slowly press the plunger to administer the dose. The other steps—positioning the client comfortably, locating the deltoid site about a couple of finger widths below the acromion, and using clean gloves—are appropriate parts of safe practice.