Why do patients absorb medications differently even when they are given by the same route?
With subcutaneous injections, local blood flow to the tissues affects absorption. Exercise
and heat or cold application influence blood flow. Circulatory shock and occlusive vascular
disease also affect blood flow and are contraindications for subcutaneous injections. When
giving insulin, the site you use affects the rate of absorption. Insulin given into the abdomen is
the most quickly absorbed, then the arms, then the thighs, and finally the buttocks, where it
has the slowest absorption rate. To minimize variation in absorption from day to day, give
insulin in one area, rotating sites within that area. With intramuscular injections, both blood
flow and the amount of muscle tissue affect absorption of the medication. Avoid giving
intramuscular injections into atrophied, poorly developed muscles. As with subcutaneous
injections, circulatory shock contraindicates intramuscular injections.
Should I take any special precautions when administering heparin? There is a risk of bruising
and pain with the administration of subcutaneous heparin, particularly low molecular weight
heparin. To minimize these effects, do not remove the air bubble prior to injection. Administer
the injection in the side of the abdomen. Inject the medication slowly, over 30 seconds. Wait
for 10 seconds after injection before withdrawing the needle, then apply gentle pressure for 30
to 60 seconds. Do not massage the site.
TIPS on documentation All medication by injection:
- name of medication, dose or amount of medication
- site
- route
- date, times, and your signature as per agency policy
- patient response
Intradermal injections:
,- name of medication, dose or amount of medication
site
- route
- date, times, and your signature as per agency policy
- appearance of the skin at the site
- teaching done about the expected outcome, for example, if it is a screening test
- patient response
Subcutaneous and intramuscular injections:
- name of medication, dose or amount of medication
site
- route
date, times, and your signature as per agency policy
- teaching done in preparation for self-administration
- patient response
Intradermal Injections 10 degree angle, 25-27G needle, 5/8-1/2" needle, barely cover bevel
under skin, do not do near a vein, do to the side, used for PPD&allergy testing
A nurse is preparing to administer an insulin injection to a patient. Which of the following is
appropriate? A) Rotate injection sites to avoid tissue injury
B) Administer no more than 2 mL per injection
C) Use the non-dominant hand to displace the skin and subcutaneous tissue at the site about 1
to 1 1/2 inches
D) Inject the medication after aspirating the syringe
, A-CORRECT
Rotating injection sites prevents tissue damage from repeated injections at the same site
A nurse is preparing to give an intramuscular injection into the left ventrogluteal muscle. Which
of the following should the nurse do to locate the appropriate site? A) Measure 2
fingerbreadths below the acromion process
B) Measure a handbreadth above the knee and a handbreadth below the greater trochanter
C) With the heel of the hand on the greater trochanter, point the index finger up toward the
anterior superior iliac spine, extending the other fingers back along the iliac crest
D) Divide the buttock into four quadrants and give the injection in the upper, outer quadrant.
C-CORRECT
This will locate the ventrogluteal site
A nurse is administering a subcutaneous injection to a patient. Which of the following data
should the nurse recognize as the highest priority to prevent potential complications? A)
Identify the patient's level of knowledge about the medication
B) Identify if the patient has allergies to the medication
C) Identify a specific site for the injection
D) Identify the rationale for the patient receiving the medication
B-CORRECT
this is the highest priority.
D is NOT -the nurse should already know this and also what the physiology is occuring after
giving the injection
Which of the following terms indicates a medication is given by injection? A) Enteral
B) Sublingual