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SubQ Injections

SubQ Injections

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Outline

Overview

  1. Purpose
    1. Some medications are given under the skin in the subcutaneous layer
    2. Improper administration can make the medication be too shallow (intradermal) or too deep (intramuscular)

Nursing Points

General

  1. Supplies needed
    1. Required medication vial
    2. Appropriate size syringe
      1. Insulin syringe
      2. 1 mL
      3. 3 mL
    3. Appropriate size needle
    4. Alcohol pad
    5. Gauze
  2. Injection sites
    1. Anterolateral thigh
    2. Upper outer tricep
    3. Upper buttocks
    4. Abdomen
  3. Needle size
    1. Length – ½ – ⅝”
    2. Gauge – 26 – 30 g
  4. NOTES
    1. Rotate sites with frequent injections
      1. Especially insulin – risk for maldistribution of fat
    2. Must choose site with good subcutaneous fat layer
    3. With heparin
      1. Do not inject over a bruise
      2. Do NOT press or massage

Nursing Concepts

  1. Steps and Nursing Considerations
    1. Verify provider order
    2. ALWAYS follow 5 rights BEFORE preparing medication
      1. Right Patient
      2. Right Drug
      3. Right Dose
      4. Right Route
      5. Right Time
    3. ALWAYS prepare medications at the patient’s bedside
    4. Gather supplies
    5. Perform hand hygiene
    6. Don clean gloves
    7. Let the patient know what meds they will be receiving
    8. Draw up medication in appropriate syringe
    9. Select appropriate site
      1. Rotate from previous site
    10. Select appropriate needle size and attach needle
    11. Clean the site with alcohol in circles starting at the center and working outward – LET DRY
    12. Pinch the skin up off the muscle so there’s a layer of subcutaneous fat between your fingers
    13. Insert the needle at a 45-90 degree angle
    14. Inject medication slowly
    15. Remove needle
    16. Apply gentle pressure with gauze
      1. Do NOT massage
    17. Activate safety and/or dispose of needle in sharps container
    18. AFTER administration
      1. Document administration and patient’s response
      2. If using barcode medication administration
        1. Scan all meds before preparing
        2. Confirm administration AFTER giving to patient
    19. Discard all used supplies
    20. Remove gloves
    21. Perform hand hygiene
    22. For PRN meds, return in 15-30 minutes to evaluate response

Patient Education

  1. Indication and possible side effect(s) of medication(s)
  2. Signs to report to nurse or provider
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Transcript

In this video, we’re going to show you the proper technique for subcutaneous injections. Remember you should always rotate sites, so make sure you know the last place they got their shot. And, of course, always follow your 5 rights.

First, of course, calculate your required dose and draw up the medication in an appropriate syringe and needle size. In this case, we’ve got 15 units of NPH insulin to administer, so we’re using an insulin syringe.
Now, you will choose an appropriate site – in this case, we’re going to give it in the upper outer arm on the patient’s right side.
Open your alcohol pad and cleanse the site in circles from the center outward and let it dry.
Pinch the skin away from the muscle so you have a layer of subcutaneous fat between your fingers.
Insert the needle at a 45-90 degree angle and inject the medication slowly. Then remove the needle.
You can apply gentle pressure with gauze, but do NOT massage the area.
Activate the safety on the needle and/or throw the needle away in the sharps container.

Remember any time you give insulin you should be checking blood sugars before and checking on the patient afterward.

Document your administration and monitor your patient for the effects of the meds! Now, go out and be your best selves today. And, as always, happy nursing!

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Nursing Clinical 360

With the rapid expansion of the COVID-19 pandemic many schools, instructors and students are left wondering what just happened?Students can’t access the tools and onsite clinical help they desperately need and instructors are trying to piece together online learning that prepares their students for success.It is because of this uncertainty and abrupt change that we have developed the Nursing Clinical 360 Course.Featuring:38 Highly Detailed Nursing Skills Video Lessons18 Health Assessment Lessons26 IV Skills Videos42 Case Studies30+ Care PlansWe want to give students the practical knowledge they need to feel confident going into a clinical or practical situation, as well as give instructors a concise library of online resources to handle the sudden demand for distance learning.

Course Lessons

1 - Head to Toe and Health Assessment
Intro to Health Assessment
Barriers to Health Assessment
The 5-Minute Assessment (Physical assessment)
Adult Vital Signs (VS)
Pediatric Vital Signs (VS)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
2 - IV Insertion
Supplies Needed
Using Aseptic Technique
Selecting THE vein
Tips & Tricks
IV Catheter Selection (gauge, color)
IV Insertion Angle
How to Secure an IV (chevron, transparent dressing)
Drawing Blood from the IV
Maintenance of the IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Needle Safety
IV Drip Therapy – Medications Used for Drips
IV Drip Administration & Safety Checks
Understanding All The IV Set Ports
Giving Medication Through An IV Set Port
How to Remove (discontinue) an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Combative: IV Insertion
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
3- Nursing Skills
Nursing Skills (Clinical) Safety Video
Bed Bath
Linen Change
PPE Donning & Doffing
Sterile Gloves
Mobility & Assistive Devices
Spinal Precautions & Log Rolling
Restraints
Starting an IV
Drawing Blood
Blood Cultures
Central Line Dressing Change
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Trach Suctioning
Trach Care
Inserting an NG (Nasogastric) Tube
NG (Nasogastric)Tube Management
NG Tube Med Administration (Nasogastric)
Stoma Care (Colostomy bag)
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Pill Crushing & Cutting
EENT Medications
Topical Medications
Drawing Up Meds
Medications in Ampules
Insulin Mixing
SubQ Injections
IM Injections
IV Push Medications
Spiking & Priming IV Bags
Hanging an IV Piggyback
Chest Tube Management
Pressure Line Management
4- Nursing Care Plans
Purpose of Nursing Care Plans
How to Write a Nursing Care Plan
Using Nursing Care Plans in Clinicals
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Renal Calculi
5- Nursing Concept Maps
Concept Map Course Introduction
Coronary Artery Disease Concept Map
COPD Concept Map
Asthma Concept Map
Pneumonia Concept Map
Bowel Obstruction Concept Map
Gastrointestinal (GI) Bleed Concept Map
Congestive Heart Failure Concept Map
Hypertension (HTN) Concept Map
Breast Cancer Concept Map
Amputation Concept Map
Sepsis Concept Map
Stroke Concept Map
Depression Concept Map