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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ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Fluid & Electrolytes Course Introduction
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Nursing Skills (Clinical) Safety Video
Pressure Line Management
Chest Tube Management
Hanging an IV Piggyback
Spiking & Priming IV Bags
IV Push Medications
IM Injections
SubQ Injections
Insulin Mixing
Medications in Ampules
Drawing Up Meds
Topical Medications
EENT Medications
Pill Crushing & Cutting
Wound Care – Wound Drains
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Wound Care – Assessment
Stoma Care (Colostomy bag)
NG Tube Med Administration (Nasogastric)
NG (Nasogastric)Tube Management
Inserting an NG (Nasogastric) Tube
Trach Care
Trach Suctioning
Inserting a Foley (Urinary Catheter) – Male
Inserting a Foley (Urinary Catheter) – Female
Central Line Dressing Change
Blood Cultures
Drawing Blood
Starting an IV
Restraints
Spinal Precautions & Log Rolling
Mobility & Assistive Devices
Sterile Gloves
PPE Donning & Doffing
Linen Change
Bed Bath
Nursing Skills Course Introduction
The 5-Minute Assessment (Physical assessment)
Adult Vital Signs (VS)
Pediatric Vital Signs (VS)
General Assessment (Physical assessment)
Drawing Pictures
Outline Question Method (Note taking)
NCLEX® Question Traps
Denying Feelings
Repeating Words
Duplicate Facts
What do you want me to know?
Acute vs Chronic
Priority
Nursing Process
Same
Opposites
Absolute Words
SATA
Anatomy of an NCLEX Question
What is the NCLEX?
Bloom’s Taxonomy
Critical Thinking
Goal Setting
Study Setting
Time Management
Test Taking Course Introduction