SubQ Injections
Included In This Lesson
Study Tools For SubQ Injections
Outline
Overview
- Purpose
- Some medications are given under the skin in the subcutaneous layer
- Improper administration can make the medication be too shallow (intradermal) or too deep (intramuscular)
Nursing Points
General
- Supplies needed
- Required medication vial
- Appropriate size syringe
- Insulin syringe
- 1 mL
- 3 mL
- Appropriate size needle
- Alcohol pad
- Gauze
- Injection sites
- Anterolateral thigh
- Upper outer tricep
- Upper buttocks
- Abdomen
- Needle size
- Length – ½ – ⅝”
- Gauge – 26 – 30 g
- NOTES
- Rotate sites with frequent injections
- Especially insulin – risk for maldistribution of fat
- Must choose site with good subcutaneous fat layer
- With heparin
- Do not inject over a bruise
- Do NOT press or massage
- Rotate sites with frequent injections
Nursing Concepts
- Steps and Nursing Considerations
- Verify provider order
- ALWAYS follow 5 rights BEFORE preparing medication
- Right Patient
- Right Drug
- Right Dose
- Right Route
- Right Time
- ALWAYS prepare medications at the patient’s bedside
- Gather supplies
- Perform hand hygiene
- Don clean gloves
- Let the patient know what meds they will be receiving
- Draw up medication in appropriate syringe
- Select appropriate site
- Rotate from previous site
- Select appropriate needle size and attach needle
- Clean the site with alcohol in circles starting at the center and working outward – LET DRY
- Pinch the skin up off the muscle so there’s a layer of subcutaneous fat between your fingers
- Insert the needle at a 45-90 degree angle
- Inject medication slowly
- Remove needle
- Apply gentle pressure with gauze
- Do NOT massage
- Activate safety and/or dispose of needle in sharps container
- AFTER administration
- Document administration and patient’s response
- If using barcode medication administration
- Scan all meds before preparing
- Confirm administration AFTER giving to patient
- Discard all used supplies
- Remove gloves
- Perform hand hygiene
- For PRN meds, return in 15-30 minutes to evaluate response
Patient Education
- Indication and possible side effect(s) of medication(s)
- Signs to report to nurse or provider
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!
NCLEX
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