SubQ Injections

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Study Tools For SubQ Injections

140 Must Know Meds (Book)
Medication Administration Pro-Tips (Cheatsheet)
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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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Pharmacology

Concepts Covered:

  • Medication Administration
  • Adult
  • Emergency Care of the Cardiac Patient
  • Intraoperative Nursing
  • Microbiology
  • Cardiac Disorders
  • Anxiety Disorders
  • Depressive Disorders
  • Vascular Disorders
  • Nervous System
  • Upper GI Disorders
  • Central Nervous System Disorders – Brain
  • Gastrointestinal Disorders
  • Immunological Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Understanding Society
  • Circulatory System
  • Concepts of Pharmacology
  • Studying
  • Hematologic Disorders
  • Newborn Care
  • Adulthood Growth and Development
  • Disorders of Pancreas
  • Respiratory Disorders
  • Postoperative Nursing
  • Pregnancy Risks
  • Neurological
  • Postpartum Complications
  • Substance Abuse Disorders
  • Noninfectious Respiratory Disorder
  • Bipolar Disorders
  • Peripheral Nervous System Disorders
  • Learning Pharmacology
  • Psychotic Disorders
  • Prenatal Concepts
  • Tissues and Glands
  • Test Taking Strategies

Study Plan Lessons

6 Rights of Medication Administration
ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Anesthetic Agents
Anti-Infective – Antifungals
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Bariatric: IV Insertion
Basics of Calculations
Benztropine (Cogentin) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Epoetin Alfa
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
12 Points to Answering Pharmacology Questions