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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  • Studying
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  • Basics of NCLEX
  • Terminology
  • Substance Abuse Disorders
  • Communication
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  • Legal and Ethical Issues
  • Community Health Overview
  • Respiratory Disorders
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  • Cardiac Disorders
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  • Learning Pharmacology
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Study Plan Lessons

Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Anatomy of an NCLEX Question
Diagnostics Terminology
Head to Toe Nursing Assessment (Physical Exam)
How to Take Nursing Report
How to Write A Nursing Progress Note
Intro to Community Health
Lung Sounds
MedTerm Suffixes
Nursing Process
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Evaluate
Nursing Process – Implement
Nursing Process – Plan
Nutrition (Diet) in Disease
Overview of the Nursing Process
Head to Toe Nursing Assessment (Physical Exam)
10.02 Breath Sounds for CCRN Review
Heart (Cardiac) Sound Locations and Auscultation
Heart (Cardiac) and Great Vessels Assessment
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Lung Sounds
Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease) for Certified Perioperative Nurse (CNOR)
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Sterile Field
Sterile Gloves
Sterile Field Maintenance (Aseptic Technique) for Certified Perioperative Nurse (CNOR)
Sterilization and Cleaning (Instruments, Reusable Goods) for Certified Perioperative Nurse (CNOR)
Sterilization and Storage Environment Conditions for Certified Perioperative Nurse (CNOR)
Transportation and Storage (Single Use Items) for Certified Perioperative Nurse (CNOR)
Using Aseptic Technique
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Wound Drains
Complex Calculations (Dosage Calculations/Med Math)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
ABGs Nursing Normal Lab Values
Albumin Lab Values
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Blood Plasma
Bowel Obstruction Concept Map
C. Difficile for Certified Emergency Nursing (CEN)
Dehydration
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid & Electrolytes Course Introduction
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluid Volume Overload
Formation & Excretion of Urine
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Therapeutic Management
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
6 Rights of Medication Administration
Drawing Up Meds
EENT Medications
Ethical Dilemmas for Certified Emergency Nursing (CEN)
Hanging an IV Piggyback
Insulin Mixing
IM Injections
IV Drip Administration & Safety Checks
IV Push Medications
Medication Errors
Medications in Ampules
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nursing Case Study for Mania (Manic Syndrome)
Pill Crushing & Cutting
Safety Checks
Spiking & Priming IV Bags
SubQ Injections
Topical Medications
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
ACLS (Advanced cardiac life support) Drugs
C – Content
Epinephrine (EpiPen) Nursing Considerations
Nursing Care Plan (NCP) for Angina
Renin Angiotensin Aldosterone System
Renin Angiotensin Aldosterone System (RAAS)
Artificial Airways
Hierarchy of O2 Delivery
Oxygen Delivery Module Intro
54 Common Medication Prefixes and Suffixes