Practice and Learn - Administering a Subcutaneous Injection
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CUNY Kingsborough Community College *
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Medicine
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Jan 9, 2024
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Practice and Learn: Administering a Subcutaneous Injection Case Study: Michael Gallagher Screen 1 of 12 Part 1: Hospital Admission Michael Gallagher is 77 years old and has a history of hypertension, peripheral neuropathy, and diabetes, for which he requires daily insulin injections. 4 [ Patient Interview } - Vital Signs B .. "N When Mr. Gallagher was admitted to the hospital, he complained of angina and i shortness of breath. After numerous tests and laboratory work, the doctor ruled | & out myocardial infarction. Mr. Gallagher was then transferred to your medical unit. ) His physicians are adjusting his medication to better control his angina and hypertension. He should be discharged in a few days. PREV NEXT Case Study: Michael Gallagher Screen 1 of 12 Part 1: Hospital Admission Michael Gallagher is 77 years old and has a history of hypertension, peripheral neuropathy, and diabetes, for which he requires daily insulin injections. % Patient Interview Vital Signs 8¢ - i\ : Mr. Gallagher's medical orders include the administration of insulin at 7:30 a.m., e before his breakfast at 8:00 a.m. Mr. Gallagher's finger-stick blood glucose at 7:30 \& ' a.m. was 167. The procedure to administer a subcutaneous injection should take Z‘r you about two minutes. © O PREV NEXT
Case Study: Michael Gallagher Screen 2 of 12 Part 1: Assessment 7:30 AM. You've been assigned to care for Mr. Gallagher. When he sees you, he says: "Where's breakfast? I'm really hungry." It looks like Mr. Gallagher is eager for breakfast. What are the main communication points that you should review before administering Mr. Gallagher's insulin? Choose all that apply. & [/It's time for his insulin injection to help control his blood sugar. & [#|The insulin injection must be administered half an hour before breakfast. v [The injection process, including prep, will take about 2 minutes. Breakfast will be served in about an hour. Case Study: Michael Gallagher Screen 3 of 12 Part 1: Assessment 7:30 AM. You've informed Mr. Gallagher that you're here to administer his insulin injection. You compare and confirm his identification with the Medication Administration Record (MAR). You also assess his medical record for allergies. Now you must assess Mr. Gallagher. What will you assess Mr. Gallagher for? (Hint: Check the patient history and hospital guidelines.) Choose all that apply. Assess Mr. Gallagher's height and weight. +| Assess the area where the injection is to be given. « | Ask Mr. Gallagher about known allergies. «| Assess for the appropriate site to use. + | Assess Mr. Gallagher's knowledge of the medication « | Ask Mr. Gallagher about his preference for the injection site. Assess Mr. Gallagher's blood pressure. +| Assess Mr. Gallagher's body size and condition. @ @ !EVIEW FEEDBAC! PREV NEXT CXCCCLKCKLX
Case Study: Michael Gallagher Screen 4 of 12 Part 1: Assessment 7:31 AM. You've assessed Mr. Gallagher and found that he has no wounds or alterations in his skin integrity. He is of moderate build, with even distribution of subcutaneous tissue. Now you must take steps to prevent infection. Choose all that apply. Put on sterile gloves. #/|Put on clean gloves. «|Clean the injection site. Put on goggles and a mask. «|Maintain surgical asepsis. Put on a gown. «|Perform hand hygiene. @ @ IEVIEW FEEDBAEI e S CX <X <€ <X Case Study: Michael Gallagher Screen 5 of 12 Part 1: Assessment 7:31 AM. You've reviewed the medication order and prepared the injection. As per the order, you are to administer Humulin N insulin 26 units and Humulin R insulin 10 units subcutaneously to Mr. Gallagher 30 minutes before breakfast. When you ask him his preference regarding the injection site, this is what he says: "Use my arms, please. | can't do it there myself, so I like to give the other sites a break when I'm in the hospital. That's where I've been getting it since I've been here." Mr. Gallagher does have a preference regarding the injection site. What will you do? & @ Comply with his request. x Urge him to allow the use of a different site. x Proceed to administer the injection at a site of your choice. EVIEW FEEDBA @ @
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Case Study: Michael Gallagher Screen 6 of 12 Part 1: Assessment 7:31 AM. You've complied with Mr. Gallagher's request, assessed his left upper arm, and found it suitable for the injection. As you may know, the angle of insertion varies for each kind of injection. What is the normal angle of insertion for a subcutaneous injection? X ) 72 degrees. v @ 451090 degrees. x 15 degrees. VIEW FEEDBAC @ @ PREV NEXT Case Study: Michael Gallagher Screen 7 of 12 Part 1: Assessment 7:31 AM. You are aware of the angle for inserting the injection. Now you must have Mr. Gallagher assume the appropriate position to administer the injection in his arm. What is the appropriate position Mr. Gallagher should assume to receive the injection in his arm? x The arm must be folded at the side of the body with the fist. & @ The arm must be relaxed at the side of the body. x The arm must be stretched in front with the palm open. VIEW FEEDBACK @ @ PREV NEXT
Case Study: Michael Gallagher Screen 8 of 12 Part 1: Assessment 7:32 AM. You've verified Mr. Gallagher's identification and his arm is at the side of his body and relaxed. You've put on clean gloves. Now, you must administer the injection. The steps for administering the injection are given on the screen. Put the steps in the order by numbering each step in the correct sequence. 1. Clean the area around the site with an antimicrobial swab. Hold the syringe in the dominant hand and remove the needle cap. Spread the skin taut at the site and quickly insert the needle. Move the non-dominant hand to steady the lower end of the syringe. Slide your hand to the tip of the barrel and inject the medication slowly. Withdraw the needle quickly and engage the needle guard. Blot the area around the site with a cotton ball or dry swab. Discard gloves, needle, and syringe in the appropriate receptacle. N @ @ IEVIEW FEEDBACI PREV NEXT © N o v AW N Case Study: Michael Gallagher Screen 9 of 12 Part 1: Assessment 7:32 AM. You've successfully administered the subcutaneous injection to Mr. Gallagher, assisted him to a comfortable position, and performed hand hygiene. Now you must complete your documentation. What will you document? Choose all that apply. Humulin N Insulin 26 units and Humulin R Insulin 10 units administered subcutaneously in outer aspect left upper arm. & [¥/Blood sugar at 7:30 am: 167. X Pain level. x Blood pressure. Oxygen saturation. © O PREV NEXT
Case Study: Michael Gallagher Screen 10 of 12 Part 1: Assessment 7:33 AM. You've completed your documentation. You must assess Mr. Gallagher after administering him an injection. Which of the following should be included in your assessment of Mr. Gallagher? Choose all that apply. & [#]signs of hypoglycemia. & [¥/Numbness at the injection site. x Measurement of coagulation time. v «|Signs of an allergic reaction. REVIEW FEEDBACK @ @ PREV NEXT Case Study: Michael Gallagher Screen 11 of 12 Score 100% Review Quiz
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Case Study: Michael Gallagher Screen 12 of 12 Recap We've come to the end of this topic already! In this topic, we discussed how to administer a subcutaneous injection. You've reviewed: * The possible sites for administering a subcutaneous injection. * The additional parameters to remember when administering the injection. The steps to prepare the site. * The steps in administering the injection. * The required documentation. Hope to see you again. END CASE STUD! PREV