medication administration

1. Administering a
Subcutaneous Injection
Presented By
Mrs.Usha Rani Kandula, MSc(N),
Assistant professor in Adult health nursing, Department of Clinical
nursing, Arsi University, College of health sciences, Asella, Ethiopia,
Institutional email: usharani2020@arsiun.edu.et.

2. Subcutaneous Injection
-Subcutaneous (SC or SQ) injections are commonly used in the
administration of medications such as insulin and heparin because these
drugs are absorbed slowly, to produce a sustained effect.
-SC injections place the medication into the subcutaneous tissue,
between the dermis and the muscle.
-Clients who administer frequent subcutaneous injections should rotate
sites regularly.

3. Con--
-An administration chart can help them keep track of the sites used.
-The amount of medication given varies but should not exceed 1.0 ml;
-If repeated drug doses are given, rotate the sites.
-Subcutaneous tissues are sensitive to irritating medications.
-Hard painful lumps can develop beneath the skin if the sites are not
rotated.

4. Common sites for SC injections
-Common sites for SC injections are the abdomen, the lateral and
anterior aspects of the upper arm or thigh, the scapular area on the
back, and upper ventro-dorsal gluteal areas.
-The nurse should select a sterile 0.5- to 3-ml syringe with a 25- to 29-
gauge, 3/8- to 1/2-inch needle.
-The medication is administered by angling the needle 45° or 90° to
the skin.
-The client’s body weight will influence the angle used for injection.

6. Equipment
 Medication administration record (MAR)
 Sterile syringe and 5/8-inch needle
 Disposable gloves
 2 alcohol swabs
 Medication as prescribed

7. Sl.No Action Rationale
1 Check with client and the chart for any
known allergies.
Prevents the occurrence of
hypersensitivity reactions such as hives,
urticaria, or anaphylactic shock.
2 Wash your hands. Reduces transmission of microorganisms.
3 Follow the rights of drug
administration.
Promotes client safety.
4 Prepare the medication from an
ampoule or vial; refer to Procedure 29-
2 or 29-3 as appropriate.
-Take medication to the client’s room
and place on a clean surface.

8. Sl.No Action Rationale
5 Check the client’s identification
armband.
Accurately identifies the client.
6 Explain the procedure to the client. Reduces the client’s anxiety and
enhances
cooperation.
7 Place the client in a comfortable
position; provide for privacy.
Promotes relaxation of the muscles,
decreasing discomfort from the injection.
8 Don non sterile gloves. Decreases contact with blood and body
fluids.
9 Select and clean the site. Promotes absorption of drug when
injected into healthy tissue.

9. Sl.No Action Rationale
Assess the client’s skin for bruises,
redness,
hard tissue, or broken skin.
Cleanse the site with an alcohol swab;
cleanse from inside outward.
10 Prepare for the injection.
Remove the needle guard and express
any
air bubbles from the syringe;
-check the dosage in the syringe.
Prevents the injection of air into the
subcutaneous tissue.
-With dominant hand, hold the syringe
like a dart between your thumb and
fore fingers.
Decreases risk for accidental
contamination
of the needle.

10. Sl.No Action Rationale
-Pinch the subcutaneous tissue
between the thumb and forefinger with
the non dominant hand.
-If the client has substantial
subcutaneous
tissue, spread the tissue taut.
Ensures insertion of the needle into the
subcutaneous tissue.
11 Administer the injection.
-Insert the needle quickly at a 45° or
90°
angle.
Quick insertion decreases the client’s
anxiety
and the amount of discomfort.
-Release the subcutaneous tissue and
grasp
the barrel of the syringe with non
dominant hand.
-With dominant hand, aspirate by Indicates needle has entered a blood

11. Sl.No Action Rationale
If blood appears, remove needle and
discard
in a sharps container.
Prevents the injection of medication into
the blood, which causes a faster
absorption
rate that may be dangerous to the client.
Inject medication slowly if there is no
blood present.
Remove the needle quickly and lightly
massage area with alcohol swab; do
not massage the injection site after the
administration of an anticoagulant.
Promotes dispersement of medication in
the
tissues and facilitates absorption.
Do not recap the needle; discard the
needle in a sharps container.
Prevents needlesticks.
Position client for comfort.

12. Sl.No Action Rationale
13 Remove gloves and wash hands. Reduces the spread of microorganisms.
14 Record on the MAR the route, site, and
time of injection.
Provides documentation that the
medication
was administered.
15 Observe the client for any side or
adverse
effects and assess the effectiveness of
the medication at the appropriate time.
Alerts the nurse to hypersensitivity
reactions;
the peak plasma level is dependent on the
drug’s half-life.
Thanking you