Administering A Subcutaneous Injection
Administering A Subcutaneous Injection
PREPARATION
Assess:
Allergies to medication.
Specific drug action, side effects, and adverse reactions.
Client’s knowledge and learning needs about the medication.
Status and appearance of subcutaneous site for lesions, erythema, swelling,
ecchymosis, inflammation, and tissue damage from previous injections.
Ability of the client to cooperate during the injection.
Previous injection sites used.
Assemble equipment:
MAR or computer printout
Vial or ampule of the correct sterile medication
Syringe and needle
Antiseptic swabs
Dry, sterile gauze for opening an ampule (optional)
Clean gloves
Check the MAR.
Check the label on the medication carefully against the MAR to make sure that
the correct medication is being prepared.
Follow the three checks for administering medications. Read the label on the
medication:
When it is taken from the medication cart
Before withdrawing the medication
After withdrawing the medication.
Organize the equipment.
PROCEDURE 1 2 3 4 5
1. Perform hand hygiene and observe other appropriate
infection control procedures.
2. Prepare the medication from the ampule or vial for
drug withdrawal.
3. Provide for client privacy.
Prepare the client.
4 Introduce yourself and verify the client’s identity.
5 Assist the client to a position in which the arm, leg, or
abdomen can be relaxed, depending on the site to be
used.
6 Obtain assistance in holding an uncooperative client.
7 Explain the purpose of the medication and how it will
help, using language that the client can understand.
Include relevant information about effects of the
medication.
8 Select and clean the site. The site should be free of
tenderness, hardness, swelling, scarring, itching,
burning, and localized inflammation. Select a site that
has not been used frequently.
9. Put on clean gloves.
10 As agency protocol indicates, clean the site with an
antiseptic swab. Start at the center of the site and
clean in a widening circle to approximately 5 cm (2
inches). Allow the area to dry thoroughly.
11 Place and hold the swab between the third and fourth
fingers of the non dominant hand, or position the swab
on the client’s skin above the intended site.
Prepare the syringe for injection.
12 Remove the needle cap while waiting for the antiseptic
to dry. Pull the cap straight off to avoid contaminating
the needle by the outside edge of the cap.
13 Dispose of the needle cap.
Inject the medication.
14 Grasp the syringe in your dominant hand by holding it
between your thumb and fingers. With palm facing to
the side or upward for a 45-degree angle insertion, or
with the palm downward for a 90-degree angle
insertion, prepare to inject.
15 Using the non dominant hand, pinch or spread the skin
at the site, and insert the needle, using the dominant
hand and a firm, steady push.
16 When the needle is inserted, move your non dominant
hand to the end of the plunger.
17 Inject the medication by holding the syringe steady and
depressing the plunger with slow, even pressure.
With many subcutaneous injections, the needle should
be imbedded within the skin for five seconds after
complete depression of plunger to ensure complete
delivery of the dose.
18 Remove the needle slowly and smoothly, pulling along
the line of insertion while depressing the skin with your
non dominant hand.
19 If bleeding occurs, apply pressure to the site with dry,
sterile gauze until it stops.
Dispose of supplies appropriately.
20 Activate the needle safety device or discard the
uncapped needle and attached syringe into designated
receptacles.
22 Remove gloves. Perform hand hygiene.
Document all relevant information.
23 Document the medication given, dosage, time, route,
and any assessments.
24 Many agencies prefer that medication administration
be recorded on the medication record.
25 Assess the effectiveness of the medication at the time
it is expected to act.
Variation: Administering a Heparin Injection
PROCEDURE
26 Select a site on the abdomen away from the umbilicus
and above the level of the iliac crests.
27 Use a ⅜-inch, 25- or 26-gauge needle, and insert it at
a 90-degree angle. If a client is very lean or wasted,
use a needle longer than ⅜-inch, and insert it at a 45-
degree angle. The arms or thighs may be used as
alternate sites.
28 Do not aspirate when giving heparin by subcutaneous
injection.
29 Do not massage the site after the injection.
30 Alternate the sites of subsequent injections.
TOTAL