- Assess the patient in 24 to 72 hours. If the patient is allergic to the med-
ication, then the diameter of the wheal should increase. If the patient is
tested for TB, assess the hardness of the wheal and not the redness of
the area.
SUBCUTANEOUS
The subcutaneous injection is suited for medications that need to be absorbed
slowly to produce a sustained effect, such as insulin and heparin. Subcutaneous
medications are absorbed through capillaries and the onset of the medication is
slower than intramuscular and intravenous routes.
Choose an injection site that has an adequate fatpad. To prevent lypodystro-
phy, sites must be rotated if injections are given frequently. Lypodystrophy is a
loss of the fat area under the skin causing ineffective absorption of insulin.
These sites are: abdomen, upper hips, upper back, lateral upper arms, and
lateral thighs.
Subcutaneous injections are given using a 25–27-gauge needle that is^1 / 2 or(^5) / 8 inches in length and with a 1 to 3 mL syringe calibrated 0.5 to 1.5 mL. How-
ever, syringes used for insulin are measured in units and not mL.
Here’s how to administer medication subcutaneously:
- Check the prescriber’s medication order.
- Wash hands and then put on clean gloves.
- Properly identify the patient.
- Cleanse the area of the site in a circular motion using alcohol, betadine, or
soap and water as per agency policy. - Pinch the skin.
- Insert the needle at 45–90-degree angle. 45 degree is preferred when the
patient has a small amount of subcutaneous tissue. - Release the skin.
- Inject the medication slowly.
- Quickly remove the needle.
- Gently massage the area unless heparin is injected.
- Apply a band aid as necessary.
INTRAMUSCULAR
Intramuscular injections are used so that the medication is rapidly absorbed into
the patient’s body. The absorption rate depends on the patient’s circulatory state.(^106) CHAPTER 6 Route of Administration