Clinical Skills Assessment: Subcut and IM Injections Flashcards
What are the Eight Rights of Medication Administration?
Patient
Medication
Dose
Time
Route
Documentation
Reason
To refuse
How do you verify the patient?
- Verify the patient’s identity using two identifiers (e.g., name, DOB).
- Ensure correct patient to avoid medication errors.
How do you verify the medication?
- Confirm the medication is the correct one as per the prescription.
- Cross-check the medication label with the prescription.
How do you verify the dose?
- Verify the prescribed dose matches the medication label.
- Use proper calculation methods if necessary.
How do you verify the time?
- Administer medication at the correct time as per the prescription.
- Consider factors such as frequency, meal times, and interactions.
How do you verify the route?
- Ensure the medication is given via the correct route (e.g., oral, IV, IM).
- Double-check that the route is safe and appropriate for the medication and patient.
How do you verify the documentation?
- Accurately document the administration details immediately after giving the medication.
- Include time, dose, route, and any patient observations.
How do you verify the reason?
- Confirm the reason for giving the medication aligns with the patient’s condition.
- Understand the intended effects of the medication.
What is the right to refuse?
- Patients have the right to refuse medication.
- Ensure the patient is informed of the consequences of refusal.
- Document the refusal and notify the healthcare provider.
What type of insulin is actrapid?
Short-acting
What are the adverse effects of Actrapid insulin?
Adverse effects
hypoglycaemia (below), weight gain, allergic reactions, local reactions including erythema, itching, lipodystrophy, amyloidosis
Hypoglycaemia
The most frequent and serious adverse effect; may occur with excessive dosage, delayed or insufficient food, increased physical activity. Warning symptoms may include sweating, hunger, faintness, palpitations, tremor, lip tingling, headache, visual disturbance, confusion and altered mood.
Describe the activity of actrapid insulin?
onset: 30 minutes
peak: 2–3 hours
duration: 6–8 hours
When should actrapid be given in relation to meal times?
give within 30 minutes before meal
What are the indications for actrapid insulin?
Diabetes mellitus, including type 1, type 2 or gestational diabetes
What is a normal fasted blood glucose range?
3.0 and 6.1 mmol/L
What is a normal random blood glucose range?
3.0-7.7 mmol/L
What are the common sites for IM injections?
Deltoid
Vastus lateralis
Ventrogluteal muscle
When would you use the deltoid for an IM injection?
Small volumes and vaccines
When would you use the vastus lateralis for an IM injection?
Often used for infants and children, but also suitable for adults, particularly for larger volumes of medications.
When would you use the ventrogluteal muscle for an IM injection?
Preferred for larger volumes and viscous medications due to its large muscle mass and the absence of major nerves and blood vessels.
What are the most common sites for subcutaneous injections?
- The outer aspect of the upper arm
- The anterior aspect of the thigh
- The abdomen, at least five centimeters away from the belly button
- The upper outer quadrant of the buttock
What is the route of administration for Actrapid?
Subcutaneous injection
What is the site of administration for Actrapid? Why?
Lower abdomen
Provides a consistent and predictable absorption rate and is easily accessible
What is the indication for Actrapid?
Diagnosed Diabetes Mellitus (Type 1) with current high BGL 8.9mmol/L
If the stock solution of Enoxaparin is a 10mL vial with 100mg/mL, how many mL does the patient require?
0.6mL
What is the route of administration for Enoxaparin ?
Subcutaneous injection
What is the site of administration for Enoxaparin ? Why?
Lower abdomen
Provides a consistent and predictable absorption rate and is easily accessible
What is the indication for Enoxaparin?
VTE prophylaxis
(preventing blood clots)
Shreya is limited in her ability to mobilise which increases her risk for blood clots
What are the potential side effects of Enoxaparin?
Local reactions (bleeding, bruising and pain)
Hyperkalaemia
mild reversible thrombocytopenia
Allergic reactions
If the stock solution of Metoclopromide is a 10mL vial with 5mg/mL, how many mL does the patient require?
2mL
What is the route of administration for Metoclopromide?
Intramuscular injection
What is the site of administration for Metoclopromide? Why?
Deltoid/Vastus lateralis
Good muscle mass which allows for better absorption
What is the indication for Metoclopromide?
Nausea
Metoclopromide is an anti-emetic
What are the potential side effects of Metoclopromide?
Akathisia (restlessness), drowsiness, dizziness, headache
If the stock solution of Vitamin B12 is a 10mL vial with 1mg/mL, how many mL does the patient require?
1mL
What is the route of administration for Vitamin B12?
Intramuscular injection
What is the site of administration for Vitamin B12? Why?
Deltoid/Vastus lateralis
Good muscle mass which allows for better absorption
What is the indication for Vitamin B12?
Vitamin deficiency
What are the potential side effects of Metoclopromide?
What size needle would you use for Enoxaparin?
1-2.5 cm
27 gauge
What size needle would you use for Metoclopromide?
2.5-3cm
23 gauge
What size needle would you use for Vitamin B12?
2.5-3cm
21-23 gauge
