Subcutaneous Butterfly (M5C)

Question 1

subQ infusion route indications

Answer 1

• used for selected meds
• infusion of fluids for hydration or nutrition
• effective w/ meds to stop preterm labour & treat pulm HTN
• often used for oncological and post-op pain control in infants, children and adults

Question 2

rate of absorption with continuous subQ injection

Answer 2

• infusion rate of CSQI = rate of med absorption
• most pts absorb 1-2mL/hr of med
• rate of absorption more dependent on osmotic pressure than rate of admin

Question 3

benefits of CSQI

Answer 3

• benefits pts with poor venous access
• provides pain relief to pts unable to tolerate oral pain meds
• allows pts greater mobility
• onset of action about 20mins
• better pain control than IM
• lower rates of infection
• avoid multiple injections
• avoids turning and re-positioning of pt
• allows better rest during night
• absorbs effectively
• simple and ineffective

Question 4

ideal sites of CSQI

Answer 4

• same as subQ injections
• upper chest
• site selection based on pt’s activity lvl and type of med delivered
• avoid sites where tubing of pump could be disturbed

Question 5

assessments with CSQI

Answer 5

• assess site at least every 4 hours for redness, pain, drainage, swelling

Question 6

pt teaching with CSQI

Answer 6

• never immerse pumps in water or expose them to x-ray films or magnetic resonance imaging
• instruct pt to carry backup batteries and extra med if going away from home

Question 7

pediatric considerations with CSQI

Answer 7

• improves glycemic control in children & adolescents
• dec rate of hypoglycemia, catheter-site infection, weight gain
• clean and change CSQI sites in children every 48-72hrs or at 1st signs of inflm

Question 8

gerontological considerations with CSQI

Answer 8

• delivers isotonic IV solns to dehydrated OA
• infuse slowly during 1st hr of therapy
• if pt comfy, inc rate of infusion
• usually infusion rates do not exceed 60mL/hr

Question 9

purpose of subQ butterly

Answer 9

• provides ATC dosing
• for pts who are unable to take meds through other routes of admin
• parenteral route of choice for chronic pain

Question 10

possible cmplx of subQ butterfly

Answer 10

• skin irritation
• infection
• pain at site
• bleeding, bruising, or swelling

Question 11

prevention of cmplx with subQ butterly

Answer 11

• change location site at least weekly and at 1st sign of inflm, erythema, leakage, bruising, or swelling
• poor absorption may result in breakthrough pain –> change site to relieve pain