Subcutaneous Injections Flashcards
What are the common injection sites
Abdomen (two inches away from the belly button)
Back or side of upper arm
Front of thigh
Why is skin pinched
To remove the subcutaneous (fat) layer from the muscle so injection only enters the subcut tissue
What syringes are used to administer insulin
Insulin syringes can only be used to administer insulin (cannot be used for any other drug)
Other subcut medications usually use a 26G needle
Why should you always check puncture site before giving injection
For inflammation (redness, bruises, pain etc.) Using same site over and over again can cause tissue damage (i.e. hardening fatty tissue) which can interfere with medication uptake
What are the different size insulin syringes
25units, 30units, 50 units, 100units
0.25mL= 25 units, 1mL = 100 units
Use smallest syringe size you can for the dose you need (lines on smaller ones are easier to see as they are further apart)
Signs of hypoglycemia
Blurry vision Rapid heartbeat Headache Fatigue Mood changes or nervousness Shaking Dizziness Sweating Loss consciousness Seizure or coma Hunger
Signs of severe hyperglycemia
Thirst Headache Blurred vision Frequent urination Trouble concentrating
When are ketones checked for
When patient has hyperglycemia (BGL above 16mmol/l)
When glucose (lack insulin) cannot be used be cells for energy fatty acid is broken down in liver to produce energy. End product is ketones in the blood which can lead to ketoacidosis which can cause cell death
<0.6mmol/L is acceptable
Signs of ketoacidosis
Along with severe hyperglycemia signs also,
Sweet acetone smell on breath
Fast breathing
What are the two types of insulin
Actrapid is a short acting drug with effect of 5-8hrs usually given at mealtimes
Lantus is long acting insulin with duration of 20+ hours usually given at bedtime
What are the 3 types of insulin orders
Explain with chart
Routine - mealtimes pre-printed as insulin always given before a patient eats or within 20-30 minutes of eating
Supplemental - if BGL falls within coloured section, extra amount needed on top of routine
Stat/Phone - when order isn’t written, doctor must be phoned, prescription signed within 24 hrs of administering, note ‘phone’ order
Which insulin orders need a new prescription each day
Routine prescriptions written every day
Supplemental don’t have to be written every day - can be changed by doctor depending on patient status
What is the normal BGL range
4-10mmol/L but generally 4-12mmol/L okay
Always looked at doctors ‘special instructions’ - some patients need tighter control than others e.g. pregnant women
What does frequency of supplemental insulin tell you
When to give supplemental doses
Most is before meals there if BGL was out of range before bed (21:00) it wouldn’t be given
What is standard BGL measuring in hospitals
Pre-meals and at 21:00
Could be given at other times e.g. 0200 is patient unstable or fasting, or 2 hrs post meal if pregnant
