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Preparing and Administering Subcutaneous Medications

Overview

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

Subcutaneous medication administration is a parenteral approach to administer small amounts of medication (less than 2 mL) into the layer of tissue just below the skin. Common medications administered via the subcutaneous route include anticoagulant medications, such as heparin or enoxaparin; epinephrine administered for allergic reactions; insulin; and some immunizations.

Subcutaneous injection preparations are commonly provided in vials or ampules for withdrawal into a subcutaneous syringe. Subcutaneous needles have a shorter length and smaller diameter than syringes used for intramuscular injections, are typically less than 5/8th of an inch, and are 26 gauge or smaller. Medication absorption and onset is slower than for intravenous routes, with some absorption rates lasting 24 h or longer. This approach is selected for many medications that may be denatured or deactivated if given via the oral route, given the acidity of the gastrointestinal tract.

Subcutaneous injection preparations are commonly provided in vials or ampules for withdrawal into a subcutaneous syringe. The nurse should determine the appropriate medication dose according to the concentration provided on the container. This demonstration will present how to prepare and administer subcutaneous medications after the medication has been obtained from the medication dispensing device. The discussion also includes the five "rights" and the medication documentation in the electronic Medication Administration Record (MAR).

Procedure

1. General medication administration considerations (review in the room, with the patient)

  1. Upon first entering the patient's room, wash hands with soap and warm water. Apply vigorous friction for at least 20 s. Hand sanitizers applied with vigorous friction may be used if the hands are not visibly soiled.
  2. At the bedside computer, log into the patient's electronic health record and review the patient's medical history and previous administration times. Verify with the patient any medicati

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Application and Summary

This video demonstrates the administration of subcutaneous medications and discusses considerations in administration approach due to variations in patient adipose tissue. It is important to ensure that subcutaneous injection sites are rotated to decrease tissue damage and to prevent complications to adipose tissue, such as localized lipodystrophy. Common errors in subcutaneous medication administration include: contaminating the injection site by blowing or wiping the area after cleaning with an alcohol wipe; using a ne

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References
  1. Institute of Medicine. To Err is Human: Building a Safer Healthcare System. Academic Press. Washington, DC. (2000).
  2. Centers for Disease Control and Prevention. http://www.cdc.gov/. (2017).
  3. Potter, P. A., Perry, A. G., Stockert, P. A., Hall A. Essentials for Nursing Practice, Eighth Edition. Elsevier. St. Louis, MO. (2015).
Tags
Subcutaneous Medication AdministrationSmall VolumesTissue LayerAnticoagulant MedicationsEpinephrineInsulinImmunizationsAbsorption And Onset Of ActionIntravenous AdministrationSubcutaneous InjectionInsulin Preparation And AdministrationHand HygieneElectronic Health RecordMedical History ReviewMedication AllergiesMedication Administration RecordInjection Site PreferenceInjection TechniqueImmediate acting InsulinShort acting InsulinMeal TimingHypoglycemia Risk

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0:00

Overview

0:47

Preparation

5:10

Administration

8:29

Summary

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