Unit 10 SC Insulin Administration 2025 PDF

Unit 10 Insulin Administration Learning Outcomes Identify the role of the practical nurse as it pertains to subcutaneous butterfly insertion of medication and fluid administration. Describe the purpose, function, benefits and potential complications associated with use of a subcutaneou...

Unit 10 Insulin Administration Learning Outcomes Identify the role of the practical nurse as it pertains to subcutaneous butterfly insertion of medication and fluid administration. Describe the purpose, function, benefits and potential complications associated with use of a subcutaneous butterfly infusion device. Describe the purpose of hypodermoclysis and potential complications. Discuss the use of subcutaneous butterfly in pain and symptom management in EOL care. Demonstrate nursing management in the preparation and safe administration of parenteral medications and infusions utilizing a subcutaneous butterfly. Demonstrate principles of medical asepsis, musculoskeletal injury prevention and accuracy of skills when inserting a subcutaneous butterfly and administering medications via this route. Perform focused assessments related to medication administration via subcutaneous butterfly and fluid administration through hypodermoclysis. Demonstrate assessment, insertion, monitoring and removal of a subcutaneous butterfly. Demonstrate safe disposal of sharps. Demonstrate documentation related to subcutaneous infusion and hypodermoclysis, including related assessments, using the appropriate communication tools and medical terminology.  Parenteral routes of administration Parenteral – administered directly into, or in close proximity to the circulatory system What are some reasons that we would give medications via this route?3 Nursing Considerations: Insulin 1. Assess the client For S&S of hypoglycemia, appetite & most recent glucometer value Do a glucose test as ordered 2. Identify all insulins due (on MAR) 3. Check most recent doctor’s orders for all insulins due, & compare to MAR 4. 10 rights and 3 checks! 4 Nursing Considerations for Insulin… Start with newest order & work back until all current orders are found All or part of an insulin order can be changed quite frequently Is regular insulin ordered according to an insulin correction dose? You will need to do a glucometer test in order to determine the correct dose Choose appropriate size of insulin syringe Insulin suspensions (cloudy/mixed pens) need to be suspended by gently rolling pen or vial until particles are evenly mixed. Do not shake (causes bubbles and breaks down the protein) 7 Vials: Drawing up Insulin Draw up air = to amount of insulin/med to be drawn up. Hold vial firmly on flat surface and insert needle into vial and inject air into space above the solution. Invert vial and syringe unit - make sure needle is below (within) level of fluid. At eye level - pull down on plunger to required amount. With needle in vial - tap on barrel to help air bubbles move to top and inject air back into vial. Adjust dose on syringe to required dose being careful to not bend the fine needle. Remove from vial. Recap with one hand using the scoop method 8 Question Why do we need to be cautious about drawing up air into the syringe? Procedure for mixing insulins makes a ‘regular’ sandwich 1. Air → intermediate insulin 2. Air → regular insulin 3. Draw up regular insulin 4. Draw up intermediate insulin 10 Why might someone be taking 2 types of insulin at the same time?  Mixing Insulins REG NP H Into your syringe, “clear before NP REG cloudy” H 13 Sites Determine which site you will use (see site rotation schedule on MAR) Commonly used sites for insulin - upper arm, anterior & lateral portions of the thigh, buttocks & abdomen. Rotation of sites is necessary to prevent tissue fibrosis Dry swab the site for 15 sec prior to injection – why not use alcohol? 14  For an average sized client, spread skin tightly across the injection site or pinch the skin with your non-dominant hand Inject quickly and firmly For an obese client, pinch the skin at the injection site Subcutaneous and insert the needle at a 90-degree angle Injection If you can grasp 5 cm of tissue, insert at a 90-degree angle (the majority of subcut injections will be 90 degrees) If you can only grasp 2.5 cm of tissue, insert at a 45- degree angle 15 Low Molecular Weight Heparin (LMWH) Injection site is the abdomen. Injection site is to the right or left of the abdomen at least 5 cm from the umbilicus. Gently grasp the cleansed skin and hold throughout the injection Don’t pinch the injection site. Administer LMWH in its prefilled syringe with the attached needle; don’t expel the air bubble before giving the injection. (The air bubble helps to ensure you get all of the medicine out of the syringe when it is injected.) Don’t massage 16 17 Questions What will you assess about your client prior to giving insulin? Why? Why do you think the abdomen is the site of choice for subcutaneous heparin? Your client is obese, what angle will you choose for subcutaneous needle insertion? 18