Chapter 7: Parenteral Medication Administration
7.4 Subcutaneous Injections
Critical Thinking Exercises: Questions, Answers, and Sources / References
- Name four nursing considerations specific to SC insulin administration.
Answer:
| Guidelines for Administering SC Insulin |
| Insulin nursing considerations | Additional Information |
| Insulin is considered a high-risk medication. | Special care must be taken to ensure the correct amount of medication and type of insulin is administered, at the correct time. It is highly recommended to always have an independent double check prior to insulin administration. Always follow the standard for medication preparation at your agency. |
| There are specific syringes for insulin | Insulin syringes have a needle attached. Insulin is always ordered and administered in units, based on a blood sugar reading and a diabetic insulin protocol (or sliding scale). Some hospitals have preprinted physician orders, and some hospitals have handwritten orders. Insulin syringes can come in 30-, 50-, or 100-unit measurements. Always read the increments (calibration) carefully. |
| Insulin can also be administered via other devices | Insulin pens are one method for insulin administration. The pen consists of a syringe (pen), needle, and prefilled cartridge of insulin. It is essential that patients be taught how to use injection pens so they understand the technology. One pen per person to avoid risk of BBF exposure. The needle has to be primed prior to administration. In hospital settings, needles with safety systems must be used. Due to the expense, persons using insulin pens at home can opt for a less expensive needle that doesn’t have the safety system in place.
A mini-infusion pump is a battery-operated machine that delivers medications in very small amounts to patients with controlled infusion times. The most common types of mini-infusion sets are insulin pumps or subcutaneous infusion devices. For more information on mini-infusion sets and volume-controlled sets, see Suggested Online Resources in section 7.8. |
| There are different types of insulin. | There are rapid-, short-, intermediate-, mixed-, and long-acting insulins. For each type of insulin, it is important to know how the insulin works and the onset, peak, and duration of the insulin. Recognizing and responding to hypoglycemia is essential. |
| Administering two different types of Insulin. | If a patient is ordered two types of insulin, some insulins may be mixed together in one syringe. Many insulins MAY NOT be mixed together. Do not mix Lantus (Glargine) or Levemir (Determir). If administering cloudy insulin preparations (Humulin – N), gently roll the vial between the palms of your hands to re-suspend the medication. To get into good habit, always draw up the short acting (clear) insulin before the cloudy insulin. You cannot contaminate either vial. If too much insulin is drawn up from the second vial, discard syringe and start again. Insulin orders may c