A client is ordered a heparin injection following open-heart surgery. What method would the nurse use to administer this medication?
Intravenous
Subcutaneous
Intradermal
Intramuscular
The Correct Answer is B
A. Intravenous: While Heparin can be administered intravenously (IV) for immediate therapeutic effect (e.g., treating an active clot), the term "injection" in a post-operative context typically refers to prophylactic low-dose administration. Furthermore, compared to the other options, the specific distinction nursing students must know is that Heparin is never given IM.
B. Subcutaneous: Heparin is administered into the subcutaneous tissue (fat), usually of the abdomen. This allows for slow, sustained absorption to prevent Deep Vein Thrombosis (DVT). The abdomen is the preferred site to minimize muscle involvement and bruising.
C. Intradermal: Intradermal injections deposit medication just under the epidermis (e.g., TB skin tests). This route has poor absorption and holds very little volume, making it unsuitable for anticoagulants.
D. Intramuscular: Intramuscular (IM) administration of Heparin is contraindicated. Because Heparin prevents clotting, injecting it deep into vascular muscle tissue can cause a hematoma (a large, painful collection of blood) and potential muscle necrosis.
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Related Questions
Correct Answer is C
Explanation
A. Insulin 100 unit:A 100-unit insulin syringe holds up to 100 units (1 mL). While it can technically hold 15 units, it is calibrated in 2-unit increments and is not the most precise option for small doses like 15 units.
B. 1-ML:A 1-mL syringe (often a Tuberculin or TB syringe) is calibrated in milliliters (mL) and hundredths of a milliliter (0.01 mL). Since the order is in units, a TB syringe is only appropriate if a conversion table is used, which is highly discouraged and error-prone for insulin administration.
C. Insulin 50 unit:A 50-unit insulin syringe holds up to 50 units (0.5 mL) and is calibrated in 1-unit increments. It provides the highest level of accuracy for measuring small insulin doses, such as the ordered 15 units, making it the preferred choice over a 100-unit syringe.
D. 3mL:A 3-mL syringe is far too large and is calibrated in milliliters (0.1 mL increments). It cannot accurately measure a dose as small as 15 units of insulin.
Correct Answer is C
Explanation
A. 1-mL tuberculin syringe with 1-inch bevel:Tuberculin syringes are used for small-volume Intradermal or Subcutaneous injections. They are not suitable for the viscosity or depth required for an IM corticosteroid injection.
B. 1-to 2-mL syringe with 1/2-to 1-inch needle:While a 1-inch needle canbe used for the deltoid in some adults, a 1/2-inch needle is too short to reach deep muscle tissue in an average adult, risking subcutaneous deposition (which can cause tissue damage with corticosteroids).
C. 2-to 3-ml syringe with 1-to 1 1/2-inch needle:This is the standard equipment for an adult IM injection. A 3-mL syringe accommodates the medication volume, and a 1 to 1.5-inch needle ensures the medication passes through subcutaneous fat and reaches the deep muscle tissue (Ventrogluteal or Vastus Lateralis).
D. 2-to 3-ml syringe with 1- to 2-inch needle:While the syringe size is correct, a 2-inch needle is typically reserved for patients with obesity who have a larger layer of adipose tissue to penetrate. For an average adult, this may be too long and could strike bone.
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