A nurse is collecting data from an older adult client who is receiving ondansetron IV, has a history of diabetes mellitus and cardiac myopathy, and is receiving chemotherapy to treat cancer. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply)

B. Subcutaneous injections are generally administered at a 45° or 90° angle, depending on the amount of subcutaneous tissue present. In obese clients, there is typically more subcutaneous tissue, so inserting the needle at a 90° angle may be necessary to ensure proper medication absorption.

A. A smaller gauge needle (such as 25 or 26 gauge) is usually more appropriate for subcutaneous injections to minimize discomfort and tissue trauma, especially in obese clients where there is more subcutaneous tissue.

C. Massaging the injection site after administering heparin is not recommended. It can cause discomfort, bruising, and potentially alter the absorption rate of the medication. The injection site should be gently

pressed with a dry gauze pad after withdrawal of the needle to help disperse the medication and prevent leakage, but massaging should be avoided.

D. Aspiration is not necessary for subcutaneous injections. It is generally used for intramuscular injections to ensure the needle is not in a blood vessel, which is less of a concern for subcutaneous injections. The injection technique involves pinching the skin and injecting the medication into the subcutaneous tissue without aspirating.

A. Using a filter needle is indeed a recommended practice when withdrawing medication from an ampule. This is because filter needles are designed to prevent glass particles from being drawn into the syringe after breaking the ampule.

B. Ampules should not be bent to open them. The proper method involves using a gauze or an ampule opener to snap the neck of the ampule away from the body. Bending the ampule can lead to shards of glass, risking injury to the nurse or contamination of the medication.

C. The ampule should be tapped gently to ensure all medication is in the lower portion before opening.

D. Withdrawing medication from the center of the ampule is the correct action because it ensures that the needle does not touch the broken glass edges, which could contaminate the medication or dull the needle.