A nurse is preparing to administer heparin subcutaneously to an obese client who has a deep vein thrombosis. Which of the following actions should the nurse take?

Select a 22-gauge needle for heparin administration.

Insert the needle at a 90° angle.

Massage the injection site after administering the heparin.

Aspirate for a blood return prior to injecting the heparin.

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is C

Explanation

C. Dextrose 5% in water is a hypotonic solution that contains 5 grams of dextrose in each 100 mL of water. It provides free water without adding significant sodium, which helps to dilute the elevated sodium levels in hypernatremia. This solution is effective in correcting hypernatremia by promoting water movement from the intravascular space into the cells and extracellular space.

A. Albumin solutions are primarily used for volume expansion and to increase oncotic pressure in conditions like hypoalbuminemia or shock. They do not provide free water and are not typically used for treating hypernatremia.

B. Dextrose 10% in water is a hypertonic solution used primarily for providing calories and treating hypoglycemia. It does not correct hypernatremia because it does not significantly affect sodium levels or provide sufficient free water to dilute sodium.

D. Dextran 40 is a colloid solution that is used for volume expansion in hypovolemia or shock. It does not provide free water and is not indicated for correcting hypernatremia.

A. Cleanse the injection site with a circular motion. B. Don sterile gloves prior to the injection. C. Use the dominant hand to pinch the client's skin D. Inject the medication at a 15° angle to the client's skin

Correct Answer is A

Explanation

A. Cleansing the injection site is important to reduce the risk of infection.

B. Sterile gloves are not typically required for administering subcutaneous injections unless there is a specific indication, such as when dealing with a client who has a compromised immune system or if there is potential for exposure to bodily fluids.

C. Pinching the skin can help in creating a fold where the needle can be inserted. However, there is no standard recommendation on which hand should be used.

D. Subcutaneous injections are typically administered at a 45-degree or 90-degree angle to the client's skin, depending on the amount of subcutaneous tissue present.

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A nurse is preparing to administer heparin subcutaneously to an obese client who has a deep vein thrombosis. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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