A patient has an order for a subcutaneous injection of insulin. The nurse will prepare to give this injection into which of the following tissues?

Choice A reason: Narcotics are controlled substances requiring strict accountability; two nurses—one ending and one starting the shift—verify counts to ensure accuracy and prevent diversion per regulatory standards.

Choice B reason: The head nurse and pharmacist may oversee inventory, but shift change counts involve direct caregivers for real-time accuracy, not administrative staff, ensuring immediate responsibility and oversight.

Choice C reason: Involving all nurses from both shifts is impractical and unnecessary; it dilutes accountability and increases error risk, as only two are needed to confirm the count efficiently.

Choice D reason: Pharmacy technicians lack authority over unit narcotics, and the charge nurse alone doesn’t suffice; two nurses ensure a witnessed, reliable count per hospital policy and law.

Choice A reason: Bone marrow transplant patients are immunocompromised; animals pose infection risks (e.g., zoonotic bacteria), making therapy contraindicated in this sterile setting.

Choice B reason: C. difficile is contagious; animal-assisted therapy risks cross-contamination via fur or handlers, endangering the patient and facility, ruling out this option.

Choice C reason: Acute asthma with dyspnea may worsen with animal dander triggering allergies or bronchospasm; therapy could exacerbate respiratory distress, making it unsuitable.

Choice D reason: Alzheimer’s patients benefit from animal therapy; it reduces agitation and boosts mood via oxytocin release, with no acute infection or allergy barriers.