If a patient has a non-blanchable area of redness on the right malleolus, what stage of pressure injury should be recorded in the patient’s medical record?

Choice A rationale:

Intravenous (IV) administration delivers medication directly into the bloodstream. This route is not appropriate for insulin because it would result in a rapid and potentially dangerous drop in blood glucose levels. Insulin needs to be absorbed more slowly to mimic the natural release of insulin from the pancreas.

IV administration also requires sterile technique and specialized equipment, making it more complex and time-consuming than subcutaneous injection.

Additionally, there is a higher risk of infection and other complications with IV administration.

Choice B rationale:

The vastus lateralis is a muscle in the thigh that is commonly used for intramuscular (IM) injections. However, IM injections are not typically used for insulin administration because they can be more painful and have a slower absorption rate than subcutaneous injections.

IM injections also carry a higher risk of hitting a blood vessel, which could lead to erratic absorption of insulin.

Choice D rationale:

The deltoid is a muscle in the upper arm that can be used for subcutaneous injections. However, the abdomen is generally the preferred site for insulin injection because it has a greater amount of subcutaneous fat, which helps to slow the absorption of insulin and provide a more consistent effect.

The abdomen is also a more convenient site for self-injection, as it is easily accessible.

Choice C rationale:

The fatty tissue of the abdomen is the ideal site for subcutaneous insulin injection because it provides slow and consistent absorption of insulin.

The abdomen has a rich blood supply, which helps to distribute the insulin throughout the body.

The subcutaneous tissue in the abdomen is relatively thin, which makes it easy to inject insulin without causing pain or discomfort.

The abdomen is also a large area, which allows for multiple injection sites to be used and rotated to prevent lipohypertrophy (thickening of the subcutaneous tissue).

Choice A rationale:

Irrigating with sterile saline before swabbing can dilute the wound specimen and reduce the accuracy of the culture results. This is because the saline can wash away some of the bacteria that are present in the wound, making it more difficult to identify the specific bacteria that are causing the infection.

Additionally, swabbing the center of the wound may not collect a representative sample of the bacteria present, as bacteria can often be found in higher concentrations at the edges of the wound. This is because the edges of the wound are often where the tissue is most damaged and where the bacteria are able to enter the body more easily.

Choice B rationale:

Obtaining a sample of the drainage from the dressing on the wound may not be as accurate as collecting a sample directly from the wound. This is because the drainage may contain bacteria from the surrounding skin or environment, which could contaminate the culture results.

Additionally, the drainage may not contain a representative sample of the bacteria present in the wound, as some bacteria may not be able to drain out of the wound.

Choice D rationale:

Collecting a tissue sample from the wound during a surgical procedure is the most accurate way to obtain a culture. However, this is not always feasible or necessary.

It is often possible to obtain an accurate culture by collecting a sample from the wound using a sterile swab. This is a less invasive procedure and can be done at the bedside.