The nurse is assessing orientation in a 79-year-old patient.
Which of these responses would lead the nurse to conclude that this patient is oriented?

Choice A rationale

The anterior thighs are a permissible site for subcutaneous injections because they offer a good layer of subcutaneous fat, which allows for proper absorption of the medication. The vastus lateralis muscle, located in this region, is often used, providing a safe and accessible area for injection due to its distance from major nerves and blood vessels.

Choice B rationale

The area 2 inches around the umbilicus, while containing subcutaneous tissue, is generally avoided for routine subcutaneous injections due to the presence of numerous blood vessels and nerve endings, which can increase the risk of pain, bruising, and potential complications. It's often reserved for specific medications like insulin.

Choice C rationale

The posterior upper arm, specifically the triceps area, is a common and appropriate site for subcutaneous injections. This region provides a sufficient layer of subcutaneous tissue for medication absorption and is relatively free of major nerves and blood vessels, minimizing discomfort and potential complications for the patient.

Choice D rationale

The lateral aspect of the thigh is a frequently used and recommended site for subcutaneous injections. Similar to the anterior thigh, this area offers a large surface of subcutaneous fat, facilitating optimal drug absorption and reducing the likelihood of injecting into muscle or hitting critical neurovascular structures.

Choice E rationale

The forearms, particularly the ventral aspect, are generally not preferred sites for routine subcutaneous injections due to the thinner subcutaneous tissue layer and the proximity of numerous blood vessels and nerves. This area is more commonly used for intradermal injections, where a shallower injection is required.

Choice A rationale

Delayed documentation increases the risk of medication errors, as details about administration, patient response, and specific timing can be forgotten or inaccurately recalled, compromising patient safety and the accuracy of the medical record.

Choice B rationale

Nurses are legally and professionally obligated to document medications they personally administer. Documentation by a pharmacy technician is inappropriate and violates the principle of direct accountability for medication administration.

Choice C rationale

Only the individual who directly administers the medication should document its administration. This ensures accuracy, accountability, and traceability of the medication process, preventing errors and maintaining legal integrity of the medical record.

Choice D rationale

Immediate documentation after medication administration is a critical safety principle. It accurately reflects the precise time of administration, allowing for timely assessment of patient response, identification of adverse effects, and continuity of care.