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The nurse is to administer enoxaparin 40 mg subcutaneously to the patient. Which technique is correct?

The nurse aspirates immediately prior to injecting the medication.

The nurse gently massages the injection site immediately afterward.

The nurse draws up the medication into a 1-mL syringe with a 32-gauge needle.

The nurse injects the medication into the soft tissue of the patient’s abdomen.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Aspirating prior to injecting enoxaparin is not recommended.

Aspiration was once a common practice to check if a needle had entered a blood vessel.

However, research has shown that aspiration is not necessary for subcutaneous injections and may even be harmful. It can cause pain, bruising, and hematoma formation.

Additionally, aspirating can increase the risk of needlestick injuries.

For these reasons, aspiration is no longer recommended for subcutaneous injections of enoxaparin or other anticoagulants.

Choice B rationale:

Massaging the injection site after administering enoxaparin is not recommended. Massaging can increase the risk of bruising and hematoma formation.

It can also cause the medication to be absorbed too quickly, which can increase the risk of bleeding.

The best practice is to apply gentle pressure to the injection site with a dry gauze pad for a few seconds after the injection. This will help to prevent bleeding and bruising.

Choice C rationale:

The size of the syringe and needle used to administer enoxaparin is not specified in the question. However, a 1-mL syringe with a 32-gauge needle is a common choice for subcutaneous injections.

This size syringe is small enough to be easy to handle, and the 32-gauge needle is thin enough to minimize discomfort.

Choice D rationale:

The abdomen is the preferred site for subcutaneous injections of enoxaparin.

The abdomen has a large surface area of soft tissue, which makes it easy to inject the medication.

The abdomen is also relatively free of blood vessels and nerves, which reduces the risk of bruising, bleeding, and pain. Other potential injection sites for enoxaparin include the upper arms, thighs, and buttocks.

However, the abdomen is generally the preferred site.

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Correct Answer is C

Explanation

Choice A rationale:

Incorrect dosage form: Metformin is typically administered orally as a tablet or liquid suspension, not as a powder for reconstitution (PO).

Missing route of administration: The medication order does not specify the route of administration, such as oral (PO), intravenous (IV), or intramuscular (IM).

Potential for medication errors: The lack of clarity in the medication order could lead to errors in administration, such as giving the wrong dose or administering the medication by the wrong route.

Choice B rationale:

Incorrect dosage unit: Methotrexate is typically administered in milligrams (mg), not grams (g).

Potential for overdose: The order for 15.0 g of methotrexate is a very high dose that could lead to serious adverse effects, including toxicity and death.

Choice C rationale:

Correctly written: The medication order specifies the drug name (meropenem), the dose (1.0 g), the dosage form (IV), and the route of administration (IV).

Appropriate dosage range: The dose of 1.0 g of meropenem is within the typical dosage range for this antibiotic.

Clear and concise: The medication order is clear, concise, and easy to understand, which helps to reduce the risk of medication errors.

Choice D rationale:

Incorrect: While choices A and B are both incorrect, choice C is a correctly written medication order.

A. Dorsal gluteal B. Deltoid C. Vastus lateralis D. Lateral piriformis

Correct Answer is C

Explanation

Choice A rationale:

The dorsal gluteal site, also known as the dorsogluteal site, was once a common choice for intramuscular injections. However, it has fallen out of favor due to several concerns, including:

Risk of sciatic nerve injury: The sciatic nerve, the largest nerve in the body, runs deep within the gluteal region. Injections into the dorsal gluteal site have a higher risk of accidentally hitting this nerve, which can lead to pain, numbness, and weakness in the leg.

Difficulty in landmarking: Accurately locating the dorsal gluteal site can be challenging, especially in patients with excessive adipose tissue or those who are unable to position themselves properly. Incorrect injection placement can increase the risk of tissue damage and poor drug absorption.

Pain: The dorsal gluteal site is often more painful than other intramuscular injection sites, likely due to the presence of more nerve endings in the area.

Choice B rationale:

The deltoid muscle, located in the upper arm, is a common site for intramuscular injections, particularly for vaccines. However, it has limitations when it comes to administering larger volumes of medication:

Small muscle mass: The deltoid is a relatively small muscle, limiting the amount of medication that can be safely injected. It's generally recommended to inject no more than 1-2 mL of medication into the deltoid muscle.

Proximity to nerves and blood vessels: The deltoid muscle is located near the radial nerve and brachial artery. Improper injection technique could potentially injure these structures.

Choice C rationale:

The vastus lateralis muscle, located in the anterolateral aspect of the thigh, is considered the preferred site for intramuscular injections in adults when the volume of medication exceeds 2 mL. Here's why:

Large muscle mass: The vastus lateralis is a large, thick muscle, capable of accommodating larger volumes of medication (up to 5 mL).

Easy to access: The vastus lateralis is easily accessible and can be injected with the patient in a sitting or lying position.

Fewer nerves and blood vessels: The vastus lateralis has fewer major nerves and blood vessels compared to other injection sites, reducing the risk of injury.

Pain tolerance: Studies have shown that injections into the vastus lateralis are generally less painful than injections into the deltoid or gluteal muscles.

Choice D rationale:

The lateral piriformis muscle is not a recognized or recommended site for intramuscular injections. It's a deep muscle located within the pelvic region, making it difficult to access and posing a higher risk of injury to surrounding structures.

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The nurse is to administer enoxaparin 40 mg subcutaneously to the patient. Which technique is correct?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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