The physician orders Kefzol 2 g in 100 mL of NS IVPB to infuse over 30 minutes.

Tubing drop factor is 15 gtt/mL. Calculate the flow rate in drops per minute.

(ROUND TO WHOLE NUMBER: LABEL CORRECTLY TO RECEIVE CREDIT)

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

Partially withdrawing and redirecting the needle after aspirating blood significantly increases the risk of tissue trauma, pain, and the formation of a hematoma at the injection site. Furthermore, there is a risk of inadvertently injecting medication into a blood vessel or the interstitial tissue, which could lead to complications such as nerve damage or localized irritation.

Choice B rationale

Aspirating blood indicates the needle tip has entered a blood vessel. Administering medication intravenously when an intramuscular injection is intended can have serious systemic consequences, including rapid absorption and potential adverse drug reactions or toxicity. Therefore, the safest action is to withdraw the needle, discard the contaminated medication, and prepare a new dose to ensure proper drug delivery.

Choice C rationale

Administering the drug despite aspirating blood significantly increases the risk of injecting the medication directly into a blood vessel (intravascular injection) rather than the muscle. This can lead to rapid systemic absorption, potentially causing adverse effects or toxicity, and may also result in a larger, more painful hematoma and delayed drug action.

Choice D rationale

Continuing to administer the drug after aspirating blood, regardless of the injection speed, is dangerous because it confirms the needle's placement within a blood vessel. Intravascular administration of an IM medication can lead to immediate systemic effects, allergic reactions, or drug overdose, bypassing the intended slower absorption rate of muscle tissue, and increasing risk of complications.