When administering insulin with an insulin syringe, which of the following is correct?
Site of administration is rotated frequently
Angle of insertion is always 45 degrees
Site is massaged after administration
Injection must be given close to the umbilicus
The Correct Answer is A
A. Site of administration is rotated frequently: Rotating insulin injection sites is essential to prevent lipohypertrophy and lipoatrophy, which can impair insulin absorption and lead to glycemic variability. Consistent rotation within the same anatomical region (such as the abdomen) promotes more predictable absorption while protecting subcutaneous tissue integrity.
B. Angle of insertion is always 45 degrees: The angle of insulin injection depends on needle length and the patient’s body habitus. Many insulin syringes today use short needles that are administered at a 90-degree angle. A 45-degree angle may be used in very thin individuals but is not universally required.
C. Site is massaged after administration: Massaging the injection site is contraindicated because it can accelerate insulin absorption unpredictably, potentially leading to hypoglycemia. Gentle pressure may be applied if needed, but rubbing the area should be avoided.
D. Injection must be given close to the umbilicus: Insulin should not be injected within approximately 2 inches (5 cm) of the umbilicus because absorption may be inconsistent. The abdomen is preferred for consistent absorption, but injections should be spaced appropriately away from the navel.
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Related Questions
Correct Answer is B
Explanation
A. The ventrogluteal: The ventrogluteal site is considered the safest for IM injections because it is free of major nerves and blood vessels. Even in thin patients, it provides adequate muscle mass and reduces the risk of nerve injury, making it a preferred site for medications like morphine.
B. The dorsalgluteal: The dorsalgluteal site is located near the sciatic nerve, which increases the risk of nerve injury, especially in extremely thin or cachectic patients like Mrs. Westmore. Due to her significant muscle and fat loss, the likelihood of accidentally hitting the nerve is higher, making this the least favored site for IM injections.
C. The vastus lateralis: The vastus lateralis (anterolateral thigh) is safe for IM injections, particularly in adults who may have reduced gluteal mass. It is free of major nerves and vessels, making it a suitable alternative when the gluteal muscles are atrophied.
D. The deltoid: The deltoid muscle is an option for small-volume IM injections, but in cachectic patients, muscle mass may be insufficient for larger doses. However, it is still safer than the dorsalgluteal site because it avoids proximity to the sciatic nerve.
Correct Answer is A
Explanation
A. 90 degrees: The recommended angle for subcutaneous injection using an insulin pen is typically 90 degrees, especially with short needles (4–8 mm). This angle ensures the medication is delivered into the subcutaneous tissue rather than intradermally or intramuscularly, which could alter absorption and efficacy.
B. 45 degrees: A 45-degree angle may be used in patients with very little subcutaneous tissue or when using longer needles to avoid intramuscular injection. However, with most insulin pen needles today, 90 degrees is standard practice.
C. It doesn’t matter: The injection angle is critical for ensuring proper subcutaneous delivery. Administering at an incorrect angle could result in intramuscular injection, faster absorption, or tissue damage, so this is unsafe.
D. 30 degrees: Injecting at 30 degrees is generally reserved for intradermal injections, such as tuberculosis testing, and is not appropriate for insulin pen administration. Using this angle could result in improper dosing and reduced effectiveness.
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