A nurse is preparing to administer heparin subcutaneously to a client.

A nurse is preparing to administer heparin subcutaneously to a client.

Which of the following is an appropriate action by the nurse?

A.
Use a 1-inch needle to inject the medication.

B.
Use a 22-gauge needle to inject the medication.

C.
Massage the injection site after administration of the medication.

D.
Inject the medication into the abdomen above the level of the iliac crest.

The Correct answer and Explanation is:

The correct answer is D. Inject the medication into the abdomen above the level of the iliac crest.

Explanation

Heparin is an anticoagulant medication used to prevent and treat blood clots. It is typically administered subcutaneously (under the skin) rather than intramuscularly (into the muscle) due to its effects on blood clotting and to minimize complications. Here’s a detailed explanation of the appropriate actions when administering heparin subcutaneously:

1. Injection Site: Heparin is most commonly injected into the abdomen, specifically into the area above the level of the iliac crest. This region is preferred because it has a layer of subcutaneous fat that can absorb the medication effectively. The abdomen is also an area where the risk of injecting into muscle tissue is minimized. Injection sites should be rotated to prevent irritation and skin damage.
2. Needle Selection: The appropriate needle for administering heparin subcutaneously is generally a smaller gauge needle (such as 25-27 gauge) and a length of about 5/8 inch. A 22-gauge needle is too large for this purpose and could cause unnecessary discomfort or injury. A 1-inch needle is also too long for subcutaneous injections, where shorter needles are typically used to ensure that the medication is delivered into the subcutaneous layer rather than deeper tissues.
3. Site Preparation and Aftercare: After injecting heparin, it is crucial not to massage the injection site. Massaging can increase the risk of hematoma formation (a localized collection of blood outside of blood vessels) and could interfere with the medication’s absorption. Instead, the site should be left undisturbed to ensure proper absorption of the medication.
4. Technique: To administer the heparin injection, the nurse should pinch the skin to lift the subcutaneous tissue away from the muscle layer. The needle is then inserted at a 90-degree angle to the skin, and the medication is injected slowly. After withdrawing the needle, pressure can be applied gently to the site with a sterile gauze pad to minimize bleeding and bruising.

In summary, injecting heparin into the abdomen above the iliac crest ensures effective absorption and minimizes complications, making it the correct choice among the options provided.