The nurse is to administer enoxaparin 40 mg subcutaneously to the patient. Which technique is correct?
A. The nurse aspirates immediately prior to injecting the medication.
B. The nurse gently massages the injection site immediately afterward.
C. The nurse draws up the medication into a 1-mL syringe with a 32-gauge needle.
D. The nurse injects the medication into the soft tissue of the patient’s abdomen.
The Correct Answer and Explanation is:
The correct answer is D. The nurse injects the medication into the soft tissue of the patient’s abdomen.
Explanation:
Enoxaparin, a low molecular weight heparin, is commonly used for anticoagulation therapy and is administered subcutaneously. The technique for administering enoxaparin involves several key considerations:
- Injection Site: Enoxaparin is best administered in the fatty tissue of the abdomen. The abdomen is preferred because it is an area with a consistent layer of subcutaneous fat, which ensures proper absorption of the medication. The injection site should be at least 2 inches away from the umbilicus to avoid potential irritation or complications. Injecting into the abdominal subcutaneous tissue helps achieve optimal medication absorption and efficacy.
- Aspiration: The practice of aspirating the syringe (pulling back on the plunger before injection to check for blood return) is generally not required for subcutaneous injections, including enoxaparin. Aspiration is more relevant for intramuscular injections where there is a risk of injecting into a blood vessel. For subcutaneous injections, it is not necessary and may cause unnecessary discomfort.
- Massaging the Injection Site: Massaging the injection site immediately after administering enoxaparin is not recommended. This can cause irritation or increase the risk of bruising. Enoxaparin is designed to be absorbed slowly and evenly, and massaging the site could disrupt this process.
- Syringe and Needle Size: Enoxaparin is typically administered using pre-filled syringes, which are designed specifically for this medication and come with appropriate needle sizes (usually around 30-31 gauge). Drawing up the medication into a different syringe or using an inappropriate gauge needle is unnecessary and could affect the accuracy of the dosage or the comfort of the patient.
In summary, administering enoxaparin involves injecting into the fatty tissue of the abdomen without aspirating or massaging the site, using the provided pre-filled syringe. This technique ensures proper medication delivery and minimizes patient discomfort.