A nurse is preparing to administer subcutaneous enoxaparin. In which order should the nurse perform the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
A.
Locate the injection site 5 cm (2 in) to the right or left of the umbilicus.
B.
Check the medication administration record to verify the client’s allergies.
C.
Slowly inject the medication into the site without aspirating.
D.
Pinch clean skin at the injection site and dart the needle into the skinfold at a 90° angle.
E.
Ensure an air bubble is present in the prefilled enoxaparin syringe.
The correct answer and Explanation is :
To administer subcutaneous enoxaparin, the nurse should follow these steps in the correct order:
- B. Check the medication administration record to verify the client’s allergies.
- A. Locate the injection site 5 cm (2 in) to the right or left of the umbilicus.
- E. Ensure an air bubble is present in the prefilled enoxaparin syringe.
- D. Pinch clean skin at the injection site and dart the needle into the skinfold at a 90° angle.
- C. Slowly inject the medication into the site without aspirating.
Explanation
- Verify Allergies: Before administering any medication, it’s essential to confirm the client’s allergies to prevent adverse reactions. This step ensures patient safety and adheres to best practices in medication administration.
- Locate Injection Site: The correct site for subcutaneous injection of enoxaparin is typically at least 5 cm from the umbilicus, which helps avoid areas that may be more vascular and ensures proper absorption.
- Air Bubble in Syringe: Enoxaparin comes in prefilled syringes that often include an air bubble. This bubble should not be expelled, as it helps ensure the entire dose is delivered and may also prevent leakage of the medication post-injection.
- Administering the Injection: Pinching the skin creates a skin fold, reducing the risk of injecting into muscle, which is crucial for proper subcutaneous administration. A 90° angle is typically used for subcutaneous injections, particularly in individuals with adequate subcutaneous tissue.
- Inject the Medication: Slowly injecting the medication without aspirating (pulling back on the syringe plunger) is recommended for subcutaneous injections, as aspirating is generally unnecessary for this route. This technique minimizes discomfort and ensures the medication is delivered effectively.
Following this sequence enhances patient safety, improves medication efficacy, and reduces the likelihood of complications.