Insulin and Parenteral Medication Administration: Techniques and Sites

What is the primary use of insulin?

To treat diabetes and manage hyperglycemia.

What hormone is insulin normally produced by?

The pancreas.

What are the metabolic processes promoted by insulin?

Decreases blood glucose levels, promotes energy conservation, stimulates glucose uptake, and synthesizes organic molecules.

How is insulin typically administered?

Parenterally, as the GI tract destroys insulin.

What are the common methods of insulin administration?

Subcutaneous injection, subcutaneous infusion, and intravenous infusion.

Name a type of rapid-acting insulin.

Insulin Lispro (Humalog), Insulin Aspart (Novolog), or Insulin Glulisine (Apidra).

What is the classification of Regular Insulin?

Slower acting, clear insulin.

What type of insulin is NPH Insulin?

Intermediate duration insulin that is cloudy.

What is a key characteristic of Insulin Glargine?

It is a long-duration insulin that is clear.

What supplies are needed for insulin administration?

Insulin syringe, alcohol wipes, vials of insulin, and medication administration record (MAR).

What is the correct order to mix two insulins in one syringe?

Inject air into cloudy insulin, then into clear insulin, draw up clear insulin, and finally draw up cloudy insulin.

What should be done before administering insulin?

Wash hands, don gloves, inform the patient, and verify the 7 rights.

What are the preferred administration sites for insulin?

Upper arm, thigh, abdomen (preferred), and back.

What should be avoided when administering insulin?

Injecting into scar tissue and massaging the injection site.

What is a special consideration when using insulin pens?

Administer at a 90-degree angle and hold for 6-10 seconds before removing the needle.

What are signs of hypoglycemia to monitor for?

Symptoms such as sweating, shaking, confusion, and dizziness.

What types of drug interactions should be monitored with insulin?

Hypoglycemic effects with sulfonylureas and meglitinides; hyperglycemic effects with thiazide diuretics and glucocorticoids.

How do beta-adrenergic blocking agents affect insulin administration?

They can mask hypoglycemia and worsen insulin-induced hypoglycemia.

What is the importance of gently agitating insulin before use?

To ensure proper mixing of the solution.

What is the recommended angle for subcutaneous insulin injection?

45-90 degrees.

What should be done with the needle after insulin injection?

Place it in a sharps container.

What are some reasons for administering medications parenterally?

meds are not very soluble, need to be absorbed over a long period, are better absorbed by this route, may cause gastric upset, may be destroyed by gastric contents, or the patient is unable to take medications by mouth.

What are the barriers to parenteral medication administration?

The capillary wall limits the amount of volume that can be administered, depending on site selection and patient.

What are some disadvantages of parenteral administration?

more pain, possible nerve or tissue damage, inconvenience, risk of needlestick injury, and the requirement for advanced training.

What are the three main types of injections?

Intradermal (ID), Subcutaneous (SQ), and Intramuscular (IM).

What is the purpose of an Intradermal injection?

skin tests, such as tuberculin or allergy testing, and are injected just below the epidermis.

What is the typical volume for an Intradermal injection?

0.01ml to 0.1ml.

What are the common sites for Subcutaneous injections?

abdomen, scapular area of the back, and lateral and posterior aspects of the upper arm or thigh.

What is the maximum volume for a Subcutaneous injection?

up to 1.5ml for water-soluble solutions.

What is the typical needle gauge and length for Subcutaneous injections?

25-27 gauge, with a length of 1/2" to 5/8".

What is the purpose of an Intramuscular injection?

medications that need to be absorbed more rapidly.

What is the maximum volume that can be administered via Intramuscular injection?

Most larger muscles in adults can tolerate up to 3ml via Intramuscular injection.

What is the Z-track method in Intramuscular injections?

technique used to decrease irritation by sealing medication into the muscle, involving pulling the skin to one side before injecting.

What are the landmarks for administering an Intramuscular injection in the Deltoid?

lower edge of the acromion process and injecting 1-2 inches below it.

What is the needle length and volume limit for the Deltoid injection site?

generally 1.5 inches, with a volume limit of less than 2ml.

What are the landmarks for the Vastus Lateralis injection site?

identifying the greater trochanter and lateral femoral condyle, with the injection site in the middle third anterior lateral aspect of the thigh.

What is the needle length for the Vastus Lateralis injection site?

typically 5/8 to 1 inch.

What are the landmarks for the Ventrogluteal injection site?

Landmarks include locating the anterior-superior iliac spine and greater trochanter, administering the injection directly into the center of the 'V' formed by the fingers.

What is the needle length and volume limit for the Ventrogluteal injection site?

The needle length is 1.5 inches, with a volume limit of up to 3ml.

What is the proper technique for drawing up medication from a vial?

inject air into the vial equal to the amount of medication needed, then draw up the medication while keeping the needle tip in the solution.

What should you do if you draw up air while preparing an injection?

clear the air while the needle is still in the vial.

What is the importance of recapping needles?

to prevent needlestick injuries; however, never recap a dirty or contaminated needle.

What is the purpose of using a special filter needle with ampules?

to prevent small glass particles from entering the solution.

What should you do after administering an injection?

place the sharps in a needle box immediately and maintain awareness of sharps at all times.