NCLEX-RNSafety and Infection Prevention and ControlHard
A nurse is administering a subcutaneous injection of insulin to a client. After inserting the needle, the nurse observes a small amount of blood return in the syringe. Which action should the nurse take next?
- ARemove the needle, apply pressure, and administer the dose at a different site.
- BWithdraw the needle slightly, aspirate again, and then inject.
- CWithdraw the needle immediately and prepare a new dose.
- DContinue with the injection, as this is a normal finding.
Show answer & explanationAnswer & explanation
Correct answer: A. Remove the needle, apply pressure, and administer the dose at a different site.
Subcutaneous injections are administered into the fatty tissue, not into a blood vessel. If blood is aspirated, it indicates the needle has entered a small blood vessel. The nurse should immediately remove the needle, apply pressure to the site to prevent bruising, and then prepare and administer the dose at a different subcutaneous site to ensure proper absorption and avoid injecting directly into the bloodstream.
Why the other options are wrong
- B. Attempting to re-aspirate or adjust the needle in the same site risks further trauma or improper injection into a vessel. It's safer to choose a new site.
- C. Withdrawing the needle is correct, but a new dose is not necessarily needed if the original dose was not contaminated or partially injected. Re-administering at a new site is the goal.
- D. Blood return is an abnormal finding for a subcutaneous injection and indicates improper placement.
Subcutaneous Injection Error
An improper technique during subcutaneous injection, such as injecting into a blood vessel, requiring corrective action to ensure medication safety and efficacy.
- Subcutaneous injections are given into the fatty tissue layer beneath the dermis.
- Aspiration for blood return is generally not recommended for subcutaneous injections by current guidelines, but if blood is seen, it indicates improper placement.
- If blood is aspirated, the needle should be removed, pressure applied, and the medication re-administered at a new site.
Memory trick: BLOOD in the syringe? PULL it OUT, find a NEW route!