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Difficulty: MediumPharmacological Therapies

A practical nurse is preparing to administer a scheduled subcutaneous injection of enoxaparin using a prefilled syringe. Arrange the following steps of the procedure in the correct chronological order.

  1. 1Verify the client's identity using two acceptable identifiers.
  2. 2Put on clean gloves and cleanse the abdominal injection site with an alcohol swab.
  3. 3Remove the needle cap without expelling the air bubble from the syringe.
  4. 4Pinch a fold of skin and insert the needle at a 90-degree angle.
  5. 5Administer the medication, withdraw the needle, and activate the safety device.

Answer

The correct chronological sequence is: Verify the client's identity, prepare the site with gloves and alcohol, uncap the needle while retaining the air bubble, pinch the skin to insert the needle, and finally administer the medication and activate the safety device.
Chronological adherence to standard medication administration protocols ensures client safety. Enoxaparin has specific administration requirements, including using the abdomen as the preferred site, retaining the prefilled air bubble, and injecting into a pinched fold of skin to prevent bruising and ensure proper tissue absorption.

Step-by-Step Solution

1
Verify client identity.
The correct client is identified.
Ensures adherence to the 'right client' principle of medication administration.
2
Don gloves and cleanse the abdominal site.
The site is properly disinfected.
Maintains asepsis and utilizes the preferred site (the abdomen) for enoxaparin administration.
3
Remove the needle cap.
The syringe is ready for immediate injection.
The air bubble must not be expelled, as the manufacturer includes it to push all medication into the tissue and prevent tracking.
4
Pinch a fold of skin and insert the needle.
The needle enters the correct tissue layer.
Pinching elevates the subcutaneous tissue, preventing an accidental and painful intramuscular injection.
5
Inject the medication and secure the needle.
The dose is fully administered and the sharp is safely contained.
Prevents tracking of the medication and protects the nurse from needlestick injuries.

Key Concept

Safe administration sequence for subcutaneous enoxaparin
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Topics

Pharmacological Therapies

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