The nurse is teaching a family member of an obese patient how to administer a subcutaneous U-100 insulin injection to the patient. Which instruction should be included in the teaching plan?
a. Carefully massage the site after the injection to aid absorption.
b. Draw the medication into a tuberculin syringe with a 27-gauge needle.
c. Insert the needle quickly and firmly at a 90-degree angle.
d. Rotate injection sites between the abdomen, thighs, and upper arms.
C
For an obese patient, the skin is pinched and the needle is inserted quickly and firmly at a 90-degree angle. Massage can damage underlying tissue. Subcutaneous U-100 insulin is given using an insulin syringe with a preattached needle of 28 to 31 gauge. Injection site rotation is no longer necessary because newer human insulins carry a lower risk for hypertrophy. Patients choose one anatomical area (e.g., the abdomen) and systematically rotate sites within that region—a practice that maintains consistent insulin absorption from day to day.
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