A client who is legally blind requires vitamin B12 injections every 2 weeks and insists on self-administration. What is the best way for the nurse to assist this client?
1. Teach the spouse to draw up the medication, then the client can give the injection.
2. Make sure that the injection is scheduled during a visit, so the nurse can supervise.
3. Prefill syringes with the correct dose, so the client can use them for self-administration.
4. Schedule the client's clinic appointments in accordance with the dosing schedule, then give the injection when the client is at the clinic.
Correct Answer: 3
Rationale 1: Teaching a spouse is demeaning and does not support the client's wishes for independence.
Rationale 2: Scheduling injections and visits to coincide is demeaning and does not support the client's wishes for independence.
Rationale 3: Clients who have visual impairment may need the assistance of a support person or creative care in order to remain compliant with their treatment. Because the client insists on self-administration, prefilling syringes (and keeping them away from light and heat) would be a plausible solution. The client is concerned with independence, and allowing the client to maintain that would be quite important.
Rationale 4: Scheduling injections and visits to coincide when the dose is due is demeaning and does not support the client's wishes for independence.
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