The nurse is observing a patient administer insulin. Which observation indicates the need for further instruction? (Select all that apply.)
a. The patient uses a 90-degree angle to ad-minister the injection.
b. The patient cleans the injection site with alcohol before the injection.
c. The patient rubs the injection site after administration of the insulin injection.
d. The patient draws up the cloudy insulin and then the clear insulin.
e. The patient shakes the insulin bottle before administration.
C, D, E
When administering insulin the site is cleaned with alcohol before the injection but not after. Rubbing will alter the rate of absorption. When mixing two types of insulin the clear should be drawn into the syringe first. This prevents contamination of the second vial. Shaking the bottle can damage the solution. The bottle should be gently rolled between the palms of the hands.
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