The nurse watches a patient perform an insulin injection. Which observation(s) indicate(s) that the patient needs additional 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
The patient should not rub the injection site because it could alter absorption. When mixing two types of insulin, in order to prevent contamination of the second vial, the patient should with-draw clear insulin into the syringe first. Shaking the bottle can damage the solution; the patient should gently roll the bottle between the palms of the hands. Administering the injection at a 90-degree angle and cleaning the injection site prior to injection describe appropriate technique.
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