©2008 by Kathy Quan RN BSN PHN
All Rights Reserved
Heparin and Lovenox (or other brand names of low molecular weight heparin) are administered subcutaneously in the abdomen.
These medications are anticoagulants and are given to prevent the formation of blood clots or to prevent a clot from getting bigger. (They do not dissolve clots that have formed previously.)
(NOTE: Only use one brand of low molecular weight heparin, don't mix or alternate them.)
Difficulty: Easy to Moderately Difficult
Time Required: 5 minutes
Here's How:
Confirm the practitioner's order. Check the
medication with the order. Consult the chart or medical administration record
for previous dose and site. If this is the first dose, make sure appropriate
lab work has been done to obtain baseline coagulation or hematological
information.
Wash your hands. Prepare the medication. (Some
facilities may require two nurses to observe the preparation of the
medication.)
Triple check the order and the concentration
listed on the med label!!!
Identify the patient
and explain the medication order.
Affording privacy, prepare the patient for the
injection into the abdomen.
Don gloves. Have the patient lie down.
Assess the abdomen for bruising and scars. You
will need to avoid bruised areas and stay at least 5 cm. (2 inches) from any
scar or the umbilicus.
Gently cleanse (sponge) the site with an alcohol
pad. (Explain each step to the patient as you continue.) Do not rub the site.
Gently pinch or fold the abdominal skin and tissue with your thumb and forefinger about 3 inches apart to form a thick fold. Don't pinch a small area as this can bruise or damage the skin and subcutaneous tissue.
Ask the patient to relax, and take a deep
breath. As the patient inhales, insert the needle at a right angle (90 degree
angle) into the fold of the skin. Don't move the needle once inserted as this
can cause bruising or bleeding. The needle is short (5/8 inch) and you should
have chosen a thick area of subcutaneous tissue, so you don't have to insert at
a 45 degree angle. If the patient is thin you may have to insert at a 45 degree
angle.
DO NOT aspirate.
Inject the medication slowly.
Release the folded skin and pull the needle
straight out and follow needle shield directions of the manufacturer or your
facility. DO NOT recap the needle.
Press an alcohol pad to the injection site, and hold for up to 3 minutes if the patient is bleeding. DO NOT RUB!
Discard the syringe in your sharps. Remove
gloves and wash your hands.
Assess the patient's response to the injection
and make note of any bleeding. Document time, site, dose, and patient's
response to the medication. Monitor for allergic reaction (rash, fever,
chills), and report to the health care practitioner.
What You Need:
* Medication order and medication
* syringe, needle, alcohol swabs
* gloves
Tips:
1. Rotate sites (Right to Left abdomen) with each injection. Avoid the area 2 inches (5 cm) around the umbilicus and any bruised areas or scars. Document the site so the next nurse knows where to give the next injection. The "love handles" area of the abdomen can be the best site as there may be more skin to fold and thicker subcutaneous tissue.
2. Instruct the patient to report any bruising or bleeding.
3. Do Not give IM.
4. Use a fine sharp needle 27 to 30 gauge, 5/8 inches long; or a pre-measured pre-filled syringe system from the manufacturer.
Sources:
Lippincott Manual of Nursing Practice, eighth edition
For information about heparin recall due to contamination 2008 read more....
©2007-8 by Kathy Quan RN BSN PHN, all rights reserved. No portion of this document may be used in any format without written permission. Email Me. Reprints may be purchased in single or bulk quantities.