Subcutaneous inejction

Subcutaneous injections:

SubQ is given between the fatty layer of muscle and skin. This is the easiest type of the injection that is given to patient. Insulin is most common medicine given subcutaneously. Other medicines given are growth hormones, epinephrine etc. Medicine, which needs to be delivered slowly over long period of time is given subq. There are certain sites where subcutaneous injections are given. Subcutaneous injection can be given both angle of 90 degree (if we can grasp 2 inch of skin by our thumb) and 45 degrees if we can grasp only 1 inch of skin. Injection procedure: Clean the injection site with alcohol wipe, in the round fashion, begin at the center and then go outward. Allow the alcohol to dry by air or by gauge. Hold the syringe like pen, grasp the skin between the thumb and index finger, quickly thrust the needle into the skin. Release the skin and pull back plunger to check for blood. If no blood appears release the medicine. Pull out the needle and gently press the site by gauge.

Some common abbreviation for medications:

• p.o.: by mouth
• IM: intramuscular injection
• SC: subcutaneous injection
• IV: intravenous
• PR: per rectum
• h.s.: at hour of sleep (bedtime)
• ac: before meals
• pc: after meals
• q: every, ie, q 8 h means every 8 hours
• q.d.: every day
• b.i.d.: twice/day
• t.i.d.: three times/day
• q.i.d.: four times/day
• q.o.d.: every other day

Subcutaneous injection sites

Blood glucose

All the nurses, we test the blood glucose but are lacking proper information about the blood glucose level. We are very unaware of the normal blood glucose level and more ther things. I hope this article would help nurses to have some information about the blood glucose and its complications.

Blood glucose level

Blood Sugar Levels Chart

Type of Person	Fasting Value		Post Prandial
	Min Value	Max Value	Value 2 hours after consuming glucose
Normal	70	100	Less than 140
Early Diabetes	101	126	140 to 200
Established Diabetes	More than 126	-	More than 200

Hypoglycemia: Less than 70 mg/dl. Cause may be missing of meal, excessive exercise, not eating enough carbohydrate. Other clinical cause might include: drug with insulin, liver disease, surgical absence of stomach, tumor releasing excessive insulin, and pre-diabetes. Fasting hypoglycemia (due to fasting) and Reactive hypoglycemia (after meal) is to be considered as well. Signs and symptoms: dizziness, trouble attention, or tingling around mouth. Hypoglycemia makes brain lack of sugar leading to loss of consciousness, seizure, and coma. Severe hypoglycemia can cause death. Treatment: administer of high amount of glucose, medical adjustment, for reactive hypoglycemia take fewer concentrated sweet and multiple small meals throughout the day.

Hyperglycemia: above the 200-240 mg/dl. Fasting hyperglycemia: 90-130. Postprandial: above 180. Cause: skip of insulin, consumption of excessive carbohydrate, (white bread and potato, are broken down to sugar quickly than candy), illness (diabetes 1 and 2), stress. Signs and symptoms: increased urination, excessive thirst, difficulty concentration, blurred vision, And fatigue, weight loss, prolonged: slow healing cuts, decreased vision, nerve damage, chronic constipation, erectile dysfunction. Blood glucose level above 240 can lead to keratoacidosis (blood lack insulin to break down glucose so breaks down fat leading to ketone release, kidney would not be able to remove all the ketone, leading mixing of ketone in blood, leading to diabetic coma and to death). Treatment: check the presence of ketone, if present, avoid exercise as it will increase sugar in blood else. In absence of ketone, immediate exercise, insulin, drink more water, change eating habit, change medication.

Diet; low glucose food: fruits, vegetables, grains, legumes (peanuts, lentils, chickpeas, soy beans, black eyed peas), proteins. High sugar food: carbohydrates.

Different test of sugar: Random test, (can be taken any time, more than 140 prediabetes, more than 200 diabetes, needs other testing). Fasting blood glucose test (at least 8-10 hours fasting), glucose more than 100, prediabetes, more than 125, diabetes). Oral glucose tolerance (done after fasting 10 above, not more than 16 hrs), glucose level is measure. After than given glucose drink, and checks for glucose, first at ½ hour, 1 hr, 1 ½ hr, 2 hr, and 3 hr. 5 times in 3 hr. With normal person, glucose rise and then drops to normal). A1C: glycelated hemoglobin test which measure glucose level averaged over to a 2 to 3 months period. Normal value 4% to 6%. 6%-6.5% prediabetes, 6.5% above diabetes.

Factors affecting glucose level: age, sex, general health, race, medications, alcohol, pregnancy.

If you have any queries or any comment i would love to welcome them