Fundamentals of Nursing Q 514

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Which of the following is the appropriate route of administration for insulin?

  

     A. Intramuscular

     B. Intradermal

     C. Subcutaneous

     D. Intravenous

    

    

Correct Answer: C. Subcutaneous

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The subcutaneous tissue of the abdomen is preferred because the absorption of the insulin is more consistent from this location than subcutaneous tissues in other locations. Insulin may be injected into the subcutaneous tissue of the upper arm and the anterior and lateral aspects of the thigh, buttocks, and abdomen (with the exception of a circle with a 2-inch radius around the navel).

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Option A: Intramuscular injection is not recommended for routine injections. Rotation of the injection site is important to prevent lipohypertrophy or lipoatrophy. Rotating within one area is recommended (e.g., rotating injections systematically within the abdomen) rather than rotating to a different area with each injection. This practice may decrease variability in absorption from day to day.

Option B: Site selection should take into consideration the variable absorption between sites. The abdomen has the fastest rate of absorption, followed by the arms, thighs, and buttocks. Exercise increases the rate of absorption from injection sites, probably by increasing blood flow to the skin and perhaps also by local actions.

Option D: Administration of mixtures of rapid- or short- and intermediate- or long-acting insulins will produce a more normal glycemia in some patients than the use of single insulin. The formulations and particle size distributions of insulin products vary. On mixing, physicochemical changes in the mixture may occur (either immediately or over time). As a result, the physiological response to the insulin mixture may differ from that of the injection of the insulins separately.

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