NAME: ANDRIE COñADO

COURSE/SECTION: BSN-1D

Critical Thinking Exercises

i. Your patient is dysphagic. Discuss the steps you should take and the considerations you
should be cognizant of to administer oral medication safely.

To safely give oral medication to a patient with difficulty swallowing, you need to:
1. Determine the severity of their dysphagia.
2. Consider the form of the medication and potentially crush it or switch to a liquid/soluble
form.
3. Adjust the medication dosage to ensure they get the correct amount.
4. Check for drug interactions.
5. Use appropriate techniques to help them swallow, such as sitting upright or using a
straw/syringe.
6. Watch for adverse effects.
7. Involve a team of healthcare professionals if needed, such as a speech-language
pathologist, dietitian, and pharmacist.

ii. Why should a health care provider rotate sites with a heparin SC injection, but only rotate
within a site with insulin SC injections?

Although both heparin and insulin are given subcutaneously, they have different
characteristics and necessitate various injection techniques. Healthcare professionals rotate the
injection location since repeated heparin injections into the same spot might result in tissue
damage and necrosis. Although local tissue injury from insulin injections is possible, it is often
less likely than from heparin injections. However, lipohypertrophy can result from repeated
injections into the same spot, hence medical professionals alternate injection sites within a certain
area to avoid it. In conclusion, rotating sites with heparin SC injections prevents tissue injury,
while rotating within a site with insulin SC injections avoids lipohypertrophy and guarantees
constant insulin absorption.

iii. What are three risks associated with administering insulin and heparin subcutaneously?

Subcutaneous administration of heparin and insulin carries a number of hazards. If insulin is injected
repeatedly in the same location, it can result in fatty tissue buildup, hypoglycemia (low blood sugar), and
hyperglycemia (high blood sugar). Heparin can occasionally, but potentially seriously, result in bleeding,
skin problems, and allergic reactions. To avoid difficulties, healthcare professionals must closely monitor
patients and alternate injection sites.
iv. How can you make an injection less painful for a patient? Name four techniques.

To make an injection less painful for a patient, here are four techniques that healthcare providers
can use:
1. Use a smaller needle: A smaller needle causes less pain and discomfort for the patient.
2. Apply a topical anesthetic: A topical anesthetic, such as lidocaine cream or spray, can numb the
skin and reduce pain during the injection.
3. Inject medication at room temperature: Cold medication can cause pain upon injection. Warming
the medication to room temperature can reduce the pain.
4. Distract the patient: Providing a distraction, such as talking to the patient or having them focus on
something else in the room, can help reduce their focus on the pain of the injection.

v. When giving an IM injection, how can you avoid injury to a patient who is very thin?

When administering an intramuscular (IM) injection to a patient who is very thin, it's
important to take extra precautions to avoid injury. Here are some tips to help prevent injury:
1. Choose the correct needle length: Use a shorter needle to avoid hitting bone or causing injury to
nerves or blood vessels. For adults, a needle length of 1 inch is typically sufficient for most IM
injections.
2. Select an appropriate injection site: Avoid injecting in areas where there is little muscle tissue,
such as the upper arm, as this can increase the risk of hitting bone or causing injury. The preferred
sites for IM injections in thin patients are the deltoid muscle in the shoulder or the ventrogluteal
muscle in the hip.
3. Use the Z-track method: This technique involves pulling the skin to the side before inserting the
needle and then releasing it after the medication is injected. This helps to create a zigzag path for
the medication, which can reduce the risk of leakage and irritation at the injection site.
4. Monitor the patient for adverse effects: After the injection, monitor the patient for any signs of
complications, such as bleeding, pain, or swelling at the injection site. If any adverse effects
occur, seek medical attention immediately.