Medical Surgical Pernicious anemia #5

Question

The nurse is providing teaching to a client diagnosed with pernicious anemia on self-administration of a cyanocobalamin injection. Which action by the nurse is most appropriate? Select the best answer.

Answers

  1. The nurse points to the middle third of the vastus lateralis muscle of the thigh.
    • Rationale:

      This answer is correct because it is the best site for self-administration by a client. It is easiest to reach and best absorbed intramuscularly. This is because the muscle has better blood supply than skin tissue.

  2. The nurse points to the deltoid muscle of the nondominant arm.
    • Rationale:

      This answer is not correct since it would be difficult for the client to inject adequately into his nondominant arm. Most clients lack the dexterity to even perform an injection to themselves. For this reason, self-administration to the arm is not recommended. The deltoid muscle would be appropriate if a caretaker or a nurse was administering the injection.

  3. The nurse points to the dorsogluteal site on the client's bottom.
    • Rationale:

      This answer is not correct because it would be most arduous for the client to visualize the dorsogluteal muscle site for an injection. The dorsogluteal site is more appropriate for a caregiver or nurse to perform the injection.

  4. The nurse points to the upper subcutaneous tissue of the nondominant arm.
    • Rationale:

      This answer is not correct since a vitamin B12 injection should be injected intramuscularly or deep into the subcutaneous tissue. The preferred method is intramuscularly. If a client decides to perform a subcutaneous injection, the stomach area around the umbilicus is suitable.

Overview

A cyanocobalamin injection (B12) is best administered intramuscularly. If a client is being instructed on self-administration, the easiest site is the vastus lateralis muscle of the thigh.

Explanation

Learning Outcomes

A cyanocobalamin injection (B12) is best administered intramuscularly. If a client is being instructed on self-administration, the easiest site is the vastus lateralis muscle of the thigh. It is easiest to reach and best absorbed intramuscularly. This is because the muscle has better blood supply than skin tissue. It can be administered subcutaneously, but deep subcutaneous, taking care not to inject into the dermis or upper subcutaneous tissue. If a client has a caretaker to administer the injection, sites include the deltoid muscle of the arm, ventrogluteal muscle of the hip, or the dorsogluteal muscle of the buttocks. If a client prefers to inject subcutaneously, the stomach area around the umbilicus is an appropriate site.

Test Taking Tip

Know the most appropriate site to administer self injections and which medications require which type of injection.

Video Rationale