Does anyone know the answer?

  1. Just wondering if anyone can help me answer this question that we had on finals this week--

    A patient has liver disease and you have orders to administer an IM injection, which of the following will you implement?

    A. Do not use deltoid for injection site
    B. Use a glass syringe, not plastic
    C. Use betadine to cleanse the injection site
    D. Apply pressure to injection site for a longer period
    of time.

    I chose C--my rationale was that the alcohol prep would absorb into system

    My other classmate chose D--their rationale was that the liver is not making the clotting factors correctly.

    Which one would you have chosen, or could they both be right?

    I would really appreciate your opinions--
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  2. 6 Comments

  3. by   CATHYW
    The answer is D, because of a prolonged clotting time, secondary to liver damage. I won't go through the whole clotting cascade, but I am sure that you remember it from Biology.
  4. by   kewlnurse
    yes, definatly d, betadine only works when it has had enough time to dry, than it should be wiped off, as it can become a medium for bacterial growth.
  5. by   psychomachia
    D.

    for reasons already stated - bad liver = bad blood
  6. by   skgonzales
    Thanks everyone--I really appreciate your input!! I understand why D is the answer now.
  7. by   Nicunurse_RN
    I would have put D as well. When your taking these nursing tests its easy to over analyze and miss a question you already knew
    Last edit by Nicunurse_RN on May 2, '04
  8. by   skgonzales
    Thanxs Nicnurse--That's exactly what I did--instead of thinking of the clotting factors that are messed up with liver disease, I was thinking about the effects of the alcohol prep--a very big stretch now that I think about it. But it's ok--I still made an A on the exam!!!! And--I'll never forget that question!!

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