Which injection is given under the skin?

Appeared in: Bihar CHO -2019

Explanation

The term 'subcutaneous' is derived from Latin, where 'sub' means under and 'cutaneous' refers to the skin.
This type of injection delivers medication into the adipose (fatty) tissue located just beneath the dermis.
It is used for medications that require slow and steady absorption, such as insulin and heparin.
The absorption rate is slower than intramuscular injections because subcutaneous tissue has fewer blood vessels.

Option A: An intradermal injection is administered into the dermis, which is the layer of skin just below the epidermis, not under the entire skin layer into the fatty tissue.
Option C: An intravenous injection delivers medication directly into a vein, entering the bloodstream immediately. This is not 'under the skin' but into the circulatory system.
Option D: An intramuscular injection is administered deep into a muscle, such as the deltoid or gluteus. This is a deeper layer than the subcutaneous tissue.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Parenteral drug administration routes as background academic context rather than a clinical decision trigger.
Understanding the correct parenteral route is a fundamental nursing skill essential for patient safety and medication efficacy. Using the wrong route can lead to incorrect absorption rates, drug failure, or local tissue injury.
For subcutaneous injections like insulin, it is crucial to rotate injection sites (e.g., between different areas of the abdomen, thighs, and arms) to prevent lipodystrophy, a condition where fat tissue either breaks down or builds up, which can interfere with insulin absorption.
What if a patient in diabetic ketoacidosis needs insulin? While they might normally use subcutaneous insulin, in an emergency requiring rapid action, they would receive regular insulin intravenously to lower their blood sugar quickly.

How to Approach the Question

First, identify the key phrase in the question: 'under the skin'.
Translate this anatomical description into its corresponding medical term.
Evaluate the options provided. Each option is a medical term for an injection route.
Recall the definition of each term: 'Intra-' means within, 'Sub-' means under, 'dermal'/'cutaneous' refers to skin, 'venous' to vein, and 'muscular' to muscle.
Match the definition 'under the skin' to the correct option. 'Subcutaneous' directly translates to this, making it the correct answer.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 1 p. 134-136

E6 Anatomy Applied Ashalatha 4e p. 232-234

E6 Pharmacology Nurses Shanbhag 3e p. 14-16

Practise the full Bihar CHO -2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.