The nurse is teaching a client how to self-administer low-molecular-weight heparin subcutaneously. Which instruction should the nurse include?

A. Rotate injections between the abdomen and gluteal areas: Low-molecular-weight heparin is best absorbed in the abdominal subcutaneous tissue. Rotating to gluteal sites is not recommended because it may alter absorption and increase the risk of inconsistent therapeutic effects. B. Expel the air in the prefilled syringe prior to injection: The small air bubble in a prefilled low-molecular-weight heparin syringe is intentional and helps ensure the full dose is delivered while minimizing bruising. Expelling it can lead to medication loss and incorrect dosing. C. Massage the injection site to increase absorption: Massaging after injection can increase bruising and tissue damage, especially with anticoagulants. Absorption is adequate without massage, and avoiding this reduces the risk of hematoma formation. D. Inject in the abdominal area at least 2 inches (5.08 cm) from the umbilicus: The abdominal area provides consistent absorption, and keeping injections away from the umbilicus avoids scar tissue and bruising. This is the recommended site and technique for safe administration.