A laxative has been ordered for a patient.

The nurse checks the patient’s medical history and would be concerned if which condition is present?

Choice A rationale
When a patient is administering both regular insulin and NPH insulin, it’s important to draw up the regular insulin first. This is because regular insulin is clear and NPH insulin is cloudy. If the NPH (cloudy) insulin were drawn up into the syringe first, it could contaminate the regular (clear) insulin when drawing it up second. This could affect the action of the regular insulin, which is meant to be fast-acting.
Choice B rationale
Mixing insulins in a vial before drawing them up is not recommended. This could lead to inaccurate dosing and potential contamination of one or both vials. It’s safer and more accurate to draw up each type of insulin separately into the syringe.
Choice C rationale
While it’s possible to administer insulin using separate syringes, it’s usually not necessary and can be more cumbersome for the patient. As long as the patient is careful to avoid contaminating the insulins and to draw them up in the correct order (regular before NPH), they can be administered together in the same syringe.
Choice D rationale
Drawing up the NPH insulin last is not correct. As mentioned earlier, the regular insulin should be drawn up first to avoid contaminating it with the NPH insulin.

Choice A rationale
While continuous pulse oximetry can provide useful information about a patient’s oxygen saturation levels, it is not the most crucial step before administering amphotericin B. Amphotericin B is an antifungal medication used to treat serious, potentially life-threatening fungal infections. It does not directly affect oxygen saturation levels.
Choice B rationale
The rate at which amphotericin B is administered can be important, as the medication must be given slowly through an IV infusion, which can take from 2 to 6 hours to complete. However, setting the IV pump to deliver the medication over a specific span of time is not the most crucial step before administration.
Choice C rationale
Continuous cardiac monitoring can be important in certain situations, but it is not the most crucial step before administering amphotericin B. While amphotericin B can cause some side effects related to the heart, such as changes in heart rate or blood pressure, these are not typically the primary concerns before administration.
Choice D rationale
Evaluating the patient’s sodium and calcium levels is the most crucial step before administering amphotericin B. Amphotericin B can cause changes in electrolyte levels, including sodium and calcium. Monitoring these levels can help prevent potential complications, making this the most crucial step before administration.