A nurse is caring for a client who has a prescription for NPH insulin 10 units and regular insulin 15 units subcutaneously. After injecting 10 units of air into the NPH insulin vial, which of the following actions should the nurse take next?

The client likely suffered from intoxication as evidenced by hypokinesia.

Intoxication from substances such as opioids can lead to a range of symptoms including sedation and altered mental status. In this case, the presence of a needle in the antecubital space and the administration of naloxone suggest opioid use.

Hypokinesia, characterized by reduced movement, aligns with the symptoms observed in opioid intoxication, such as decreased responsiveness and drowsiness. The historical pattern of sedation, miosis (constricted pupils), and mood alteration further supports the diagnosis of intoxication as the underlying condition.

A.Emptying the ostomy pouch before removing the skin barrier reduces the risk of spillage and makes the procedure less messy. It is also more comfortable for the client and helps prevent leakage of stool onto the skin, which can cause irritation.

B. It’s generally recommended to change an ostomy appliance when the bowel is least active, such as before meals or several hours after eating. Changing it one hour after breakfast may coincide with increased bowel activity, which can increase the risk of leakage and make the change more challenging.

C.Moisturizing soaps should be avoided when cleaning the skin around the stoma because they can leave a residue that interferes with the adhesion of the skin barrier, potentially leading to leakage. The nurse should use a mild, non-moisturizing soap or just water to clean the area to ensure proper adhesion of the appliance.

D.The opening on the skin barrier should closely match the size of the stoma, with a slight gap of about 1/8 inch (0.3 cm) around it to avoid pressure on the stoma while also protecting the surrounding skin. Creating an opening that is 0.5 inches (1.27 cm) larger than the stoma would leave too much skin exposed, increasing the risk of irritation and infection.