A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client is responding to the treatment?

A) Administer the insulin within 20 min of preparing it: This statement is incorrect. Insulin should be administered immediately after mixing short-acting insulin with NPH insulin, but the 20-minute time frame is not accurate. It's crucial to follow the specific instruc’ions provided by the healthcare provider or the manufacturer for timing of administration.

B) Inject air into the vial to withdraw the short-acting insulin: This is the correct action. When mixing short-acting insulin with NPH insulin from two vials, the nurse should first inject air into the NPH insulin vial, withdraw the correct dose of air into the syringe, and then inject the air into the short-acting insulin vial. This prevents the creation of a vacuum in the vial and facilitates easier withdrawal of the medication.

C) Use two separate syringes to mix the insulin: Using two separate syringes is unnecessary and may increase the risk of dosing errors or contamination. Mixing insulin from two vials can be done using a single syringe by following proper aseptic technique and the correct sequence of steps.

D) Ensure the NPH insulin is drawn into the syringe first: This statement is incorrect. When mixing short-acting insulin with NPH insulin, the short-acting insulin should be drawn into the syringe first, followed by the NPH insulin. Drawing the NPH insulin first could lead to contamination of the short-acting insulin vial with NPH insulin, potentially altering its pharmacological properties.

C) "The TPN will provide nutrients while your bowels have time to rest": Total parenteral nutrition (TPN) is a method of providing nutrition intravenously to clients who are unable to tolerate or absorb adequate nutrients through the gastrointestinal tract. It bypasses the digestive tract entirely, delivering a balanced mixture of nutrients directly into the bloodstream. One of the primary indications for TPN is to provide nutritional support while allowing the gastrointestinal tract to rest, particularly in cases where the bowels are inflamed, injured, or unable to function properly. By bypassing the digestive system, TPN can provide essential nutrients to the body while reducing the workload on the gastrointestinal tract. Therefore, the nurse should include this information in the teaching to help the client understand the purpose and benefits of TPN therapy.

A) "The TPN will stimulate your appetite so that you'll be able to eat more food": TPN does not stimulate appetite. In fact, TPN is often used when the client cannot eat or tolerate oral intake due to various medical conditions or gastrointestinal issues. Therefore, this statement is incorrect and may confuse the client about the purpose of TPN therapy.

B) "The TPN contains medication that will help your digestive tract absorb nutrients": TPN does not contain medication to help the digestive tract absorb nutrients. Instead, TPN provides nutrients directly into the bloodstream, bypassing the need for digestion. This statement is inaccurate and does not accurately describe the mechanism of action of TPN.

D) "The TPN will help keep your bowels clear in case you need surgery": While TPN can help maintain nutritional status in clients who are unable to eat or tolerate oral intake, it is not primarily used to keep the bowels clear for surgery. Bowel preparation for surgery typically involves other interventions such as bowel rest, mechanical cleansing, or medication administration. Therefore, this statement is not directly related to the purpose of TPN therapy and may mislead the client about its intended use.