A nurse is caring for a client whose current bag of total parenteral nutrition (TPN) has finished infusing, and the next bag is not yet available. Which of the following fluids should the nurse prepare to administer?

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.

A) Document the administration of the medication: Documentation of medication administration is an essential step in the medication administration process, ensuring accurate recording of the time, dose, route, and client's response to the medication. However, before administering a controlled substance, the nurse should first identify the client using two identifiers to prevent medication errors.

B) Identify the client using two identifiers: This is the correct initial action. Verifying the client's identity using two identifiers, such as name and date of birth, is a crucial safety measure to ensure that the medication is administered to the correct individual. By confirming the client's identity, the nurse helps prevent medication errors and promotes patient safety.

C) Remove the medication from the medication dispensing cabinet: While obtaining the medication from the medication dispensing cabinet is necessary for administration, it should occur after confirming the client's identity. Identifying the client using two identifiers is the priority to ensure accurate medication administration.

D) Compare the amount of medication available to the inventory record: Verifying the amount of medication available against the inventory record is an important step in medication management to maintain adequate stock levels and prevent medication shortages. However, it is not the first action the nurse should take before administering a controlled substance. Confirming the client's identity is the priority to ensure safe medication administration.