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A nurse is preparing regular and NPH insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take?

A.

Shake both insulin vials for 2 min before withdrawing the doses.

B.

Administer the mixture within 5 min of preparing it.

C.

Withdraw the NPH insulin before the regular insulin.

D.

Inject air into the regular insulin vial before injecting air into the NPH vial.

Answer and Explanation

The Correct Answer is D

A. Shake both insulin vials for 2 min before withdrawing the doses. Insulin vials should never be shaken, as this can create air bubbles and affect dosage accuracy. NPH insulin should be gently rolled between the hands to mix.
B. Administer the mixture within 5 min of preparing it. While insulin should be administered promptly, there is no strict 5-minute requirement.
C. Withdraw the NPH insulin before the regular insulin. Regular insulin should be drawn up first to prevent contamination with the cloudy NPH insulin.
D. Inject air into the regular insulin vial before injecting air into the NPH vial. Air should be injected into the regular insulin first, then into the NPH insulin vial, before withdrawing the doses in the correct order.


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Related Questions

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Anticipated Interventions:

  • Initiate an IV infusion of lactated Ringer's
  • Place the client in a left lateral position
  • Maintain continuous monitoring of the FHR

Contraindicated Intervention:

  • Monitor blood pressure every hour

Rationale:

  • Initiate an IV infusion of lactated Ringer’s: Hydration is important for labor progression and maternal hemodynamic stability, especially considering the client has a history of chronic hypertension and gestational diabetes.
  • Place the client in a left lateral position: This improves uteroplacental perfusion, helping to optimize fetal oxygenation.
  • Maintain continuous monitoring of the FHR: The presence of meconium-stained amniotic fluid and an elevated FHR (165/min) suggests potential fetal distress, warranting continuous fetal monitoring.
  • Monitor blood pressure every hour (Contraindicated): The client has chronic hypertension and gestational diabetes, both of which increase the risk for complications like preeclampsia and fetal distress. More frequent BP monitoring (e.g., every 15-30 minutes) is necessary to detect any abnormalities early.

Correct Answer is C

Explanation

A. Plan for your son to meet his sister for the first time at home. This is incorrect because allowing the sibling to visit the newborn in the hospital can help with early bonding and ease the transition.
B. Give your son plenty of "alone time" with his sister. This is incorrect because young children require supervision around infants to ensure safety.
C. Give your son a little gift from his new sister. This is correct because presenting a small gift from the baby helps the older sibling feel included and fosters a positive association with the new arrival.
D. Hold your daughter when your son first meets her. This is incorrect because allowing the older sibling to greet the parent first before introducing the baby can help them feel reassured and less displaced.

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