A nurse is reinforcing teaching with client who has diabetes mellitus and is taking insulin lispro and insulin glargine. Which the following instructions should the nurse include in the teaching?

"Draw up the insulin lispro and insulin glargine in separate syringes.

"Take an extra dose of insulin lispro prior to aerobic exercise."

‘’Expect insulin glargine to be cloudy."

"Anticipate that the insulin glargine will peak in 3 hours."

Answer and Explanation

The Correct Answer is A

A) "Draw up the insulin lispro and insulin glargine in separate syringes.":
Insulin lispro (a rapid-acting insulin) and insulin glargine (a long-acting insulin) should be administered separately, as they have different properties and mechanisms of action. Mixing them in one syringe can affect their effectiveness and may cause inaccurate dosing. Therefore, the nurse should instruct the client to draw up each insulin in a separate syringe to ensure proper administration and action of both insulins.

B) "Take an extra dose of insulin lispro prior to aerobic exercise.":
Taking an extra dose of insulin lispro before exercise is not recommended unless directed by a healthcare provider. Exercise can lower blood glucose levels, and additional insulin may increase the risk of hypoglycemia. Instead, clients with diabetes are typically advised to monitor their blood glucose levels before and after exercise and adjust their insulin dose or carbohydrate intake accordingly, under the guidance of their healthcare provider.

C) "Expect insulin glargine to be cloudy.":
Insulin glargine is a clear, long-acting insulin. It should not be cloudy. If the insulin appears cloudy, it may be a sign that the insulin has been improperly stored or is no longer effective. The nurse should educate the client to inspect the insulin for cloudiness or particles and to discard any insulin that appears abnormal.

D) "Anticipate that the insulin glargine will peak in 3 hours.":
Insulin glargine is a long-acting insulin that does not have a pronounced peak. It provides a steady release of insulin over 24 hours and helps to maintain baseline insulin levels. It is not meant to peak like rapid-acting or short-acting insulins. Therefore, this instruction is incorrect, as insulin glargine does not follow the same peak-action pattern as other insulins.

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Correct Answer is D

Explanation

A) Administer aspirin for pain: Aspirin is an anticoagulant and should be avoided in clients receiving other anticoagulant therapy, especially in the context of deep vein thrombosis (DVT). Using aspirin could increase the risk of bleeding and complications. Therefore, it is not appropriate for pain management in this situation.

B) Initiate bed rest: While rest may be indicated for comfort and to reduce the risk of further clot formation, complete bed rest is generally not recommended in the management of DVT unless specifically directed by the healthcare provider. Early ambulation and the use of compression devices or stockings are typically encouraged to promote circulation and reduce the risk of complications, such as pulmonary embolism.

C) Massage the affected extremity every 4 hr: Massaging the affected extremity is contraindicated in a client with DVT, as it can dislodge the clot and increase the risk of a pulmonary embolism or other complications. It is important to avoid any direct manipulation of the affected limb to prevent causing harm.

D) Apply an ice pack to the affected extremity for 20 min every 2 hr: Applying an ice pack is
an appropriate intervention for reducing swelling and providing comfort in the case of a DVT. The cold therapy helps to constrict blood vessels, reduce inflammation, and relieve pain. This intervention should be done carefully to avoid skin damage, and the nurse should monitor the skin for signs of injury.

A. Wait 1 min between 1 suctioning attempts B. Apply intermittent suction for 30 seconds C. Insert the catheter 10 cm (4 in.) D. Apply suction while inserting the catheter.

Correct Answer is C

Explanation

A) Wait 1 min between suctioning attempts: The nurse should wait 20 to 30 seconds between suctioning attempts, not a full minute. Waiting too long between attempts can cause the patient unnecessary distress. The goal is to allow for oxygenation and recovery of the airway in between suctioning attempts.

B) Apply intermittent suction for 30 seconds: Suctioning should be limited to 10 to 15 seconds at a time to prevent hypoxia and damage to the mucous membranes. Applying suction for 30 seconds could lead to complications such as hypoxia, mucosal trauma, and increased risk of infection.

C) Insert the catheter 10 cm (4 in.): This is the correct technique. For an adult client, the catheter should be inserted 10 cm (4 inches) into the airway. Inserting the catheter too far can cause trauma to the airway, while inserting it too shallow may not effectively clear secretions.

D) Apply suction while inserting the catheter: Suction should not be applied while inserting the catheter. Suctioning should only be applied while withdrawing the catheter, not while inserting it, to prevent mucosal trauma and to ensure effective clearance of secretions. Suctioning during insertion could damage the airway and increase discomfort for the client.

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A nurse is reinforcing teaching with client who has diabetes mellitus and is taking insulin lispro and insulin glargine. Which the following instructions should the nurse include in the teaching?

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