A patient develops constipation after taking a daily iron supplement prescribed by the physician. Which term best describes the patient’s reaction to the supplement?

Choice A rationale:

STAT orders are urgent and require immediate action. They are typically used for life-threatening situations or when a rapid response is needed to prevent serious harm. In this case, an EKG is important for patients admitted to the cardiac unit, but it is not necessarily an urgent procedure that requires immediate action in all cases.

STAT orders are often given verbally or over the phone, and they are typically written in all capital letters with the word "STAT" prominently displayed.

Examples of STAT orders include medications for cardiac arrest, intubation for respiratory distress, or emergency surgery for a ruptured appendix.

Choice B rationale:

PRN orders are "as needed" orders, meaning they are only carried out when a specific condition or symptom arises. They are not routinely implemented for all patients in a particular unit or setting.

PRN orders allow for flexibility in treatment plans and can help to manage pain, nausea, anxiety, or other symptoms that may fluctuate over time.

Examples of PRN orders include pain medication, anti-nausea medication, or sedatives.

Choice C rationale:

One-time orders are administered only once and are not repeated. They are often used for procedures, diagnostic tests, or medications that are not required on an ongoing basis.

In this case, an EKG is typically a one-time order for patients outside of the cardiac unit, but it becomes a standing order for patients admitted to the cardiac unit due to the increased importance of cardiac monitoring in this setting.

Examples of one-time orders include a chest X-ray, a blood draw, or a dose of antibiotics.

Choice D rationale:

Standing orders are routine orders that are implemented for all patients in a particular unit or setting, unless otherwise specified. They are designed to provide consistent and standardized care, and they often reflect best practices or guidelines for a specific patient population.

Standing orders can help to streamline care processes, reduce the need for individual orders, and ensure that patients receive necessary treatments or interventions without delay.

In this case, the standing order for an EKG upon admission to the cardiac unit ensures that all patients receive this important cardiac assessment, even if the ordering provider does not specifically write an order for it.

Other examples of standing orders in a cardiac unit might include daily weights, regular vital sign checks, or administration of cardiac medications.

Rationale for Choice A:

Mixing insulin detemir and insulin aspart in the same syringe is not recommended due to their differing physicochemical properties and potential for altered absorption and action profiles.

It's crucial to follow manufacturer guidelines, as mixing may lead to suboptimal glycemic control or unpredictable insulin activity.

Rationale for Choice B:

The order of mixing insulin detemir and insulin aspart, even if done incorrectly in the same syringe, would not significantly impact the overall contraindication of mixing them.

The primary concern remains the potential for altered pharmacodynamics and pharmacokinetics when these insulins are combined.

Rationale for Choice C:

Drawing up insulin aspart and insulin detemir in separate syringes is the correct procedure.

This approach ensures that each insulin maintains its intended action profile and absorption characteristics, leading to more predictable glycemic control.

It also aligns with best practices and guidelines for insulin administration.

Rationale for Choice D:

While drawing up insulin detemir first in a separate syringe is technically correct, it offers no specific advantage over drawing up insulin aspart first in a separate syringe.

The key principle is to avoid mixing the two insulins in the same syringe.