A patient is scheduled to receive insulin aspart and insulin detemir.
What is the correct procedure for the nurse to draw up the insulins for administration?
Mix the detemir and aspart in the same syringe, drawing up the aspart first
Mix the detemir and aspart in the same syringe, drawing up the detemir first
Administer the two insulins using different syringes and different sites of the body
Roll the bottles between the palms of the hands before drawing up the insulins
The Correct Answer is C
Choice A rationale:
Incorrect. Mixing insulin detemir and insulin aspart in the same syringe is generally not recommended due to the following reasons:
Altered Pharmacokinetics: Mixing insulins can potentially alter their absorption and action profiles, leading to unpredictable blood glucose control.
Stability Concerns: The compatibility of different insulins in a mixed solution is not always guaranteed, potentially leading to precipitation or decreased potency.
Dosing Accuracy: Drawing up mixed insulins accurately can be challenging, especially when different dosages are required for each type.
Manufacturer Recommendations: Insulin manufacturers typically advise against mixing different insulins unless specifically instructed by a healthcare professional.
Choice B rationale:
Incorrect. While the order of drawing up insulins may have a minor impact on mixing, it does not address the fundamental concerns of mixing different insulins in the same syringe. The primary issue is the potential for altered pharmacokinetics, stability concerns, and dosing accuracy, as explained in the rationale for Choice A.
Choice D rationale:
Incorrect. Rolling insulin bottles between the palms is a technique used to gently resuspend insulin particles that may have settled at the bottom. However, it does not pertain to the correct procedure for drawing up different insulins for administration.
Choice C rationale:
Correct. Administering insulin detemir and insulin aspart using separate syringes and different injection sites is the most appropriate approach for several reasons:
Maintains Pharmacokinetics: It ensures that each insulin maintains its intended absorption and action profile, promoting optimal blood glucose control.
Ensures Stability: Using separate syringes eliminates the risk of potential incompatibility issues that could arise from mixing insulins.
Promotes Dosing Accuracy: Drawing up insulins in separate syringes allows for greater precision in administering the correct dosage of each type.
Aligns with Manufacturer Guidelines: This approach adheres to the recommendations of insulin manufacturers, ensuring safe and effective administration.
Additional Considerations:
Nurses should always consult the latest insulin administration guidelines and individual patient needs for optimal care.
Proper education and counseling should be provided to patients who require multiple insulin injections to ensure adherence and understanding of correct administration techniques.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Choice A rationale:
Splinting the incision when coughing helps to minimize pain and discomfort, which can encourage deeper breathing and coughing. This is essential because deep breathing and coughing help to clear secretions from the lungs and prevent atelectasis (collapse of lung tissue).
Steps for splinting the incision:
Place a pillow or folded towel over the incision site.
Instruct the patient to apply gentle pressure to the pillow or towel with their hands when coughing or deep breathing. Encourage the patient to relax their abdominal muscles during coughing and deep breathing exercises.
Choice B rationale:
Sitting up in a chair and ambulating promote lung expansion and help to mobilize secretions. This is because gravity assists in moving secretions from the smaller airways into the larger airways, where they can be more easily coughed up.
Additional benefits of sitting up and ambulating: Improved circulation
Decreased risk of pneumonia Enhanced recovery from surgery Choice C rationale:
Using an incentive spirometer hourly helps to increase lung capacity and prevent atelectasis. The device encourages the patient to take slow, deep breaths, which helps to inflate the alveoli (air sacs) in the lungs.
Instructions for using an incentive spirometer:
Sit upright in a chair or bed.
Place the mouthpiece of the spirometer in your mouth and seal your lips around it.
Inhale slowly and deeply through the mouthpiece, aiming to raise the piston inside the device as high as possible. Hold your breath for 3-5 seconds.
Exhale slowly and completely through the mouthpiece.
Repeat the process 10-15 times per hour, or as instructed by your healthcare provider.
Correct Answer is ["B","C","E"]
Explanation
Choice B rationale:
Heart rate: During a stress response, the sympathetic nervous system is activated, leading to a release of hormones such as adrenaline and cortisol. These hormones increase heart rate, preparing the body for a "fight or flight" response. A heart rate of 132 beats per minute is significantly elevated compared to a normal resting heart rate of 60-100 beats per minute, suggesting a stress response.
Choice C rationale:
Pupil dilation: Pupil dilation is another physiological change associated with the activation of the sympathetic nervous system during stress. The dilation allows more light to enter the eyes, enhancing visual acuity and awareness of surroundings, which can be helpful in responding to potential threats.
Choice E rationale:
Difficulty sleeping: Stress can negatively impact sleep in several ways. It can cause racing thoughts, anxiety, and physical tension, making it difficult to fall asleep and stay asleep. Sleep disturbances are a common symptom of stress and can further exacerbate its effects.
Rationale for incorrect choices:
Choice A: Blood glucose level can be affected by stress, but a low blood glucose level of 36 mg/dL is more likely to be due to other causes such as hypoglycemia or insulin therapy. It's not a direct indicator of a stress response.
Choice D: Blood pressure can increase during stress, but a blood pressure of 104/56 mmHg is within the normal range and does not necessarily indicate a stress response.
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