A patient is to receive insulin Regular and insulin NPH. How will the nurse draw up the insulins for administration?
Administer the two insulins using different syringes and different sites of the body.
Mix the Regular and NPH in the same syringe, drawing up the Regular first.
Shake the bottles vigorously before drawing up the insulins.
Mix the Regular and NPH in the same syringe, drawing up the NPH first.
The Correct Answer is B
Choice A reason: Separate syringes increase injection sites and patient discomfort; mixing is standard as Regular and NPH are compatible, optimizing insulin delivery efficiency and absorption.
Choice B reason: Drawing Regular (clear) before NPH (cloudy) in one syringe prevents contamination of the short-acting vial with the intermediate-acting insulin, ensuring accurate dosing and stability.
Choice C reason: Shaking insulin damages its structure; NPH requires gentle rolling to mix, while Regular needs no mixing, making vigorous shaking inappropriate for preparation.
Choice D reason: Drawing NPH first risks contaminating the Regular vial with NPH particles, altering its rapid action; the clear-to-cloudy sequence maintains insulin integrity and efficacy.
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Related Questions
Correct Answer is A
Explanation
Choice A reason: Consulting ensures safety; not all drugs can be altered, and the provider adjusts the order, preventing errors in bioavailability or efficacy.
Choice B reason: Liquid may work, but without approval, it’s unauthorized; some drugs lack liquid forms, and this bypasses necessary prescriber oversight.
Choice C reason: Parenteral needs an order change; administering without it violates scope, and it’s invasive, escalating care unnecessarily as a first step.
Choice D reason: Crushing alters pharmacokinetics; many tablets (e.g., extended-release) can’t be crushed, and doing so without checking risks toxicity or inefficacy.
Correct Answer is A
Explanation
Choice A reason: Deltoid and vastus lateralis are large muscles with good vascularity; they safely absorb IM injections, minimizing nerve damage or tissue irritation risks.
Choice B reason: Chest and abdomen lack sufficient muscle mass for IM; these are subcutaneous or IV sites, risking poor absorption or injury if used intramuscularly.
Choice C reason: Forearm and scapula are too thin or bony; IM injections here risk nerve or bone damage, lacking the muscle bulk needed for safe drug delivery.
Choice D reason: Lower leg (e.g., calf) has small muscles and major vessels; IM use risks vascular injury or slow absorption, making it an unsafe injection site.
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