A patient using an insulin pump reports redness at the infusion site. What is the nurse's first action?
Increase the insulin dose to compensate for reduced absorption.
Reassure the patient that this is normal.
Change the infusion site and assess for signs of infection.
Apply a warm compress to the site.
The Correct Answer is C
A. Increase the insulin dose to compensate for reduced absorption: Increasing the dose without addressing the site problem may lead to unpredictable absorption and risk of hypoglycemia once the site heals.
B. Reassure the patient that this is normal: While minor irritation can occur, redness may indicate inflammation or early infection. Dismissing it without assessment could delay necessary treatment.
C. Change the infusion site and assess for signs of infection: The first priority is to stop using the affected site to prevent further irritation or infection. Assessing the area ensures early detection and management of potential complications.
D. Apply a warm compress to the site: Applying heat without evaluating the cause may worsen inflammation or mask infection. The site should first be assessed and the infusion moved.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. They indicate the expiration date of the medication: Expiration dates are included on labels but are separate from warnings and contraindications. They do not prevent unsafe administration to at-risk patients.
B. They list all possible side effects of the medication: Labels may include some side effects, but they do not typically list every possible reaction. Side effect information alone does not fully address patient safety concerning contraindications.
C. They help prevent administration to patients with potential risks: Warnings and contraindications identify conditions, allergies, or interactions that make the medication unsafe for certain patients. Including this information guides nurses and prescribers in preventing adverse events and ensuring safe administration.
D. They provide information on how to store the medication: Storage instructions are important for maintaining drug stability but are unrelated to preventing administration to patients at risk due to contraindications or warnings.
Correct Answer is C
Explanation
A. Enhanced pharmacodynamic responses: Older adults may have altered pharmacodynamic responses, such as increased sensitivity to certain medications, but this alone is not the primary reason for the increased risk of adverse events.
B. Increased volume of distribution: In aging, the volume of distribution for some drugs may change, but these changes are variable and less influential than organ function decline in causing adverse events.
C. Decline in liver and kidney function: Aging commonly leads to decreased hepatic metabolism and renal excretion, which can cause drugs to accumulate in the body. This significantly increases the risk of toxicity and adverse medication events in older adults.
D. Increased absorption in the GI tract: Absorption in the gastrointestinal tract is generally not significantly increased in older adults. Therefore, this factor contributes little to the heightened risk of adverse medication effects.
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