Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?
Pull up 30 units from the 70/30 vial, but only administer one third.
Withdraw ten units regular insulin from the 70/30 vial.
Withhold the dose until insulin regular is available on the unit.
Obtain a new vial of regular insulin and withdraw ten units.
The Correct Answer is C
A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Taking an antiemetic medication: This information is not directly relevant before administering misoprostol. Misoprostol does not typically interact with antiemetic medications in a way that would change the administration plan.
B. Allergy to aspirin: While important to know for general medication safety, misoprostol's primary concern is its potential effects on pregnancy rather than an allergy to aspirin.
C. Currently pregnant: Misoprostol is contraindicated in pregnancy due to its potential to induce uterine contractions and cause miscarriage. It is crucial to confirm that the patient is not pregnant before administering this medication.
D. History of glaucoma: While important for other medications, a history of glaucoma is not a primary concern when administering misoprostol.
Correct Answer is A
Explanation
A. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin: It is appropriate to administer a PRN dose of sublingual nitroglycerin for immediate relief of acute angina while leaving the transdermal patch in place. The sublingual nitroglycerin acts quickly to relieve chest pain, while the transdermal patch provides a longer, more sustained effect.
B. Reassure the client that the patch will begin to take effect within a few minutes: The transdermal patch generally takes 30 to 60 minutes to reach therapeutic levels, which is not suitable for immediate relief of acute chest pain. Therefore, reassurance alone may not address the current symptoms effectively.
C. Withhold further doses of nitroglycerin until contacting the healthcare provider: Withholding further doses of nitroglycerin without assessing the situation can delay appropriate relief of chest pain. Immediate intervention is necessary, and it is appropriate to use sublingual nitroglycerin as needed.
D. Obtain another transdermal patch and position it on the patient's left upper chest: Applying an additional transdermal patch is not necessary and could lead to excessive nitroglycerin exposure. The current patch should be left in place, and sublingual nitroglycerin can be used for acute symptoms.
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