The nurse is teaching a patient about home administration of insulin.
The patient will receive regular insulin and NPH insulin at 0700 every day. What is important to teach the patient?
Draw up the regular insulin last.
Draw up the insulins after mixing them in a vial.
Draw up the medications in separate syringes.
Draw up the NPH insulin last.
The Correct Answer is A
Choice A rationale
When a patient is administering both regular insulin and NPH insulin, it’s important to draw up the regular insulin first. This is because regular insulin is clear and NPH insulin is cloudy. If the NPH (cloudy) insulin were drawn up into the syringe first, it could contaminate the regular (clear) insulin when drawing it up second. This could affect the action of the regular insulin, which is meant to be fast-acting.
Choice B rationale
Mixing insulins in a vial before drawing them up is not recommended. This could lead to inaccurate dosing and potential contamination of one or both vials. It’s safer and more accurate to draw up each type of insulin separately into the syringe.
Choice C rationale
While it’s possible to administer insulin using separate syringes, it’s usually not necessary and can be more cumbersome for the patient. As long as the patient is careful to avoid contaminating the insulins and to draw them up in the correct order (regular before NPH), they can be administered together in the same syringe.
Choice D rationale
Drawing up the NPH insulin last is not correct. As mentioned earlier, the regular insulin should be drawn up first to avoid contaminating it with the NPH insulin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Tuberculous meningitis is a serious condition, but it is not a contraindication for the use of prednisone.
Choice B rationale
Chronic obstructive pulmonary disease (COPD) is not a contraindication for prednisone. In fact, prednisone is often used to treat exacerbations of COPD56.
Choice C rationale
Cerebral edema is not a contraindication for prednisone. Prednisone is sometimes used to reduce inflammation and swelling in the brain.
Choice D rationale
Peptic ulcer disease is a contraindication for the use of prednisone. Prednisone can increase the risk of peptic ulcers by increasing stomach acid secretion and decreasing the production of protective mucus in the stomach.
Correct Answer is A
Explanation
Choice A rationale
This choice is correct. Calcium carbonate, which is used to treat GERD, can lead to hypercalcemia, or high levels of calcium in the blood, if taken in excess or if the client has impaired kidney function. Hypercalcemia can cause various symptoms, including nausea, vomiting, constipation, and abdominal pain. It can also affect the nervous system, leading to confusion, lethargy, and fatigue. In severe cases, it can cause cardiac arrhythmias.
Choice B rationale
Metabolic alkalosis is a condition characterized by a high level of bicarbonate in the blood, leading to an increase in blood pH. While antacids like calcium carbonate can potentially cause metabolic alkalosis if taken in large amounts, it is less likely to occur in patients taking the medication for GERD, as the medication is used to neutralize stomach acid. Therefore, while it’s a potential risk, it’s less likely than hypercalcemia.
Choice C rationale
Hepatotoxicity, or liver damage, is not typically associated with the use of calcium carbonate. This medication does not have a direct effect on the liver, so it’s unlikely to cause hepatotoxicity unless the client has an underlying liver condition or is taking other medications that can cause liver damage.
Choice D rationale
Hyperphosphatemia, or high levels of phosphate in the blood, is not typically a risk associated with the use of calcium carbonate. In fact, calcium carbonate can bind to phosphate in the gut and reduce phosphate absorption, which can help manage high phosphate levels in certain conditions. Therefore, this choice is not the most likely risk for the client.
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