The 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.
Draw up the aspart in one syringe and the detemir in another.
Draw up the detemir in one syringe and the aspart in another.
The Correct Answer is C
Rationale for Choice A:
Mixing insulin detemir and insulin aspart in the same syringe is not recommended due to their differing physicochemical properties and potential for altered absorption and action profiles.
It's crucial to follow manufacturer guidelines, as mixing may lead to suboptimal glycemic control or unpredictable insulin activity.
Rationale for Choice B:
The order of mixing insulin detemir and insulin aspart, even if done incorrectly in the same syringe, would not significantly impact the overall contraindication of mixing them.
The primary concern remains the potential for altered pharmacodynamics and pharmacokinetics when these insulins are combined.
Rationale for Choice C:
Drawing up insulin aspart and insulin detemir in separate syringes is the correct procedure.
This approach ensures that each insulin maintains its intended action profile and absorption characteristics, leading to more predictable glycemic control.
It also aligns with best practices and guidelines for insulin administration.
Rationale for Choice D:
While drawing up insulin detemir first in a separate syringe is technically correct, it offers no specific advantage over drawing up insulin aspart first in a separate syringe.
The key principle is to avoid mixing the two insulins in the same syringe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Intravenous (IV) administration delivers medication directly into the bloodstream. This route is not appropriate for insulin because it would result in a rapid and potentially dangerous drop in blood glucose levels. Insulin needs to be absorbed more slowly to mimic the natural release of insulin from the pancreas.
IV administration also requires sterile technique and specialized equipment, making it more complex and time-consuming than subcutaneous injection.
Additionally, there is a higher risk of infection and other complications with IV administration.
Choice B rationale:
The vastus lateralis is a muscle in the thigh that is commonly used for intramuscular (IM) injections. However, IM injections are not typically used for insulin administration because they can be more painful and have a slower absorption rate than subcutaneous injections.
IM injections also carry a higher risk of hitting a blood vessel, which could lead to erratic absorption of insulin.
Choice D rationale:
The deltoid is a muscle in the upper arm that can be used for subcutaneous injections. However, the abdomen is generally the preferred site for insulin injection because it has a greater amount of subcutaneous fat, which helps to slow the absorption of insulin and provide a more consistent effect.
The abdomen is also a more convenient site for self-injection, as it is easily accessible.
Choice C rationale:
The fatty tissue of the abdomen is the ideal site for subcutaneous insulin injection because it provides slow and consistent absorption of insulin.
The abdomen has a rich blood supply, which helps to distribute the insulin throughout the body.
The subcutaneous tissue in the abdomen is relatively thin, which makes it easy to inject insulin without causing pain or discomfort.
The abdomen is also a large area, which allows for multiple injection sites to be used and rotated to prevent lipohypertrophy (thickening of the subcutaneous tissue).
Correct Answer is B
Explanation
Choice A rationale:
Secondary erythema refers to redness that develops after the initial injury or insult. It's not the most accurate term to describe an area that doesn't blanch, as blanching specifically assesses for the presence of blood in the tissue. Secondary erythema can be blanchable or nonblanchable, depending on the underlying cause.
Choice C rationale:
Blanchable hyperemia is a reddening of the skin that blanches (turns lighter) when pressed. This indicates that blood is still flowing to the area and that the tissue is not damaged. It's not the correct term for an area that doesn't blanch.
Choice D rationale:
Reactive hyperemia is a temporary increase in blood flow to an area that has been deprived of blood flow. It's often seen after pressure is relieved from a body part. While reactive hyperemia can cause redness, this redness typically blanches when pressed.
Choice B rationale:
Nonblanchable erythema is the most accurate term to describe an area of redness that does not turn lighter in color when pressed with a finger. This indicates that blood is not flowing to the area and that the tissue is likely damaged. Nonblanchable erythema is a significant finding because it can be a sign of a pressure injury (also known as a bedsore or pressure ulcer).
Key points about nonblanchable erythema:
It's a sign of impaired blood flow to the tissue. It's a potential indicator of a pressure injury.
It requires prompt assessment and intervention to prevent further tissue damage.
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