Which assessment finding indicates that the patient is at high risk for development of pulmonary embolism?

Choice A rationale:

Echinacea: It has anti-inflammatory properties and is not typically associated with exacerbating rheumatoid arthritis symptoms. Studies have shown potential benefits in reducing inflammation, including evidence of possible effectiveness for osteoarthritis and rheumatoid arthritis. However, more research is needed to confirm its efficacy and safety in rheumatoid arthritis.

Choice B rationale:

Turmeric:

Curcumin, the active component of turmeric, has both anti-inflammatory and pro-inflammatory effects.

While it has potential benefits for some inflammatory conditions, it can also stimulate the immune system, which could worsen rheumatoid arthritis symptoms in certain individuals.

Studies have shown mixed results, with some indicating potential benefits and others suggesting a possible worsening of symptoms.

Due to this uncertainty, caution is advised, and patients with rheumatoid arthritis should consult with their healthcare providers before using turmeric supplements.

Choice C rationale:

Ginger: It has well-documented anti-inflammatory properties and is not known to exacerbate rheumatoid arthritis symptoms.

Studies have shown ginger to be potentially effective in reducing pain and inflammation in individuals with rheumatoid arthritis.

It is generally considered safe for use in this population.

Choice D rationale:

Valerian: It is a herb primarily used for its sedative and sleep-promoting effects.

It has not been shown to have any significant impact on inflammation or rheumatoid arthritis symptoms. There is no evidence to suggest that it would worsen the condition.

Choice A rationale:

Incorrect. Mixing insulin detemir and insulin aspart in the same syringe is generally not recommended due to the following reasons:

Altered Pharmacokinetics: Mixing insulins can potentially alter their absorption and action profiles, leading to unpredictable blood glucose control.

Stability Concerns: The compatibility of different insulins in a mixed solution is not always guaranteed, potentially leading to precipitation or decreased potency.

Dosing Accuracy: Drawing up mixed insulins accurately can be challenging, especially when different dosages are required for each type.

Manufacturer Recommendations: Insulin manufacturers typically advise against mixing different insulins unless specifically instructed by a healthcare professional.

Choice B rationale:

Incorrect. While the order of drawing up insulins may have a minor impact on mixing, it does not address the fundamental concerns of mixing different insulins in the same syringe. The primary issue is the potential for altered pharmacokinetics, stability concerns, and dosing accuracy, as explained in the rationale for Choice A.

Choice D rationale:

Incorrect. Rolling insulin bottles between the palms is a technique used to gently resuspend insulin particles that may have settled at the bottom. However, it does not pertain to the correct procedure for drawing up different insulins for administration.

Choice C rationale:

Correct. Administering insulin detemir and insulin aspart using separate syringes and different injection sites is the most appropriate approach for several reasons:

Maintains Pharmacokinetics: It ensures that each insulin maintains its intended absorption and action profile, promoting optimal blood glucose control.

Ensures Stability: Using separate syringes eliminates the risk of potential incompatibility issues that could arise from mixing insulins.

Promotes Dosing Accuracy: Drawing up insulins in separate syringes allows for greater precision in administering the correct dosage of each type.

Aligns with Manufacturer Guidelines: This approach adheres to the recommendations of insulin manufacturers, ensuring safe and effective administration.

Additional Considerations:

Nurses should always consult the latest insulin administration guidelines and individual patient needs for optimal care.

Proper education and counseling should be provided to patients who require multiple insulin injections to ensure adherence and understanding of correct administration techniques.