A nurse is caring for a client who has urticaria following administration of an antibiotic. Which of the following medications should the nurse prepare to administer?

A. The client engages in quiet activities in their room. While this may seem positive, it is not a reliable indicator of improvement in this context. It could suggest withdrawal or sedation rather than clinical stabilization. Further assessment would be needed to determine its significance.
B. The client slept 5 hr the previous night. This is a clear sign of improvement. The client had not slept for 2 days previously, and sleep is one of the first indicators of recovery in clients experiencing mania. Restorative sleep helps stabilize mood and reduce disorganized thinking.
C. The client takes 2 short naps during the day. Napping indicates the client is able to rest voluntarily, which contrasts with their earlier constant movement and hyperactivity. This suggests reduced mania-related agitation and increased capacity for rest.
D. The client appears to listen to unseen others. This behavior reflects ongoing hallucinations, which indicate that the client is still experiencing active psychosis. This is not an improvement and suggests further monitoring and treatment adjustment may be needed.
E. The client consumes 8 oz of high-calorie fluids each hour. Adequate nutrition and hydration are key components of recovery, especially since the client had been unable to recall their last meal and showed signs of dehydration. This is a positive sign of improved self-care and physical stability.

A. Draw up regular insulin prior to NPH insulin. This is the correct technique when mixing short-acting (regular) and intermediate-acting (NPH) insulins in the same syringe. Drawing up regular insulin first prevents contamination of the clear insulin vial with the cloudy NPH, which could alter the action of the regular insulin.
B. Roll the syringe gently to ensure mixture of the insulins. Insulin should be mixed in the vial before drawing it into the syringe—not after. NPH insulin should be gently rolled between the hands to mix it, but the syringe itself should not be rolled after drawing both insulins, as this can introduce bubbles and affect dosing accuracy.
C. Inject into the vastus lateralis. The preferred sites for subcutaneous insulin administration are areas with sufficient subcutaneous tissue, such as the abdomen, upper outer arms, thighs, or buttocks. The vastus lateralis is more commonly used for intramuscular injections, such as vaccines.
D. Use a 15° angle for the injection. A 15° angle is appropriate for intradermal injections, not subcutaneous insulin injections. For insulin, the correct angle is typically 45° or 90°, depending on the client’s body habitus and needle length, to ensure proper subcutaneous delivery.