A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions?

Choice A rationale:
Placing the client back in bed during a seizure could potentially cause injury. The priority is to protect the client from harm during the seizure.
Choice B rationale:
Placing the client on his side, specifically the recovery position, helps keep the airway clear and prevents aspiration.
Choice C rationale:
Holding the client’s arms and legs from moving could cause injury. It’s important to let the seizure take its course while protecting the client from harm.
Choice D rationale:
Inserting a tongue blade or any other object in the client’s mouth during a seizure is not recommended. It could cause injury to the client or the nurse.

The correct answer is choice B. Inject 20 units of air into the NPH insulin vial.

Choice A rationale:

Replacing the needle for withdrawal with a safety needle is an important step to ensure safety and prevent needle-stick injuries. However, this action is not the first step when mixing two types of insulin. The initial steps involve preparing the insulin vials by injecting air into them.

Choice B rationale:

Injecting 20 units of air into the NPH insulin vial is the correct first step. This is because NPH insulin is a suspension and needs to be mixed properly. Injecting air into the vial helps to equalize the pressure, making it easier to withdraw the correct amount of insulin later. This step is crucial to ensure accurate dosing and proper mixing of the insulin.

Choice C rationale:

Injecting 10 units of air into the regular insulin vial is also necessary, but it is not the first step. The correct sequence is to first inject air into the NPH insulin vial, then into the regular insulin vial. This order helps prevent contamination of the regular insulin with NPH insulin.

Choice D rationale:

Withdrawing 10 units of insulin from the regular insulin vial is an important step, but it should be done after injecting air into both vials. The correct sequence ensures that the insulin is mixed properly and that the doses are accurate.

By following these steps in the correct order, the nurse ensures that the insulin is mixed safely and effectively, minimizing the risk of errors and ensuring proper glycemic control for the patient.