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A nurse is preparing regular and NPH insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take?

A.

Shake both insulin vials for 2 min before withdrawing the doses.

B.

Administer the mixture within 5 min of preparing it.

C.

Withdraw the NPH insulin before the regular insulin.

D.

Inject air into the regular insulin vial before injecting air into the NPH vial.

Answer and Explanation

The Correct Answer is D

A. Shake both insulin vials for 2 min before withdrawing the doses. Insulin vials should never be shaken, as this can create air bubbles and affect dosage accuracy. NPH insulin should be gently rolled between the hands to mix.
B. Administer the mixture within 5 min of preparing it. While insulin should be administered promptly, there is no strict 5-minute requirement.
C. Withdraw the NPH insulin before the regular insulin. Regular insulin should be drawn up first to prevent contamination with the cloudy NPH insulin.
D. Inject air into the regular insulin vial before injecting air into the NPH vial. Air should be injected into the regular insulin first, then into the NPH insulin vial, before withdrawing the doses in the correct order.


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Related Questions

Correct Answer is D

Explanation

A. Scant lochia rubra with a few small clots. Lochia rubra is expected in the early postpartum period, and small clots are normal unless excessive bleeding occurs.
B. Urine output 2,500 mL/day. Increased urine output is expected postpartum as the body eliminates excess fluid retained during pregnancy.
C. Bilateral ankle edema. Mild edema is common postpartum due to fluid shifts and typically resolves on its own.
D. 4+ deep-tendon reflexes. Hyperreflexia is a sign of central nervous system irritability and may indicate preeclampsia, which requires immediate evaluation.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}

Explanation

Findings Consistent with Chorioamnionitis:

  • Purulent amniotic fluid
  • Fever

Findings Consistent with Preeclampsia:

  • Elevated uric acid level
  • Decreased platelet count
  • Blurred vision

Rationale:

  • Purulent amniotic fluid (Chorioamnionitis): Chorioamnionitis is an intra-amniotic infection, often leading to foul-smelling, purulent, or discolored amniotic fluid.
  • Fever (Chorioamnionitis): Maternal fever is a hallmark sign of chorioamnionitis, indicating infection.
  • Elevated uric acid level (Preeclampsia): Uric acid elevation is associated with endothelial dysfunction and reduced renal clearance seen in preeclampsia.
  • Decreased platelet count (Preeclampsia): Thrombocytopenia can occur due to platelet consumption in severe preeclampsia or HELLP syndrome.
  • Blurred vision (Preeclampsia): Visual disturbances occur due to cerebral edema and vasospasms, common in preeclampsia.

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