A nurse is preparing to administer regular insulin to a client. Which of the following actions should the nurse plan to take?

Administer the injection IM.

Roll the vial to mix the particulate matter within the suspension.

Draw up the insulin with a U-500 syringe.

Verify the dosage with another nurse.

Answer and Explanation

The Correct Answer is D

A. Administer the injection IM: Insulin should be administered subcutaneously, not intramuscularly, because IM injections can lead to faster absorption and increase the risk of hypoglycemia.

B. Roll the vial to mix the particulate matter within the suspension: Regular insulin is a clear solution and does not contain particulate matter, so rolling the vial is unnecessary. Only cloudy or suspension insulins, like NPH, require gentle mixing.

C. Draw up the insulin with a U-500 syringe: U-500 syringes are reserved for clients requiring very high insulin doses. Most standard doses of regular insulin are drawn using U-100 syringes, and using a U-500 syringe unnecessarily increases the risk of dosing errors.

D. Verify the dosage with another nurse: Verification by another nurse is a critical safety step, particularly for high-alert medications like insulin. It helps prevent dosing errors and ensures safe administration to the client.

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Correct Answer is A

Explanation

A. Hyperglycemia: TPN contains high concentrations of glucose, which can lead to elevated blood sugar levels. Clients receiving TPN should have frequent blood glucose monitoring, and insulin may be required to manage hyperglycemia.

B. Hyperkalemia: While electrolyte imbalances can occur with TPN, potassium is typically added in controlled amounts to the solution. Hyperkalemia is not a common direct adverse effect unless the formulation is incorrect or the client has impaired renal function.

C. Hypermagnesemia: Magnesium levels in TPN are carefully regulated, and hypermagnesemia is uncommon. Over-supplementation could cause this, but it is not a typical adverse effect for most clients receiving standard TPN.

D. Urine output of 160 mL in 4 hr: This urine output falls within normal limits (approximately 0.5 mL/kg/hr). Oliguria or significantly reduced urine output would be concerning, but 160 mL in 4 hours does not indicate an adverse effect of TPN.

Correct Answer is ["60"]

Explanation

Calculation:

Determine the concentration of the available solution in mg/mL.

Total drug amount: 2g

Total volume: 500mL

Convert grams (g) to milligrams (mg): 2g × 1000mg/g

= 2000mg

Available concentration (mg/mL) = 2000mg/500mL

= 4mg/mL.

Calculate the infusion rate in milliliters per minute (mL/min).

Desired rate: 4mg/min

Available concentration: 4mg/mL

Rate (mL/min) = Desired rate (mg/min) / Available concentration (mg/mL)

= 4mg/min/4mg/mL

= 1mL/min.

Convert the rate from milliliters per minute (mL/min) to milliliters per hour (mL/hr).

Rate (mL/hr) = Rate (mL/min) ×60min/hr

= 1mL/min×60min/hr

= 60mL/hr.

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A nurse is preparing to administer regular insulin to a client. Which of the following actions should the nurse plan to take?

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