A nurse is reviewing the medical record of a newly admitted client.

Which of the following laboratory values should the nurse report to the provider?

A.When mixing insulins, you should draw the short-acting insulin into the syringe first. This is done after injecting air into both vials (first into intermediate-acting, then into short-acting). Drawing intermediate-acting insulin first can contaminate the short-acting insulin vial with the longer-acting solution, which could alter the effectiveness of future doses.

B.Although this step is required when mixing insulins, it is not the first step. The nurse should first inject air into both vials to maintain vial pressure.

C.The nurse should inject air into the intermediate-acting insulin vial first because it helps prevent contamination and maintains the correct pressure within the vial. Intermediate-acting insulin, typically NPH (Neutral Protamine Hagedorn), is cloudy, and air injection into the vial allows for easy withdrawal later on without disrupting the order of mixing.

D.Injecting air into the short-acting insulin vial is necessary but should be done after injecting air into the intermediate-acting vial. By injecting air into both vials first, the nurse prevents a vacuum effect, which can make it difficult to draw up the insulin. After injecting air, the nurse can draw the short-acting insulin into the syringe before moving to the intermediate-acting insulin. This order minimizes the risk of contamination.

When receiving a new prescription over the telephone from a client’s provider, the nurse should first write down the complete prescription to ensure that all the details are accurately recorded.
Choice B is wrong because reading back the prescription to the provider should be done after writing down the complete prescription.
Choice C is wrong because documenting the prescription as a telephone prescription in the medical record should be done after writing down the complete prescription and reading it back to the provider.
Choice D is wrong because ensuring that the provider signs the prescription should be done after writing down the complete prescription, reading it back to the provider, and documenting it in the medical record.