A nurse is teaching a client who has diabetes mellitus about self-administration of insulin. Which of the following instructions should the nurse include in the teaching?

"Store unopened insulin vials in the freezer."

"Rotate injection sites within the same anatomical region."

"Mix short-acting and long-acting insulins in the same syringe."

"Draw up regular insulin before NPH insulin when mixing them."

Answer and Explanation

The Correct Answer is D

A) Incorrect. The nurse should instruct the client to store unopened insulin vials in the refrigerator, not in the freezer. Freezing can damage the insulin and make it ineffective.

B) Correct. The nurse should instruct the client to rotate injection sites within the same anatomical region, such as the abdomen, thighs, arms, or buttocks. Rotating injection sites can prevent lipodystrophy, which is a disorder of fat metabolism that causes hypertrophy or atrophy of subcutaneous tissue.

C) Incorrect. The nurse should instruct the client not to mix short-acting and long-acting insulins in the same syringe. Mixing different types of insulins can alter their onset, peak, and duration of action and affect blood glucose control.

D) Correct. The nurse should instruct the client to draw up regular insulin before NPH insulin when mixing them in the same syringe. This can prevent contamination of the regular insulin vial with NPH insulin, which can affect its potency and clarity.

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Correct Answer is ["A","B","C"]

Explanation

A) Correct. The nurse should discontinue the IV line and start a new one in another site. The IV site is showing signs of phlebitis, which is inflammation of the vein caused by mechanical, chemical, or bacterial irritation. Phlebitis can lead to complications such as thrombophlebitis, infection, or extravasation.

B) Correct. The nurse should apply a warm compress to the IV site to promote vasodilation and blood flow, which can help reduce inflammation and pain.

C) Correct. The nurse should elevate the affected extremity on a pillow to facilitate venous return and decrease edema.

D) Incorrect. The nurse should not administer an antihistamine to the client unless prescribed by the health care provider. Antihistamines are used to treat allergic reactions, not phlebitis.

E) Incorrect. The nurse should not flush the IV line with normal saline. Flushing the IV line can worsen the inflammation and increase the risk of infection or thrombus formation.

A. Instruct the client to stop taking both medications immediately. B. Assess the client for signs of gastrointestinal bleeding. C. Document the finding in the client's medical record. D. Notify the client's primary care provider.

Correct Answer is B

Explanation

A) Incorrect. The nurse should not instruct the client to stop taking both medications immediately without consulting the client's primary care provider. Abruptly discontinuing some medications can cause adverse effects or withdrawal symptoms.

B) Correct. The nurse should assess the client for signs of gastrointestinal bleeding, such as abdominal pain, black or tarry stools, or coffee-ground emesis. Ibuprofen and naproxen are both nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of gastrointestinal bleeding when taken together or for a long time.

C) Incorrect. The nurse should document the finding in the client's medical record after assessing the client and notifying the primary care provider. Documentation is an important but not a priority action in this situation.

D) Incorrect. The nurse should notify the client's primary care provider after assessing the client for signs of gastrointestinal bleeding. The primary care provider may need to adjust or change the client's medication regimen to prevent further complications.

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A nurse is teaching a client who has diabetes mellitus about self-administration of insulin. Which of the following instructions should the nurse include in the teaching?

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