A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?
Discard the NPH solution if it appears cloudy.
NPH is an intermediate-acting insulin.
Freeze unopened insulin vials.
Shake the insulin vigorously before loading the syringe.
The Correct Answer is B
Choice A reason: This is incorrect because NPH insulin is normally cloudy and should be gently mixed before use. However, the nurse should discard the solution if it has clumps, flakes, or crystals.
Choice B reason: This is correct because NPH insulin is an intermediate-acting insulin that has a slower onset and longer duration than short-acting or rapid-acting insulins. The nurse should explain to the client that NPH insulin provides basal coverage and may need to be combined with other types of insulin to control blood glucose levels.
Choice C reason: This is incorrect because freezing insulin can damage its potency and effectiveness. The nurse should instruct the client to store unopened insulin vials in the refrigerator and opened vials at room temperature.
Choice D reason: This is incorrect because shaking insulin can cause air bubbles and frothing, which can affect the accuracy of the dose. The nurse should instruct the client to roll the insulin vial between the palms of the hands to mix it gently.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Consuming a high-fat meal does not increase the medication absorption, but rather delays it. A high-fat meal can reduce the peak plasma concentration and prolong the onset of action of sildenafil.
Choice B reason: Taking the medication 2 hours prior to sexual activity is not the optimal timing, as sildenafil has a half-life of about 4 hours and reaches its peak effect within 30 to 120 minutes. The recommended dose is 50 mg taken as needed, approximately 1 hour before sexual activity.
Choice C reason: Swallowing the medication with grapefruit juice does not improve the action, but rather inhibits it. Grapefruit juice can interfere with the metabolism of sildenafil and increase its plasma concentration and side effects.
Choice D reason: Avoiding ingestion of the medication with nitrates is the correct information, as it can cause a severe and potentially fatal drop in blood pressure. Nitrates are drugs used to treat angina and heart failure, and they can interact with sildenafil to cause vasodilation and hypotension.
Correct Answer is A
Explanation
Choice A reason: Venous thromboembolism is a contraindication for taking SERMs. SERMs are drugs that act like estrogen in some tissues and block estrogen in others. They can help prevent bone loss and fractures in postmenopausal women, but they can also increase the risk of blood clots in the veins, such as deep vein thrombosis and pulmonary embolism. Therefore, women who have a history of or are at high risk for venous thromboembolism should not take SERMs.
Choice B reason: Breast cancer is not a contraindication for taking SERMs. In fact, some SERMs, such as tamoxifen and raloxifene, are used to treat or prevent breast cancer in women who have estrogen receptor-positive tumors. These SERMs block the effects of estrogen in the breast tissue and reduce the growth of cancer cells.
Choice C reason: Hypocalcemia is not a contraindication for taking SERMs. Hypocalcemia is a low level of calcium in the blood. SERMs do not affect calcium levels directly, but they can help prevent calcium loss from the bones by mimicking the effects of estrogen in the bone tissue. However, women who take SERMs should also take adequate calcium and vitamin D supplements to maintain bone health.
Choice D reason: Stress fractures are not a contraindication for taking SERMs. Stress fractures are small cracks in the bones that result from repeated stress or overuse. SERMs can help prevent stress fractures by strengthening the bones and reducing the risk of osteoporosis. However, women who take SERMs should also avoid excessive or inappropriate physical activity that can cause stress fractures.
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