A nurse mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?

A. Slow the infusion rate:
Incorrect Explanation: Slowing the infusion rate is not the appropriate action when fluid infiltration has occurred.
Explanation: Fluid infiltration occurs when the IV catheter becomes dislodged from the vein and fluid enters the surrounding tissues. Slowing the infusion rate will not prevent or address this issue.
B. Apply pressure to the IV site:
Correct Answer: Applying pressure to the IV site is an appropriate initial action when fluid infiltration occurs.
Explanation: Applying gentle pressure just above the insertion site can help prevent further fluid from entering the surrounding tissues. This can help minimize the extent of infiltration and reduce potential complications.
C. Elevate the extremity:
Incorrect Explanation: Elevating the extremity is not the primary action to take when fluid infiltration is present.
Explanation: Elevating the extremity might be helpful in reducing swelling and promoting blood flow in general, but it's not the primary action to address fluid infiltration.
D. Flush the IV catheter:
Incorrect Explanation: Flushing the IV catheter is not the appropriate action for addressing fluid infiltration.
Explanation: Flushing the catheter might exacerbate the infiltration by pushing more fluid into the surrounding tissues. It's important to address the issue of infiltration first.

A. Correct Answer: St. John's Wort
Explanation: The nurse should advise the client to avoid taking St. John's Wort. St. John's Wort is an herbal supplement commonly used to treat depression and anxiety. However, it can have significant interactions with various medications, including sertraline. Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. St. John's Wort can increase serotonin levels in the brain, and when combined with medications that also affect serotonin levels (such as sertraline), it can lead to a potentially dangerous condition known as serotonin syndrome. Therefore, it's important to avoid St. John's Wort while taking sertraline to prevent adverse effects and interactions.
B. Incorrect Explanation: Coenzyme Q10
Explanation: Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that plays a role in energy production within cells. While CoQ10 is generally considered safe, it does not have known interactions with sertraline. Therefore, the nurse would not necessarily advise the client to avoid CoQ10 solely based on its potential interaction with sertraline.
C. Incorrect Explanation: Black Cohosh
Explanation: Black cohosh is an herbal supplement often used to manage symptoms of menopause. It is not typically known to have significant interactions with sertraline. However, it's important for the client to discuss any supplements with their healthcare provider before starting them, especially when taking prescribed medications. The nurse might not necessarily advise the client to avoid black cohosh unless there are specific concerns based on the client's medical history.
D. Incorrect Explanation: Ginger Root
Explanation: Ginger root is a commonly used spice and herbal remedy. It does not have known interactions with sertraline and is generally considered safe for most people. However, as with any supplement, it's a good practice to consult with a healthcare provider before starting it, especially when taking prescribed medications like sertraline. The nurse would not necessarily advise the client to avoid ginger root without specific reasons related to the client's health.