A nurse prepares to replace the nearly empty container of total parenteral nutrition (TPN) for a client when she finds that there has been a delay in receiving the new container of solution from the pharmacy.

Which of the following solutions should the nurse infuse until the next container of TPN solution becomes available?

Choice A rationale:
A pink color with blisters present is indicative of a superficial partial-thickness burn, not a deep partial-thickness burn.
Choice B rationale:
A yellow color with severe edema is indicative of a deep partial-thickness burn. This type of burn involves the entire dermis and damage to nerve endings, blood vessels, and sweat glands.
Choice C rationale:
A black color and absence of pain is indicative of a full-thickness burn, not a deep partial-thickness burn.
Choice D rationale:
A red color with eschar present is indicative of a full-thickness burn, not a deep partial-thickness burn.

The correct answer is choice B. Inject 20 units of air into the NPH insulin vial.

Choice A rationale:

Replacing the needle for withdrawal with a safety needle is an important step to ensure safety and prevent needle-stick injuries. However, this action is not the first step when mixing two types of insulin. The initial steps involve preparing the insulin vials by injecting air into them.

Choice B rationale:

Injecting 20 units of air into the NPH insulin vial is the correct first step. This is because NPH insulin is a suspension and needs to be mixed properly. Injecting air into the vial helps to equalize the pressure, making it easier to withdraw the correct amount of insulin later. This step is crucial to ensure accurate dosing and proper mixing of the insulin.

Choice C rationale:

Injecting 10 units of air into the regular insulin vial is also necessary, but it is not the first step. The correct sequence is to first inject air into the NPH insulin vial, then into the regular insulin vial. This order helps prevent contamination of the regular insulin with NPH insulin.

Choice D rationale:

Withdrawing 10 units of insulin from the regular insulin vial is an important step, but it should be done after injecting air into both vials. The correct sequence ensures that the insulin is mixed properly and that the doses are accurate.

By following these steps in the correct order, the nurse ensures that the insulin is mixed safely and effectively, minimizing the risk of errors and ensuring proper glycemic control for the patient.