A patient is scheduled to receive insulin aspart and insulin detemir.
What is the correct procedure for the nurse to draw up the insulins for administration?
Mix the detemir and aspart in the same syringe, drawing up the aspart first
Mix the detemir and aspart in the same syringe, drawing up the detemir first
Administer the two insulins using different syringes and different sites of the body
Roll the bottles between the palms of the hands before drawing up the insulins
The Correct Answer is C
Choice A rationale:
Incorrect. Mixing insulin detemir and insulin aspart in the same syringe is generally not recommended due to the following reasons:
Altered Pharmacokinetics: Mixing insulins can potentially alter their absorption and action profiles, leading to unpredictable blood glucose control.
Stability Concerns: The compatibility of different insulins in a mixed solution is not always guaranteed, potentially leading to precipitation or decreased potency.
Dosing Accuracy: Drawing up mixed insulins accurately can be challenging, especially when different dosages are required for each type.
Manufacturer Recommendations: Insulin manufacturers typically advise against mixing different insulins unless specifically instructed by a healthcare professional.
Choice B rationale:
Incorrect. While the order of drawing up insulins may have a minor impact on mixing, it does not address the fundamental concerns of mixing different insulins in the same syringe. The primary issue is the potential for altered pharmacokinetics, stability concerns, and dosing accuracy, as explained in the rationale for Choice A.
Choice D rationale:
Incorrect. Rolling insulin bottles between the palms is a technique used to gently resuspend insulin particles that may have settled at the bottom. However, it does not pertain to the correct procedure for drawing up different insulins for administration.
Choice C rationale:
Correct. Administering insulin detemir and insulin aspart using separate syringes and different injection sites is the most appropriate approach for several reasons:
Maintains Pharmacokinetics: It ensures that each insulin maintains its intended absorption and action profile, promoting optimal blood glucose control.
Ensures Stability: Using separate syringes eliminates the risk of potential incompatibility issues that could arise from mixing insulins.
Promotes Dosing Accuracy: Drawing up insulins in separate syringes allows for greater precision in administering the correct dosage of each type.
Aligns with Manufacturer Guidelines: This approach adheres to the recommendations of insulin manufacturers, ensuring safe and effective administration.
Additional Considerations:
Nurses should always consult the latest insulin administration guidelines and individual patient needs for optimal care.
Proper education and counseling should be provided to patients who require multiple insulin injections to ensure adherence and understanding of correct administration techniques.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice B rationale:
Heart rate: During a stress response, the sympathetic nervous system is activated, leading to a release of hormones such as adrenaline and cortisol. These hormones increase heart rate, preparing the body for a "fight or flight" response. A heart rate of 132 beats per minute is significantly elevated compared to a normal resting heart rate of 60-100 beats per minute, suggesting a stress response.
Choice C rationale:
Pupil dilation: Pupil dilation is another physiological change associated with the activation of the sympathetic nervous system during stress. The dilation allows more light to enter the eyes, enhancing visual acuity and awareness of surroundings, which can be helpful in responding to potential threats.
Choice E rationale:
Difficulty sleeping: Stress can negatively impact sleep in several ways. It can cause racing thoughts, anxiety, and physical tension, making it difficult to fall asleep and stay asleep. Sleep disturbances are a common symptom of stress and can further exacerbate its effects.
Rationale for incorrect choices:
Choice A: Blood glucose level can be affected by stress, but a low blood glucose level of 36 mg/dL is more likely to be due to other causes such as hypoglycemia or insulin therapy. It's not a direct indicator of a stress response.
Choice D: Blood pressure can increase during stress, but a blood pressure of 104/56 mmHg is within the normal range and does not necessarily indicate a stress response.
Correct Answer is A
Explanation
Choice A rationale:
Thick, creamy yellow discharge is a hallmark characteristic of purulent drainage. This type of drainage is commonly referred to as pus and is indicative of an infection within the wound. It is composed of white blood cells, dead bacteria, cellular debris, and inflammatory cells, giving it its characteristic opaque, thick, and yellowish appearance.
Purulent drainage is a significant clinical finding that requires prompt attention and intervention. Early identification and management of wound infections can prevent complications such as abscess formation, cellulitis, sepsis, and delayed wound healing.
Accurate documentation of purulent drainage is essential for communication among healthcare providers, monitoring wound progress, and guiding treatment decisions.
Choice B rationale:
Serosanguineous drainage is a mixture of serous fluid (clear, thin, and watery) and blood. It often appears pink or slightly red and is commonly observed in the early stages of wound healing or after dressing changes. While it may contain a small amount of blood, it lacks the thick, creamy consistency and yellow color that are characteristic of purulent drainage.
Choice C rationale:
Serous drainage is clear, thin, and watery, resembling plasma. It is a normal part of the wound healing process and is often seen in the early inflammatory stage. It does not contain the thick consistency or yellow coloration that are indicative of purulent drainage.
Choice D rationale:
Sanguineous drainage is composed primarily of fresh blood. It is bright red in color and typically indicates active bleeding within the wound. It does not exhibit the thick, creamy consistency or yellow hue that are characteristic of purulent drainage.
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