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 C
Explanation
Choice A rationale:
While providing meticulous oral care and allowing ice chips for dry mouth can promote comfort, it does not address the primary concern of absent bowel sounds.
Ice chips could potentially stimulate bowel activity, but this is not a reliable or recommended method for managing absent bowel sounds in the immediate postoperative period.
It's essential to prioritize actions that assess and address the potential causes of absent bowel sounds, as they can indicate serious complications.
Choice B rationale:
Notifying the surgeon immediately and preparing for emergency surgery is not the appropriate first course of action in this situation.
Emergency surgery would be considered only if there were clear signs of a life-threatening complication, such as bowel perforation or peritonitis.
These complications would typically present with additional symptoms such as severe abdominal pain, fever, and hemodynamic instability.
Absent bowel sounds alone, without other concerning signs, do not warrant immediate surgical intervention.
Choice D rationale:
Allowing the patient to have clear liquids as tolerated is not appropriate when bowel sounds are absent. Introducing oral intake before bowel function has returned can increase the risk of nausea, vomiting, and aspiration.
It's crucial to wait for the return of bowel sounds before initiating oral intake to ensure proper digestion and minimize complications.
Choice C rationale:
Keeping the patient NPO (nothing by mouth) is the most appropriate action when bowel sounds are absent after major abdominal surgery.
This allows the bowel to rest and recover from the surgical manipulation.
It also prevents potential complications such as aspiration and nausea/vomiting that could arise from premature oral intake.
Documenting the absence of bowel sounds in the patient's medical record is essential for communication among healthcare providers and for monitoring the patient's progress.
This documentation provides a clear record of the patient's clinical status and facilitates appropriate decision-making regarding further interventions.
Correct Answer is C
Explanation
Choice A rationale:
Intravenous (IV) administration delivers medication directly into the bloodstream. This route is not appropriate for insulin because it would result in a rapid and potentially dangerous drop in blood glucose levels. Insulin needs to be absorbed more slowly to mimic the natural release of insulin from the pancreas.
IV administration also requires sterile technique and specialized equipment, making it more complex and time-consuming than subcutaneous injection.
Additionally, there is a higher risk of infection and other complications with IV administration.
Choice B rationale:
The vastus lateralis is a muscle in the thigh that is commonly used for intramuscular (IM) injections. However, IM injections are not typically used for insulin administration because they can be more painful and have a slower absorption rate than subcutaneous injections.
IM injections also carry a higher risk of hitting a blood vessel, which could lead to erratic absorption of insulin.
Choice D rationale:
The deltoid is a muscle in the upper arm that can be used for subcutaneous injections. However, the abdomen is generally the preferred site for insulin injection because it has a greater amount of subcutaneous fat, which helps to slow the absorption of insulin and provide a more consistent effect.
The abdomen is also a more convenient site for self-injection, as it is easily accessible.
Choice C rationale:
The fatty tissue of the abdomen is the ideal site for subcutaneous insulin injection because it provides slow and consistent absorption of insulin.
The abdomen has a rich blood supply, which helps to distribute the insulin throughout the body.
The subcutaneous tissue in the abdomen is relatively thin, which makes it easy to inject insulin without causing pain or discomfort.
The abdomen is also a large area, which allows for multiple injection sites to be used and rotated to prevent lipohypertrophy (thickening of the subcutaneous tissue).
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