A primary healthcare provider prescribes 14 units of insulin to a client.
What should a nurse do while administering this medication to the client?

Administer 14 units of medication SubQ in a U-100 syringe

Administer 14 units of medication SubQ in two divided doses in a U-100 syringe

Administer 14 units of medication SubQ in one dose in a tuberculin syringe

Administer 14 units of medication SubQ in the morning after breakfast in a tuberculin syringe

Answer and Explanation

The Correct Answer is A

Insulin is a hormone that helps regulate blood sugar levels. It is usually injected into the fat layer just under the skin (subcutaneous or SubQ) using a syringe and needle or a pen-like device². Insulin syringes are marked in units of insulin, not milliliters or cubic centimeters. The most common insulin syringe holds 1 mL of ﬂuid and has markings for 100 units of insulin². A U-100 syringe means that for every 1 mL of ﬂuid, there are 100 units of insulin³.
To administer 14 units of insulin, you would need to draw up 0.14 mL of ﬂuid in a U-100 syringe. You would inject the insulin into your abdomen, upper arm, butocks, hip, or the front or side of the thigh¹. You would use a diﬀerent area within the site each time you inject insulin to prevent lumps, swelling, or thickened skin¹.

The other options are incorrect because:

b) There is no need to divide the dose into two injections. This would increase the risk of infection and pain.

c) A tuberculin syringe is not designed for insulin administration. It is marked in milliliters or cubic centimeters, not units of insulin. Using a tuberculin syringe could result in an incorrect dose of insulin.

d) The timing of insulin administration depends on the type and duration of insulin. Some insulins are taken before meals, some are taken after meals, and some are taken once or twice a day. The primary healthcare provider should specify when to take the insulin.

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Correct Answer is ["C","D"]

Explanation

These statements are correct because they follow the guidelines for intradermal injections, which are used for skin testing, such as for allergies or tuberculosis. Intradermal injections are given into the dermis, which is the layer of skin below the epidermis.
The needle is inserted with the bevel of the needle upward at a 10- to 15-degree angle to ensure that the medication is delivered into the dermis and not into the subcutaneous tissue or the epidermis. The bevel is

the slanted part of the needle tip that creates a sharp point. Inserting the needle with the bevel upward also reduces tissue trauma and bleeding.
The inner arm or upper back are the preferred sites for intradermal injections because they have thin skin and minimal hair, which makes it easier to see and measure any reactions. The inner arm is usually used for adults, while the upper back is used for children.
The other statements are not correct because they do not apply to intradermal injections or they contain false information.

a. A depressed area around the injection sites indicates a positive reaction. This statement is false because a depressed area, also known as induration, indicates a negative reaction. A positive reaction is indicated by a raised area, also known as a wheal, that is larger than a certain size depending on the type of test.

b. After the insertion of the needle, a healthcare provider should aspirate for a blood return. This statement does not apply to intradermal injections because aspiration is not necessary for this type of injection. Aspiration is the process of pulling back on the plunger of the syringe to check for blood in the needle before injecting the medication. This is done to avoid injecting into a blood vessel, which can cause adverse eﬀects or reduce the eﬀectiveness of the medication. However, intradermal injections are given into very superficial layers of skin where there are no blood vessels, so aspiration is not required.

A. If the drug insert does not specify a pediatric dose B. If the child has an elevated temperature that has not responded to treatment C. If the child has gained or lost weight in the past month D. If the drug insert states that the medication is not for pediatric use

Correct Answer is D

Explanation

To answer this question, we need to understand the principles of pediatric dosage calculations and the factors that aﬀect them. Pediatric dosages are usually calculated based on the child's weight or body surface area, and sometimes adjusted for age, organ function, or disease severity¹. However, not all medications that are used in adults are safe or eﬀective in children. Some medications may have diﬀerent pharmacokinetics, pharmacodynamics, adverse eﬀects, or interactions in children than in adults².

Therefore, it is important to check the drug insert or label for any contraindications, warnings, or precautions for pediatric use before prescribing or administering a medication to a child. If the drug insert states that the medication is not for pediatric use, it means that the medication has not been tested or approved for use in children, or that it has been shown to be harmful or ineﬀective in children. In this case, a pediatric dose calculated from an adult dose should be avoided, as it may result in serious toxicity or therapeutic failure. The healthcare provider should consult a pediatric specialist, a pharmacist, or a reliable drug reference for alternative medications or dosing recommendations.

The other options are not correct because they do not necessarily warrant avoiding a pediatric dose calculated from an adult dose.

Option a. If the drug insert does not specify a pediatric dose, it means that there is insufficient data or evidence to support a specific pediatric dose, but it does not mean that the medication is contraindicated or unsafe in children. The healthcare provider should use clinical judgment and available resources to determine the appropriate dose for the child³.

Option b. If the child has an elevated temperature that has not responded to treatment, it means that the child may have an infection or inﬂammation that may aﬀect the absorption, distribution, metabolism, or excretion of some medications. The healthcare provider should monitor the child's condition and adjust the dose accordingly, but it does not mean that the medication should be avoided altogether⁴.

Option c. If the child has gained or lost weight in the past month, it means that the child's weight may have changed significantly since the last dose calculation. The healthcare provider should weigh the child and recalculate the dose based on the current weight, but it does not mean that the medication should be avoided altogether.

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A primary healthcare provider prescribes 14 units of insulin to a client. What should a nurse do while administering this medication to the client?

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Naxlex Comprehensive Predictor Exams

A nurse is administering an intradermal injection to a patient. Which statements are correct? Select all that apply.

Correct Answer is ["C","D"]

Explanation

Under which circumstance should a pediatric medication dose calculated from an adult dose be avoided?

Correct Answer is D

Explanation

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A primary healthcare provider prescribes 14 units of insulin to a client.
What should a nurse do while administering this medication to the client?