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
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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Related Questions
Correct Answer is D
Explanation
This numeric form is appropriate, according to the Joint Commission, because it does not use a trailing zero after a decimal point, which is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error¹². Therefore, the Joint Commission requires that a trailing zero may be used only when required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report the size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.
The other options are not appropriate numeric forms because:
a) 3.0 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
b) 0.30 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
c) 0.03 is not equivalent to 0.3, as it is 10 times smaller.
Correct Answer is C
Explanation
To find the milliliters per hour, you need to calculate the following:
- The patient's weight in kilograms
- The dose of Principen in milligrams
- The infusion rate in milliliters per hour using the formula: Infusion rate (mL/h) = (Total volume (mL) x Flow factor (gt/mL)) / Time (min) x 60 min/h
First, convert the patient's weight from pounds to kilograms by dividing by 2.2:
22 lb / 2.2 = 10 kg
Next, multiply the patient's weight by the dose of Principen per kilogram to get the total dose in milligrams:
10 kg x 25 mg/kg = 250 mg
Then, use the formula for infusion rate to find how many milliliters per hour the IV pump should deliver:
Infusion rate (mL/h) = (Total volume (mL) x Flow factor (gt/mL)) / Time (min) x 60 min/h
Since the medication is prepared in 50 mL of solution and the infusion time is 30 minutes, plug in these values into the formula:
Infusion rate (mL/h) = (50 mL x 1 gt/mL) / 30 min x 60 min/h
Simplify and solve for the infusion rate:
Infusion rate (mL/h) = 100 mL/h
Therefore, the nurse should administer **100 mL/h** to infuse Principen 250 mg over 30 minutes.
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