Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

Pull up 30 units from the 70/30 vial, but only administer one third.

Withdraw ten units regular insulin from the 70/30 vial.

Withhold the dose until insulin regular is available on the unit.

Obtain a new vial of regular insulin and withdraw ten units.

Answer and Explanation

The Correct Answer is C

A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.

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Correct Answer is D

Explanation

A. Fingerstick glucose: While important in managing diabetes or hypoglycemia, it is not directly related to evaluating the effectiveness of lactulose in treating hepatic encephalopathy.
B. Stool color and character: Lactulose acts as a laxative, and its effectiveness can affect stool characteristics. However, stool color and character are less direct indicators of therapeutic response compared to serum ammonia levels.
C. Serum hepatic enzymes: While liver enzyme levels can provide information about liver function, they do not directly measure the effectiveness of lactulose in managing hepatic encephalopathy. Serum ammonia levels are more specific for this purpose.
D. Serum electrolytes and ammonia: Lactulose is used to treat hepatic encephalopathy by reducing blood ammonia levels. Monitoring serum ammonia levels provides direct feedback on the effectiveness of the medication in treating hepatic encephalopathy. Additionally, serum electrolytes should be monitored because lactulose can lead to electrolyte imbalances due to its laxative effect.

A. Ensure that the client eats breakfast. B. Provide a mid-afternoon snack for the client. C. Assess the client for hypoglycemia around 1500. D. Perform a glucometer reading at 1000.

Correct Answer is A

Explanation

A. Ensure that the client eats breakfast: Regular insulin is a fast-acting insulin that typically begins to work within 30 minutes to an hour after administration, peaks around 2-3 hours, and can last for up to 6 hours. Therefore, it is crucial that the client eats a meal, such as breakfast, shortly after the insulin is administered to prevent hypoglycemia.
B. Provide a mid-afternoon snack for the client: While snacks may be necessary depending on the client's overall meal and insulin schedule, it is more critical to ensure the client eats the meal immediately following insulin administration to manage blood glucose levels.
C. Assess the client for hypoglycemia around 1500: While monitoring for hypoglycemia is important, it is more critical to ensure the client eats their meal soon after insulin administration to prevent hypoglycemia in the first place.
D. Perform a glucometer reading at 1000: A glucometer reading at 1000 might be useful for monitoring blood glucose levels but ensuring that the client eats a meal promptly is a more immediate and critical action following insulin administration.

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Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

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Naxlex Comprehensive Predictor Exams

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the medication?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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