History and Physical

The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes and no other significant medical histor The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.

For each nursing action below, click to specify if the action is indicated, contraindicated or non-essential.

Choice A rationale: Non-steroidal anti-inflammatory drugs (NSAIDs) are a different class of
medications commonly used to relieve pain, inflammation, and reduce fever. They are not used
for treating hypertension or acting as ACE inhibitors.
Choice B rationale: Angiotensin II receptor blockers (ARBs) are another class of
antihypertensive medications that work by blocking the action of angiotensin II, a hormone that
causes blood vessels to constrict. While ARBs are similar in function to ACE inhibitors in
managing blood pressure, captopril specifically belongs to the ACE inhibitor class.
Choice C rationale: Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE
inhibitors are a class of antihypertensive medications that work by inhibiting the enzyme ACE,
which converts angiotensin I to angiotensin II. By inhibiting this conversion, ACE inhibitors
help relax and dilate blood vessels, leading to decreased blood pressure. They are commonly
used to treat hypertension and other cardiovascular conditions.
Choice D rationale: Aldosterone antagonists are a different class of medications used to block the
action of aldosterone, a hormone that regulates sodium and water balance in the body. They are
used to manage conditions such as heart failure and hypertension but are not synonymous with ACE inhibitors like captopril.

Choice A rationale: This is essential to ensure that the insulin is not discolored or cloudy, as these changes could indicate a problem with the insulin's stability or effectiveness.
Choice B rationale: While it is essential to have a complete history and physical for proper patient care, double-checking this with another nurse is not necessary in the immediate administration of insulin lispro.
Choice C rationale: Double-checking the dose of insulin in the syringe is crucial to avoid medication errors and ensure that the correct amount is being administered to the patient.
Choice D rationale: The sliding scale order is not mentioned in the information provided, and since it is not part of the immediate insulin administration, it does not need to be double-checked in this context.
Choice E rationale: Checking the expiration date is necessary to ensure that the insulin is still within its usable period. Using expired insulin can lead to reduced potency and potentially ineffective blood sugar control.
Choice F rationale: The information provided in the nurse's notes does not indicate that insulin administration is due at a specific site (e.g., subcutaneous injection). Therefore, there is no need for a second nurse to double-check the site at this moment. However, it's important for the administering nurse to choose the appropriate site following the facility's guidelines and rotate injection sites to prevent lipodystrophy.

Choice G rationale: Different types of insulin come in different concentrations (e.g., U-100, U-200). It's important to confirm that the correct concentration is being used to ensure accurate dosing.
Choice H rationale: The nurse should verify that the insulin to be administered is indeed insulin lispro, as indicated in the medication order. Administering the wrong type of insulin can have significant implications for the patient's blood sugar control.