Patient Data
The nurse should base insulin lispro administration on the client's anticipated intake of carbohydrates. The tray has not yet arrived in the room.
For each nursing action below, click to specify if the action is indicated, contraindicated or nonessential. Each row must have one option selected.
Give insulin lispro 4 units
Restart the IV fluids until the tray arrives
Give insulin glargine 12 units
Mix the insulin lispro and insulin glargine in one syringe
Verify that the client intake matches the carbohydrate count
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}
Give insulin lispro 4 units: Administering insulin lispro before the meal tray arrives is contraindicated because it can cause hypoglycemia if the client does not eat immediately. Insulin lispro should be given based on the exact carbohydrate intake, which cannot be determined until food is present.
Restart the IV fluids until the tray arrives: Restarting the IV fluids is indicated because it helps maintain hydration, especially important for a client with hyperglycemia and recent surgery. Fluids support perfusion and protect against dehydration while waiting for the client's nutritional intake to resume.
Give insulin glargine 12 units: Giving insulin glargine now is contraindicated because the client already received her scheduled dose earlier in the morning before surgery. Re-administering it could cause insulin stacking and dangerously low blood sugar later.
Mix the insulin lispro and insulin glargine in one syringe: Mixing insulin lispro and insulin glargine together is contraindicated because glargine is designed to maintain a stable, long-acting release. Mixing it can alter its absorption profile, making it unsafe to combine in the same syringe.
Verify that the client intake matches the carbohydrate count: This action is indicated because insulin lispro is prescribed to match the carbohydrate content of meals. Verifying the number of carbohydrates ensures the correct lispro dose is administered and helps prevent dosing errors and hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Schedule the medication to be given just before bedtime: Pyridostigmine should be timed to coincide with periods of increased activity, especially before meals, to improve muscle strength. Giving it at bedtime would not offer functional benefit unless the client experiences nighttime symptoms.
B. Break the medication into small pieces and sprinkle onto food: Pyridostigmine tablets are not designed to be crushed or split unless specifically directed. Altering the form may affect its absorption and reduce its effectiveness in managing symptoms of myasthenia gravis.
C. Instruct the client to avoid dairy products for at least 30 minutes: Dairy does not interfere significantly with the absorption or action of pyridostigmine. Dietary restrictions should be based on known drug-food interactions, which are not typically associated with pyridostigmine and dairy.
D. Administer the medication thirty minutes prior to meals: Administering pyridostigmine before meals helps enhance swallowing and chewing abilities, reducing the risk of aspiration. This timing optimizes muscle strength during eating, which is a high-risk activity for clients with myasthenia gravis.
Correct Answer is C
Explanation
A. Notify the healthcare provider: Notification of the healthcare provider is not immediately necessary just because of a meal delay. The nurse can manage the situation appropriately by adjusting the medication timing to ensure patient safety without requiring immediate provider involvement.
B. Administer the medication: Acarbose should be taken with the first bite of food to effectively delay carbohydrate absorption. Administering it without food available increases the risk of hypoglycemia, especially since the glucose level is already slightly elevated but within a manageable range.
C. Hold the medication until the meal trays arrive: Acarbose must be taken with the first mouthful of food to match the timing of glucose absorption. Holding the medication until the meal arrives ensures optimal therapeutic effect and prevents unnecessary hypoglycemia.
D. Obtain another finger stick blood glucose level: Rechecking the blood glucose is unnecessary at this time. The primary concern is coordinating the medication with food intake, not monitoring glucose trends over a short 30-minute delay.
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