The nurse is caring for a client who is refusing to take their prescribed metformin (Glucophage). The nurse understands that the most common side effects of metformin are:

Choice A reason: This is incorrect. Reviewing the patient’s previous blood glucose levels may not be helpful in determining the correct dose of insulin, as the blood glucose level can fluctuate depending on various factors, such as food intake, activity, stress, and illness. The previous blood glucose levels may not reflect the current insulin needs of the patient¹.

Choice B reason: This is incorrect. No review is not an option before administering insulin, as insulin is a highalert medication that can cause serious harm if given incorrectly. The nurse should always check the patient’s blood glucose level, the insulin order, the insulin type, the insulin dose, the insulin expiration date, and the insulin injection site before giving insulin.

Choice C reason: This is correct. Reviewing the Regular insulin sliding scale for administration in the patient’s electronic medical record is the best action to determine the correct dose of insulin. A sliding scale is a chart of insulin dosages based on blood glucose level and mealtime. It is used to adjust the insulin dose according to the patient’s blood glucose level and insulin sensitivity. The nurse should follow the sliding scale protocol and verify the insulin dose with another nurse before administering it.

Choice D reason: This is incorrect. Reviewing the patient’s previous insulin administration doses may not be helpful in determining the correct dose of insulin, as the insulin dose may vary depending on the patient’s blood glucose level and insulin sensitivity. The previous insulin doses may not reflect the current insulin needs of the patient¹.

Choice A reason: Monitor the patient for addiction is not a necessary measure for the nurse to take when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Codeine is a Schedule V medication, which means that it has a low potential for abuse and dependence compared to other opioids. The nurse should follow the prescriber's order and the label instructions and use the lowest effective dose for the shortest duration. The nurse should also assess the patient's pain level, respiratory status, and cough frequency and severity.

Choice B reason: Advise the patient that the medication helps to thin out their secretions is an incorrect statement for the nurse to make when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Codeine does not affect the viscosity or production of the mucus in the airways, but rather reduces the urge to cough. The nurse should advise the patient to drink plenty of fluids, use a humidifier, or use saline nasal spray to help loosen and clear the secretions.

Choice C reason: Advise the patient to minimize intake of beets is not a relevant measure for the nurse to take when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Beets are a vegetable that are rich in antioxidants, fiber, and nitrates, which can lower blood pressure and improve blood flow. Beets do not interact with codeine or affect its metabolism or clearance. The nurse should encourage the patient to eat a balanced and nutritious diet, unless they have any dietary restrictions or allergies.

Choice D reason: Advise the patient that constipation is an adverse effect of the medication is the correct and appropriate measure for the nurse to take when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Codeine can also act on the opioid receptors in the gastrointestinal tract, which can reduce the peristalsis and cause constipation. The nurse should advise the patient to prevent or treat constipation by increasing their fluid and fiber intake, exercising regularly, and using laxatives or stool softeners as needed.