What specific administration techniques should the nurse employ when administering NPH insulin?
Never mix with another insulin.
Roll the vial gently to mix the suspension.
Only administer this insulin at bedtime.
When mixing with another insulin, draw the NPH into the syringe first.
The Correct Answer is B
Choice A Rationale:
NPH insulin can be mixed with certain other insulins, such as regular insulin, to achieve different effects and better control blood glucose levels. Therefore, stating that it should never be mixed with another insulin is incorrect.
Choice C rationale:
NPH insulin is an intermediate-acting insulin that can be administered at various times of the day, depending on the individual's needs and blood glucose patterns. It is not restricted to bedtime administration only.
Choice D rationale:
When mixing NPH insulin with another insulin, the order of mixing does not significantly affect its action. The crucial aspect is to ensure proper mixing of the insulins before administration.
Choice B rationale:
NPH insulin is a suspension, meaning the insulin particles are not fully dissolved in the liquid. Therefore, it's essential to roll the vial gently between the palms to evenly distribute the insulin particles throughout the solution. This ensures that the patient receives the correct dose and prevents injection of an uneven mixture, which could lead to unpredictable blood glucose levels.
Key points to remember:
NPH insulin is an intermediate-acting insulin that starts working within 1 to 2 hours, peaks in 4 to 12 hours, and lasts for 12 to 18 hours.
It can be mixed with regular insulin to provide both short-acting and longer-acting insulin coverage. Always follow the specific instructions provided by the insulin manufacturer and healthcare provider. Proper mixing of NPH insulin is crucial for accurate dosing and optimal glucose control.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale for Choice A:
Repeating the dose of nitroglycerin SL is not recommended at this time due to the patient's hypotension (blood pressure of 88/68 mmHg).
Administering additional nitroglycerin could further lower the blood pressure, potentially leading to adverse consequences such as dizziness, lightheadedness, or even fainting.
It's crucial to prioritize patient safety and avoid actions that could exacerbate their condition. Rationale for Choice B:
Notifying the provider is the most appropriate action in this situation for several reasons:
The patient's chest pain has not been relieved by the initial dose of nitroglycerin, indicating a need for further evaluation and potential adjustments to the treatment plan.
The patient's blood pressure is low, which warrants close monitoring and possible intervention to prevent complications.
The provider can assess the patient's overall clinical picture, including other symptoms and medical history, to determine the best course of action.
Early notification allows for timely interventions and potential prevention of further complications. Rationale for Choice C:
While nitroglycerin by translingual spray may be considered in some cases of persistent angina, it's not the most appropriate choice in this situation due to the patient's hypotension.
The translingual spray can also have a rapid onset of action, which might further lower the blood pressure if not carefully monitored.
It's essential to consider the patient's overall hemodynamic status before administering any medication that could potentially affect blood pressure.
Rationale for Choice D:
Administering NPH insulin is not relevant to the management of angina or chest pain.
Insulin is used to treat hyperglycemia in patients with diabetes, and its administration would not address the underlying issue of the patient's chest pain.
It's important to select interventions that are directly targeted at the patient's presenting symptoms and condition.
Correct Answer is C
Explanation
Choice A rationale:
Insulin glargine (Lantus) is a long-acting insulin that does not have any immediate effect on blood glucose levels. It is not typically a concern for patients undergoing CT scans with contrast.
However, it is important to monitor blood glucose levels closely in patients with diabetes who are receiving insulin therapy, as the contrast media used in CT scans can sometimes cause hyperglycemia.
Choice B rationale:
Acarbose (Precose) is an alpha-glucosidase inhibitor that works by slowing the absorption of carbohydrates from the intestines. This can help to reduce blood glucose levels after meals.
Acarbose is not typically a concern for patients undergoing CT scans with contrast. However, it is important to note that acarbose can sometimes cause gastrointestinal side effects, such as bloating, gas, and diarrhea. These side effects may be worsened by the contrast media used in CT scans.
Choice C rationale:
Metformin (Glucophage) is a biguanide that works by reducing glucose production in the liver and increasing insulin sensitivity in the muscles. It is a commonly used medication for the treatment of type 2 diabetes.
Metformin is a concern for patients undergoing CT scans with contrast because it can increase the risk of lactic acidosis. Lactic acidosis is a serious condition that can occur when there is a buildup of lactic acid in the blood. It can be caused by metformin, as well as by other factors such as dehydration, kidney problems, and liver problems.
The contrast media used in CT scans can also increase the risk of lactic acidosis. This is because the contrast media can sometimes cause kidney damage, which can impair the body's ability to remove lactic acid from the blood.
For this reason, metformin is typically discontinued for 48 hours before a CT scan with contrast. It is also important to ensure that patients are well-hydrated before and after the scan.
Choice D rationale:
Glipizide (Glucotrol) is a sulfonylurea that works by stimulating the release of insulin from the pancreas. It is a commonly used medication for the treatment of type 2 diabetes.
Glipizide is not typically a concern for patients undergoing CT scans with contrast. However, it is important to monitor blood glucose levels closely in patients with diabetes who are receiving sulfonylurea therapy, as the contrast media used in CT scans can sometimes cause hypoglycemia.
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