Which assessment finding indicates that the patient is at high risk for development of pulmonary embolism?

Rationale for Choice A:

Mixing insulin detemir and insulin aspart in the same syringe is not recommended due to their differing physicochemical properties and potential for altered absorption and action profiles.

It's crucial to follow manufacturer guidelines, as mixing may lead to suboptimal glycemic control or unpredictable insulin activity.

Rationale for Choice B:

The order of mixing insulin detemir and insulin aspart, even if done incorrectly in the same syringe, would not significantly impact the overall contraindication of mixing them.

The primary concern remains the potential for altered pharmacodynamics and pharmacokinetics when these insulins are combined.

Rationale for Choice C:

Drawing up insulin aspart and insulin detemir in separate syringes is the correct procedure.

This approach ensures that each insulin maintains its intended action profile and absorption characteristics, leading to more predictable glycemic control.

It also aligns with best practices and guidelines for insulin administration.

Rationale for Choice D:

While drawing up insulin detemir first in a separate syringe is technically correct, it offers no specific advantage over drawing up insulin aspart first in a separate syringe.

The key principle is to avoid mixing the two insulins in the same syringe.

Choice A rationale:

Alopecia (hair loss) and diaphoresis (excessive sweating) can be side effects of certain medications, but they are not typically associated with allergic reactions.

Alopecia is often a delayed side effect of medications, meaning it can take weeks or months to develop after starting a medication. It is usually caused by the medication interfering with the normal hair growth cycle.

Diaphoresis can be a side effect of medications that affect the nervous system, such as antidepressants and anti-anxiety medications. It can also be a side effect of medications that cause fever, such as antibiotics.

Choice B rationale:

Heartburn and flatulence are common side effects of many medications, especially those that affect the digestive system.

Heartburn is a burning sensation in the chest that is caused by stomach acid refluxing back up into the esophagus. It is often triggered by eating certain foods, lying down after eating, or taking certain medications.

Flatulence is the release of gas from the intestines. It is often caused by eating foods that are difficult to digest, such as beans and cabbage. It can also be a side effect of medications that slow down the digestive system.

Choice C rationale:

Nausea and constipation are also common side effects of many medications.

Nausea is a feeling of sickness or unease in the stomach that can lead to vomiting. It is often caused by medications that irritate the stomach lining or that stimulate the vomiting center in the brain.

Constipation is a condition in which bowel movements are infrequent or difficult to pass. It is often caused by medications that slow down the movement of food through the intestines.

Choice D rationale:

Itchy rash and difficulty breathing are classic symptoms of an allergic reaction.

An allergic reaction occurs when the body's immune system overreacts to a substance that it perceives as a threat. This can cause a variety of symptoms, including itchy rash, difficulty breathing, swelling, hives, and anaphylaxis.

Itchy rash is a common symptom of allergic reactions to medications. It is often caused by the release of histamine, a chemical that is involved in the body's inflammatory response.

Difficulty breathing is a serious symptom of an allergic reaction that can be life-threatening. It is often caused by swelling of the airways, which can restrict airflow.