A nurse is providing teaching for a client who has diabetes mellitus about the self-administration of insulin. The client has prescriptions for regular and NPH insulins. Which of the following statements by the client indicates an understanding of the teaching?
"I will store prefilled syringes in the refrigerator with the needle pointed downward."
"I will shake the NPH vial vigorously before drawing up the insulin."
"I will insert the needle at a 15-degree angle."
"I will draw up the regular insulin into the syringe first."
The Correct Answer is D
A) "I will store prefilled syringes in the refrigerator with the needle pointed downward.": While prefilled syringes should be stored in the refrigerator, they should actually be stored with the needle pointing upward. This prevents the insulin from settling at the needle end and ensures that the insulin is readily available for injection. This statement reflects a misunderstanding of proper storage techniques.
B) "I will shake the NPH vial vigorously before drawing up the insulin.": NPH insulin should be gently rolled between the palms rather than shaken vigorously. Shaking can cause air bubbles and damage the insulin. This statement indicates a lack of understanding of the proper technique for preparing NPH insulin.
C) "I will insert the needle at a 15-degree angle.": The correct angle for injecting insulin is typically 90 degrees (or 45 degrees for thin clients), not 15 degrees. This statement shows a misunderstanding of proper injection technique.
D) "I will draw up the regular insulin into the syringe first.": This statement indicates an understanding of the proper technique for mixing insulins. When using both regular and NPH insulins, the regular insulin should always be drawn up first to prevent contamination of the short-acting insulin with the longer-acting insulin. This response reflects correct knowledge regarding insulin administration.
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View Related questions
Correct Answer is A
Explanation
A) Glycosylated hemoglobin level: The glycosylated hemoglobin (HbA1c) level is the most reliable indicator of long-term glycemic control in clients with diabetes mellitus. It reflects average blood glucose levels over the past 2 to 3 months, allowing healthcare providers to assess how well the treatment plan is working over time.
B) Oral glucose tolerance test results: The oral glucose tolerance test (OGTT) is primarily used for diagnosing diabetes rather than monitoring long-term control. It assesses how well the body processes glucose but does not provide an ongoing measure of glycemic control.
C) Postprandial blood glucose level: While monitoring postprandial blood glucose (the blood glucose level after meals) is important for managing daily glucose levels, it does not give a long-term perspective on glycemic control. This measurement can fluctuate significantly based on diet and activity levels.
D) Fasting blood glucose level: The fasting blood glucose level is useful for assessing daily glucose control, but it does not provide a comprehensive view of long-term glycemic management over months like the HbA1c level does.
Correct Answer is C
Explanation
A) 150 mL of serosanguineous drainage indicates a mixture of serum and blood, which can be expected in the immediate postoperative period. While it should be monitored, this amount is generally not alarming and typically does not require immediate reporting to the provider unless there are other concerning signs.
B) 200 mL of brown drainage may indicate the presence of old blood or bile, depending on the source. While this could warrant further assessment, it is not an immediate cause for concern in the first hour post-surgery, especially if the client is stable and has no other symptoms.
C) 100 mL of red drainage is concerning because bright red blood can indicate active bleeding. This finding is particularly alarming in the first postoperative hour, as it suggests that there may be a significant complication such as a hemorrhage or disruption of the surgical site. Immediate reporting to the provider is necessary to assess the need for intervention.
D) 75 mL of greenish-yellow drainage likely indicates bile or gastric contents. While it should be monitored, especially in the context of the type of surgery performed, this amount alone does not typically necessitate immediate reporting to the provider unless accompanied by other abnormal signs or symptoms.