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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Correct Answer is A
Explanation
A) Remove one of the weights: This is the appropriate action. If the weights are resting on the floor, it indicates that the traction is ineffective, and removing one weight may be necessary to restore proper traction. However, the nurse should first verify the prescribed amount of weight with the healthcare provider before making adjustments.
B) Pull the client up in bed: While it may be necessary to reposition the client, pulling them up in bed does not address the issue of the weights resting on the floor and could potentially cause discomfort or injury.
C) Increase the elevation of the affected extremity: While elevating the extremity may be beneficial for swelling or comfort, it does not resolve the issue of ineffective traction caused by the weights on the floor.
D) Tie knots in the ropes near the pulleys to shorten them: This action is inappropriate. Tying knots in the ropes could interfere with the proper function of the traction system and is not a safe or effective solution to the problem.
Correct Answer is ["A","B","C"]
Explanation
A) Chronic infections of the middle ear: Chronic middle ear infections can lead to damage of the structures within the ear, resulting in conductive hearing loss. This is a significant risk factor for hearing loss, particularly in children and young adults.
B) Use of a loop diuretic: Loop diuretics, such as furosemide, can be ototoxic, especially at high doses or when used in conjunction with other ototoxic medications. This can result in hearing loss, making this a relevant risk factor to discuss.
C) Perforation of the eardrum: A perforated eardrum can lead to conductive hearing loss and increase the risk of infections, which may further compromise hearing. It is essential to include this in the discussion of risk factors for hearing loss.
D) Born with a high birth weight: High birth weight alone is not a recognized risk factor for hearing loss. While certain conditions associated with high birth weight may impact hearing, it is not a direct factor.
E) Frequent exposure to low-volume noise: Low-volume noise exposure is typically not a risk factor for hearing loss. It is the exposure to loud noise over time that poses a greater risk. Therefore, this factor should not be included in the teaching.