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 C
Explanation
A) The client moves the cane 2 feet ahead.: Moving the cane 2 feet ahead is not appropriate, as the cane should be positioned close to the body to provide support. The cane is typically moved just ahead of the weaker leg to help with balance and support.
B) The client takes a step with their right foot first.: This action does not align with the recommended method for using a quad cane with left-sided weakness. The correct technique involves moving the cane and the weaker leg together, which helps maintain balance.
C) The client holds the cane with their left hand.: This action demonstrates an understanding of how to use a quad cane effectively. Holding the cane with the stronger hand (the right hand in this case) is generally recommended, but if the client has left-sided weakness and needs to use the cane for stability, they would typically hold it with their left hand to maintain balance while stepping with the right leg.
D) The client advances the weaker leg forward to the cane.: This action indicates a misunderstanding. The correct method involves advancing the cane first, followed by the weaker leg, to ensure proper support and balance.