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) Administer aspirin: While administering aspirin is important in the management of acute angina to inhibit platelet aggregation, it is not the immediate priority. Aspirin helps prevent further clot formation but does not relieve the acute symptoms of angina.
B) Initiate IV access: Establishing IV access may be necessary for medication administration, but it should not be the first action taken when a client is experiencing acute angina. Immediate relief of chest pain is the priority.
C) Administer nitroglycerin: This is the first action the nurse should take. Nitroglycerin acts quickly to relieve angina by dilating coronary arteries, thus improving blood flow to the heart muscle. Relief of pain and ischemia is the immediate priority.
D) Measure blood pressure: While monitoring vital signs is crucial, especially in a client with cardiac issues, the most urgent intervention in the context of acute angina is pain relief. Blood pressure may be assessed after administering nitroglycerin since it can affect hemodynamics.
Correct Answer is A
Explanation
A)"Yourproviderwouldn'tprescribethismedicationifitweren'tnecessary.":Thisresponsereassurestheclientthatthemedicationisprescribedbasedonaprofessionalevaluationoftheirhealthneeds.Itemphasizestheimportanceofthemedicationwhilevalidatingtheprovider'sexpertiseanddecision-making.
B)"Iwilltellyourproviderthatyoudonotwanttotakethismedication.":Whileit'sessentialtocommunicatetheclient'sconcernstotheprovider,thisresponsemightsuggestthatthenurseisdismissingtheimportanceofthemedicationratherthanaddressingtheclient'sapprehensions.
C)"Ifyoudon'ttakethismedication,youwillfeelworse.":Thisstatementcancomeacrossasconfrontationalandmaynoteffectivelyaddresstheclient'sconcernsorhelpthemunderstandtheimportanceoftakingthemedication.
D)"Mostclientsfeelbetteraftertakingtheantibiotic.":Whilethisstatementmightbetrue,itissomewhatgenericanddoesn'tdirectlyaddresstheclient'sspecificconcernsortherationalebehindtheprescription.