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 B
Explanation
A)"Iwilltrytolimitfoodsthatcontainsalt.":Limitingsaltintakeisimportantformanagingheartfailurebutdoesn'tspecificallyaddresstheadverseeffectsoffurosemide.Thisdiureticcancauseelectrolyteimbalances,butsaltrestrictionismorerelatedtooverallheartfailuremanagement.
B)"I'mgoingtoincludemorecantaloupeinmydiet.":Furosemidecancausepotassiumdepletion,andcantaloupeishighinpotassium.Increasingpotassium-richfoodsinthediethelpscounteractthisadverseeffect,indicatingtheclientunderstandstheneedtomaintainelectrolytebalance.
C)"IwillcheckmypulsebeforeItakethemedication.":Whilemonitoringheartratecanbeusefulinmanagingheartconditions,itisnotspecifictotheprimaryadverseeffectsoffurosemide.Thekeyconcernwiththismedicationisitsimpactonelectrolytesandfluidbalance.
D)"I'llcheckmybloodpressuresoitdoesn'tgettoohigh.":Furosemidetypicallylowersbloodpressure,sotheconcernwouldbehypotension(lowbloodpressure)ratherthanhypertension(highbloodpressure).Thisstatementdoesn’treflectanunderstandingoffurosemide’sprimaryadverseeffects.
Correct Answer is D
Explanation
A) 10: A score of 10 on the Glasgow Coma Scale (GCS) indicates a moderate level of impairment in consciousness. This score typically includes a range of responses in eye opening, verbal, and motor responses. Given the client's specific symptoms, this score does not accurately reflect their condition.
B) 13: A GCS score of 13 indicates mild impairment. This score usually requires the ability to open eyes spontaneously, follow commands, and exhibit appropriate verbal responses. Since the client is not opening their eyes and only making incomprehensible sounds, this score is not applicable.
C) 2: A score of 2 on the GCS would imply a severely compromised response, but it would be misleading since the client exhibits decerebrate posturing, which is a significant motor response indicating a level of neurological function. Thus, this score does not adequately represent the client's status.
D) 5: This is the correct score. The GCS includes a score of 1 for no eye opening, 2 for incomprehensible sounds, and 2 for decerebrate posturing. Adding these together (1 for eye opening + 2 for verbal + 2 for motor) results in a total of 5. This score reflects the severe impairment of consciousness and indicates the need for urgent medical evaluation and intervention.