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 D
Explanation
A)"Keeptheclient'sroomdarkatnighttopromotesleep.":Whilemaintainingadarkroomatnightcanhelpwithsleephygiene,individualswithAlzheimer'sdiseasebenefitfromconsistentroutinesandenvironmentsthathelpreduceconfusionandanxiety,notjustdarkness.
B)"Provideplentyofstimulationintheclient'sroom.":Whilesomestimulationisbeneficial,excessivestimulationcanoverwhelmsomeonewithAlzheimer'sdisease,leadingtoincreasedconfusionandagitation.
C)"Displayamonthlycalendarintheclient'sroom.":Amonthlycalendarmightbetoocomplexandoverwhelming.SimplercueslikedailyschedulesaremoreeffectiveforsomeonewithAlzheimer'sdisease.
D)"Providetheclientwithstructuredactivitiestofilltheirtime.":Structuredactivitiescanhelpmaintaintheclient'scognitivefunctionsandprovideasenseofroutine,whichisessentialforreducinganxietyandpromotingasenseofnormalcy.
Correct Answer is B
Explanation
A) Epinephrine: Epinephrine is primarily used in emergencies for conditions such as anaphylaxis or cardiac arrest. It would not be indicated for managing thirst or urinary output
in this context.
B) Desmopressin: This medication is a synthetic vasopressin analog used to treat diabetes insipidus, which can result from brain injuries affecting the hypothalamus or pituitary gland. Given the client's significant urinary output of 4,000 mL, which suggests possible diabetes insipidus, desmopressin is the most appropriate medication to address the excessive urination and thirst.
C) Nitroprusside: Nitroprusside is a potent vasodilator used to manage acute hypertension. It is not relevant to the symptoms described and would not help in managing thirst or urinary output issues.
D) Furosemide: Furosemide is a diuretic that would increase urinary output rather than decrease it. Since the client is already experiencing high urinary output, furosemide would not be appropriate.