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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?

A.

"I will store prefilled syringes in the refrigerator with the needle pointed downward."

B.

"I will shake the NPH vial vigorously before drawing up the insulin."

C.

"I will insert the needle at a 15-degree angle."

D.

"I will draw up the regular insulin into the syringe first."

Answer and Explanation

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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View Related questions

Correct Answer is B

Explanation

A) Increased urine output: This finding is more commonly associated with hyperglycemia and diabetic ketoacidosis, where the body attempts to excrete excess glucose through urine. In hypoglycemia, urine output is typically not increased.

B) Cold, clammy skin: This is a classic symptom of hypoglycemia. As blood sugar levels drop, the body releases adrenaline, which can cause sweating and result in cold, clammy skin. This finding directly supports the suspicion of hypoglycemia.

C) Acetone breath: This is associated with diabetic ketoacidosis, a complication of uncontrolled hyperglycemia. The presence of acetone on the breath indicates the breakdown of fat for energy, not a low blood sugar state.

D) Kussmaul respirations: These deep, labored breaths are typically seen in metabolic acidosis, particularly in diabetic ketoacidosis. They are not indicative of hypoglycemia.

Correct Answer is A

Explanation

A) "I can assist you with making a list of foods you like for the dietitian.": This statement encourages the client to take an active role in their dietary management by involving them in the process of planning their meals. It fosters collaboration and empowers the client to express their preferences, making it more likely they will adhere to the dietary recommendations.

B) "I understand that the dietary choices can seem overwhelming.": While this statement acknowledges the client's feelings, it does not actively promote their involvement in the care plan. It reflects empathy but lacks the encouragement needed for the client to engage in managing their diabetes.

C) "Managing your diabetes will require you to make accommodations.": This statement emphasizes the need for change but may come across as directive and could potentially discourage the client. It doesn't foster a sense of partnership in the decision-making process.

D) "The dietitian will provide you with the best food choices to manage your diabetes.": Although this statement highlights the dietitian's expertise, it places the responsibility solely on the dietitian and does not encourage the client to participate in their own dietary decisions. Engaging the client in the conversation is key to enhancing their motivation and compliance.

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