A nurse prepares to administer insulin to a client at 1800. The ...

[washai]

A nurse prepares to administer insulin to a client at 1800. The client's medication administration record contains the following information:
 
  - Insulin glargine: 12 units daily at 1800
  - Regular insulin: 6 units QID at 0600, 1200, 1800, 2400
  Based on the client's medication administration record, which action should the nurse take?
  a.
  Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin.
  b.
  Draw up and inject the insulin glargine first, wait 20 minutes, and then draw up and inject the regular insulin.
  c.
  First draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together.
  d.
  First draw up the dose of insulin glargine, then draw up the dose of regular insulin in the same syringe, mix, and inject the two insulins together.

Question 2

A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis:
 
  Vital Signs and Assessment
  Laboratory
  Results
 
  Medications
  Blood pressure: 90/62 mm Hg
  Pulse: 120 beats/min
  Respiratory rate: 28 breaths/min
  Urine output: 20 mL/hr via catheter
  Serum potassium: 2.6 mEq/L
  Potassium chloride 40 mEq IV bolus STAT
  Increase IV fluid to 100 mL/hr
  Which action should the nurse take?
  a.
  Administer the potassium and then consult with the provider about the fluid order.
  b.
  Increase the intravenous rate and then consult with the provider about the potassium prescription.
  c.
  Administer the potassium first before increasing the infusion flow rate.
  d.
  Increase the intravenous flow rate before administering the potassium.

[fauacakatahaias]

Answer to Question 1

ANS: A
Insulin glargine must not be diluted or mixed with any other insulin or solution. Mixing results in an unpredictable alteration in the onset of action and time to peak action. The correct instruction is to draw up and inject first the glargine and then the regular insulin right afterward.

Answer to Question 2

ANS: B
The client is acutely ill and is severely dehydrated and hypokalemic. The client requires more IV fluids and potassium. However, potassium should not be infused unless the urine output is at least 30 mL/hr. The nurse should first increase the IV rate and then consult with the provider about the potassium.

[washai]

Excellent

[samiel-sayed]

Gracias!