A nurse prepares to administer prescribed regular and NPH ...

[MirandaLo]

A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse's actions in the correct order to administer these medications.
 
  1. Inspect bottles for expiration dates.
  2. Gently roll the bottle of NPH between the hands.
  3. Wash your hands.
  4. Inject air into the regular insulin.
  5. Withdraw the NPH insulin.
  6. Withdraw the regular insulin.
  7. Inject air into the NPH bottle.
  8. Clean rubber stoppers with an alcohol swab.
  a.
  1, 3, 8, 2, 4, 6, 7, 5
  b.
  3, 1, 2, 8, 7, 4, 6, 5
  c.
  8, 1, 3, 2, 4, 6, 7, 5
  d.
  2, 3, 1, 8, 7, 5, 4, 6

Question 2

A nurse reviews the medication list of a client recovering from a computed tomography (CT) scan with IV contrast to rule out small bowel obstruction. Which medication should alert the nurse to contact the provider and withhold the prescribed dose?
 
  a. Pioglitazone (Actos)
  b. Glimepiride (Amaryl)
  c. Glipizide (Glucotrol)
  d. Metformin (Glucophage)

[Expo]

Answer to Question 1

ANS: B
After washing hands, it is important to inspect the bottles and then to roll the NPH to mix the insulin. Rubber stoppers should be cleaned with alcohol after rolling the NPH and before sticking a needle into either bottle. It is important to inject air into the NPH bottle before placing the needle in a regular insulin bottle to avoid mixing of regular and NPH insulin. The shorter-acting insulin is always drawn up first.

Answer to Question 2

ANS: D
Glucophage should not be administered when the kidneys are attempting to excrete IV contrast from the body. This combination would place the client at high risk for kidney failure. The nurse should hold the metformin dose and contact the provider. The other medications are safe to administer after receiving IV contrast.