A hospital client with type 1 diabetes requires the ...

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A hospital client with type 1 diabetes requires the administration of 4 units of regular (short-acting) insulin and 12 units of NPH (long-acting) insulin. The nurse knows to combine these two types of insulin immediately before administration.
 
  What is the rationale for the nurse's action? A) Leaving the insulins combined for too long reduces the individual characteristics of each
  B) Having the insulins remain combined in the syringe increases the likelihood that precipitates will form
  C) Combining the insulins for an extended period is associated with the growth of microorganisms in the syringe
  D) Having the insulins combined for more than 15 minutes can cause cytotoxic effects (cell death) after administration

Question 2

An 81-year-old client has been admitted to the hospital during an exacerbation of chronic heart failure that has resulted in peripheral edema and hypervolemia. This client's fluid volume could be best reduced by which of the following methods?
 
  A) Performing therapeutic phlebotomy (removal of a quantity of blood)
  B) Positioning the patient with her limbs in a dependent position
  C) Administering an IV solution that is rich in potassium
  D) Administering drugs that increase urine production

[AISCAMPING]

Answer to Question 1

A
Feedback:
When mixed together, insulins tend to bind and become equilibrated. This means that the unique characteristics of each are offset by those of the other. For this reason, most types of insulin are combined just before administration. Combining insulins too early does not create a risk of precipitate formation, infection, or cytotoxicity.

Answer to Question 2

D
Feedback:
Diuresis is a common method of reducing fluid volume. This is not normally accomplished through phlebotomy. Potassium solutions and repositioning do not resolve hypervolemia.

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