SQ

A client is newly diagnosed with diabetes mellitus. The nurse identifies a nursing diagnosis of knowledge deficient related to new diagnosis and treatment needs. The most appropriate outcome statement based upon the established criteria is the following: 1.Client will perform glucose measurements often. 2. Client will appear less anxious regarding diagnosis. 3. Urinary output will reach normal young adult levels. 4.Client will independently perform subcutaneous insulin injection by 8/31.

4.Client will independently perform subcutaneous insulin injection by 8/31.

The health care provider orders 4 units of regular insulin and 10 units of NPH insulin subcutaneous before breakfast. The nurse draws the regular insulin into the syringe and is preparing to draw the NPH insulin into the same syringe. When finished, the syringe should contain _________ units.

ANS: 14

A client is started on etanercept (Enbrel). What teaching by the nurse is most appropriate? a. Giving subcutaneous injections b. Having a chest x-ray once a year c. Taking the medication with food d. Using heat on the injection site

a. Giving subcutaneous injections

The nurse is teaching a family member of an obese patient how to administer a subcutaneous U-100 insulin injection to the patient. Which instruction should be included in the teaching plan? a.Carefully massage the site after the injection to aid absorption. b.Draw the medication into a tuberculin syringe with a 27-gauge needle. c.Insert the needle quickly and firmly at a 90-degree angle. d.Rotate injection sites between the abdomen, thighs, and upper arms.

c.Insert the needle quickly and firmly at a 90-degree angle.

The nurse injects the medication into the loose connective tissue just under the dermis when giving a _____________ injection.

subcutaneous

The insulin order reads, "Check blood glucose levels before meals and at bedtime. For every 5 mg/dL over 150, give 1 unit of regular Humulin insulin, subcutaneously." The patient's blood glucose level at 11:30 ., before lunch, was 233 mg/dL. In units, identify how much insulin will the nurse give. _______

20 units

An elderly patient has had hip surgery and will be receiving heparin, 4000 units subcutaneously every 12 hours. The heparin is available in vials of 5000 units/mL. Calculate how much heparin the nurse will administer for this dose. _______

0.8 ML

The nurse is to administer epinephrine 0.3 mg subcutaneously. The ampule contains 1 mL of medication and is labeled "Epinephrine 1:1000." Identify how many milliliters of epinephrine will the nurse give. _______

ANS: 0.3 mL

A patient is to receive codeine, 40 mg subcutaneously, every 6 hours as needed for pain. The solution is available in a concentration of 30 mg/mL. Identify how many milliliters of codeine will be drawn up for this dose. (record answer to one decimal place) _______

ANS: 1.3 mL

The nurse is preparing a subcutaneous injection for a patient. The nurse is careful not to touch which part of the syringe or needle? (Select all that apply.) a.The needle hub b.The needle shaft c.The syringe outer barrel d.The needle bevel

a.The needle hub b.The needle shaft d.The needle bevel

The nurse is teaching a transgender client about the medication goserelin (Zoladex). What action by the client indicates good understanding? a. Takes a manual blood pressure b. Administers a subcutaneous injection c. Prepares an implanted port for IV insertion d. States that the axillary area will be clothed

b. Administers a subcutaneous injection

A student nurse is preparing to administer enoxaparin (Lovenox) to a client. What action by the student requires immediate intervention by the supervising nurse? a. Assessing the clients platelet count b. Choosing an 18-gauge, 2-inch needle c. Not aspirating prior to injection d. Swabbing the injection site with alcohol

b. Choosing an 18-gauge, 2-inch needle

The nurse will be injecting a drug into the fatty tissue of the patient's abdomen. Which route does this describe? a. Intradermal b. Subcutaneous c. Intramuscular d. Transdermal

b. Subcutaneous

The nurse is teaching a patient how to give a subcutaneous injection. The nurse includes which sites as acceptable for this route of administration? (Select all that apply.) a.Ventrogluteal area between the greater trochanter and the iliac crest b.Outer aspect of the upper arms c.Abdomen from below the costal margins to the iliac crests d.Anterior thighs

b.Outer aspect of the upper arms c.Abdomen from below the costal margins to the iliac crests d.Anterior thighs

. The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection? a. Using the Z-track method b. Inserting the needle at a 5- to 15-degree angle until resistance is felt c. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angled. d. Spreading the skin tightly over the injection site, inserting the needle, and then releasing the skin

c. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angled.

The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection? a. Using the Z-track method b. Inserting the needle at a 5- to 15-degree angle until resistance is felt c. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angled. D.Spreading the skin tightly over the injection site, inserting the needle, and then releasing the skin

c. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angled.

A patient has orders for 10 units of glargine (Lantus) insulin and 5 units of regular insulin to be given at the same time. Which action by the nurse is appropriate? a.Injecting 10 units of air into the glargine insulin vial first and not withdrawing the medication b.Injecting 5 units of air into the regular insulin vial first and then 10 units of air into the glargine insulin vial c.Giving two separate injections using different needles and syringes d.Withdrawing 5 units of regular insulin first and then calculating the total dose of regular and glargine insulin combined

c.Giving two separate injections using different needles and syringes

The nurse is teaching a patient about continuous subcutaneous infusion with an insulin pump. What should the nurse include in the teaching plan? a.Rotate the site every 1 to 2 days. b.Place a gauze dressing over the insertion site. c.Select an insertion site in the abdomen away from the waistline. d.Pull the skin laterally before inserting the needle.

c.Select an insertion site in the abdomen away from the waistline.

A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take? a. Apply ice to the site to reduce inflammation. b. Consult the provider for a new administration route. c. Assess the client for other signs of cellulitis. d. Instruct the client to rotate sites for insulin injection.

d. Instruct the client to rotate sites for insulin injection.

During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation? a. It neutralizes the extravasated dobutamine immediately. b. It causes arterial vasoconstriction and reduced pain and swelling at the site. c. It increases peripheral vascular resistance and reduces arterial pressure at the site. d. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

d. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

The nurse is administering an interferon and will implement which intervention? a. Giving the medication with meals b. Monitoring daily weights c. Limiting fluids while the patient is taking this medication d. Rotating sites if administered subcutaneously

d. Rotating sites if administered subcutaneously

When administering heparin subcutaneously, the nurse will follow which procedure? a. Aspirating the syringe before injecting the medication b. Massaging the site after injection c. Applying heat to the injection site d. using a 1/2 to 5/8 inch 25 to 28 gauge needle

d. using a 1/2 to 5/8 inch 25 to 28 gauge needle

The nurse is teaching a patient how to inject low-molecular-weight heparin. What instruction should be included in the teaching plan? a.The injection can be given in the abdomen or the upper thighs. b.Before injecting the medication, be sure to expel the air bubble in the syringe. c.After inserting the needle, pull back on the plunger of the syringe before injecting the medication. d.After injecting the medication, apply gentle pressure to the injection site for 30 to 60 seconds.

d.After injecting the medication, apply gentle pressure to the injection site for 30 to 60 seconds.