Question

16
100
prescriptions:

• insulin lispro:

○ 0 units 70 - 130
○ 2 units 131 - 180
○ 4 units 181 - 240
○ 6 units 241 - 300
○ 8 units 301 - 350
○ 10 units 351 - 400
○ over 400 administer 12 units and call primary health care provider
○ administer subcutaneous with meals.

• insulin glargine: 5 units subcutaneous at bedtime
• sevelamer: 800 mg by mouth three times daily with meals and prn for snacks
• renal vitamin: 1 tablet daily
• miconazole cream: apply under bilateral breasts at bedtime
• metoprolol succinate: 50 mg by mouth once daily

before answering this question, review the clients information in the ehr. identify the appropriate nursing actions. select one option in each row.
apply the miconazole cream under the breasts
check 2 patient identifies and client allegies
inject the insulin into the subcutaneous tissue of the abdomen
prepare to administer the clients metoprolol
provide breakfast to the client
continue

Explanation:

• Apply the miconazole cream under the breasts: Appropriate. Miconazole is an antifungal cream, and applying it under the breasts (a moist area prone to fungal infections) is a correct action.
• Check 2 patient identifiers and client allergies: Appropriate. This is a standard safety measure before any medical intervention (including applying cream, administering medications) to ensure the right patient and avoid allergic reactions.
• Inject the insulin into the subcutaneous tissue of the abdomen: Appropriate. The abdomen is a common and appropriate site for subcutaneous insulin injection.
• Prepare to administer the client's metoprolol: Appropriate. Metoprolol is prescribed (50 mg by mouth once daily), so preparing to administer it as per prescription is correct.
• Provide breakfast to the client: Inappropriate. Insulin Lispro is ordered to be administered with meals. If breakfast is provided without considering the insulin - meal timing (e.g., if the client has high blood sugar and insulin is given without food, it can cause hypoglycemia), it can lead to adverse effects. Also, there is no indication in the given prescriptions that breakfast provision is directly related to the ordered medications in a way that would make it an appropriate immediate action in this context.

Answer:

Action	Appropriate	Inappropriate
Check 2 patient identifiers and client allergies	○
Inject the insulin into the subcutaneous tissue of the abdomen	○
Prepare to administer the client's metoprolol	○
Provide breakfast to the client		○