Insulin Preparation and Administration Practices

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Questions and Answers

What is the purpose of drawing back air equal to the dose of unmodified insulin into the syringe?

To create a positive pressure in the vial.

To prevent contamination of the medication.

To ensure a larger withdrawal of insulin.

To prevent the formation of a partial vacuum. (correct)

Why is it important to check for air bubbles in the syringe after withdrawal?

Air bubbles would result in an inaccurate dose of medication. (correct)

Air bubbles indicate contamination.

Air bubbles make the syringe difficult to handle.

Air bubbles can alter the medication's efficacy.

What should be done before injecting air into the unmodified insulin vial?

Shake the vial to ensure the insulin is mixed.

Discard the cap of the vial.

Pierce the rubber stopper with the needle. (correct)

Invert the vial to check for air bubbles.

What is the recommended order of drawing medications when using a single-dose vial and a multidose vial?

Draw from the multidose vial first. Signup and view all the answers

Why should the vial of unmodified insulin be held on a flat surface when preparing to withdraw medication?

To ensure accurate measurement and prevent contamination. Signup and view all the answers

What is the significance of holding the syringe at eye level when withdrawing medication?

It facilitates accurate reading and air bubble removal. Signup and view all the answers

Which practice is recommended to prevent contamination when accessing a multidose vial?

Clean the top of the vial before each entry. Signup and view all the answers

Which of the following insulins cannot be mixed with other insulins?

Lantus. Signup and view all the answers

What should be done if two incompatible medications are mixed in one syringe?

Discard the mixture and prepare separately. Signup and view all the answers

What should be done after drawing the prescribed amount of medication into the syringe?

Recheck the dosage and discard any surplus. Signup and view all the answers

Which of the following medications is known to be incompatible with other drugs in the same syringe?

Diazepam (Valium). Signup and view all the answers

How many checks are generally recommended before administering medication to prevent errors?

Three checks ensure accuracy. Signup and view all the answers

What is the safest practice when combining more than two drugs in one syringe?

Consult the pharmacist for compatibility. Signup and view all the answers

What is the consequence of not injecting enough air into the vial before withdrawing unmodified insulin?

It could lead to incorrect dosage due to vacuum creation. Signup and view all the answers

How are insulin dosages typically calculated?

In units on a U100 scale. Signup and view all the answers

When mixing insulin types, why is it important to be aware of their onset and duration of action?

To ensure food is available when needed. Signup and view all the answers

What is the purpose of comparing the medication order against the original order in the medical record?

To identify transcription errors Signup and view all the answers

Why is it important for a nurse to know the actions and adverse effects of medications being administered?

To evaluate therapeutic effects related to the patient's disorder Signup and view all the answers

What is the primary reason for performing hand hygiene in a clinical setting?

To prevent the spread of microorganisms Signup and view all the answers

When should the medication cart be locked?

When not in use Signup and view all the answers

What is the significance of preparing medications for one patient at a time?

It prevents errors in medication administration Signup and view all the answers

What should be done after reading the CMAR/MAR and selecting the proper medications?

Compare the labels with the CMAR/MAR Signup and view all the answers

Why should a nurse verify calculations with another nurse if dosage calculations are necessary?

To ensure accuracy and safety in medication administration Signup and view all the answers

What does entering the pass code and scanning the employee identification safeguard?

Patient's medication supply Signup and view all the answers

What should be done to the rubber tops of the vials before injection?

Cleanse them with antimicrobial swabs Signup and view all the answers

Why is it important to allow the alcohol to dry after cleansing the vial top?

To prevent alcohol from entering the vial on the needle Signup and view all the answers

What is the preferred method for mixing a medication that is a suspension, like NPH insulin?

Roll and agitate the vial Signup and view all the answers

What is the significance of injecting an equal amount of air into the vial before withdrawing medication?

To prevent a partial vacuum Signup and view all the answers

What should be avoided when injecting air into a modified insulin vial?

Allowing the needle to contact the insulin Signup and view all the answers

How should the cap of the needle be removed to prevent needlestick injuries?

Pull it off straight Signup and view all the answers

What is the primary reason for drawing back air into the syringe before withdrawing medication?

To ensure the correct dose is withdrawn Signup and view all the answers

What is the recommended surface for holding a modified insulin vial during the injection process?

A flat surface Signup and view all the answers

Which personnel are typically not allowed to prepare medication from two vials?

Nursing assistive personnel Signup and view all the answers

What must be assessed before preparing insulin from two vials?

Compatibility of the insulins Signup and view all the answers

What characterizes unmodified preparations of insulin?

They appear as clear substances. Signup and view all the answers

What is essential to verify before administering insulin?

Patient's name, dose, route, and time Signup and view all the answers

Which nursing diagnosis relates to insufficient knowledge regarding medication administration?

Deficient Knowledge Signup and view all the answers

What must be checked regarding the medication before administration?

The expiration date Signup and view all the answers

What is the first action in the implementation phase when preparing medication?

Gather equipment Signup and view all the answers

What is a critical consideration when delegating medication preparation to LPN/LVNs?

Patient's needs and qualifications of the delegate Signup and view all the answers

What should be done to prevent contamination when accessing a multidose vial?

Use a new needle and syringe for each entry Signup and view all the answers

Which of the following medications is an example of one that cannot be mixed with others in the same syringe?

Diazepam Signup and view all the answers

What is the recommended maximum number of medications to mix in one syringe?

Two Signup and view all the answers

Before administering insulin, what must be ensured regarding the medication's effects?

Proper food is available Signup and view all the answers

What is involved in ensuring drug compatibility when preparing medications?

Consulting a drug-compatibility table Signup and view all the answers

For insulin, which of the following statements is incorrect?

Lantus can be mixed with other insulins. Signup and view all the answers

Why is it suggested to clean the top of medication vials before each entry?

To reduce the risk of contamination Signup and view all the answers

What should be done if a medication appears cloudy or forms a precipitate in the syringe?

Discard the medication and prepare it again Signup and view all the answers

What is the role of the cap on a vial before medication withdrawal?

It shields the rubber top from surface bacteria. Signup and view all the answers

What should be done when preparing a suspension medication such as NPH insulin?

Roll and agitate the vial according to protocol. Signup and view all the answers

Why is it important to cleanse the rubber tops with antimicrobial swabs?

To remove any surface bacteria contamination. Signup and view all the answers

How does injecting an equal amount of air into the vial before withdrawing medication benefit the process?

It prevents the formation of a partial vacuum. Signup and view all the answers

Which is a critical practice to prevent contamination when injecting from a modified insulin vial?

Injecting air before any fluid is withdrawn. Signup and view all the answers

What precaution should be taken when removing the needle cap?

Pull the cap straight off to avoid needlestick injuries. Signup and view all the answers

Which practice is recommended after cleaning the rubber top of a vial?

Wait for the alcohol to dry to prevent contamination. Signup and view all the answers

What is the correct method for injecting air into a modified insulin vial?

Inject air before inserting the needle into the solution. Signup and view all the answers

What is the significance of knowing the therapeutic effects of medications before administration?

It aids in evaluating the medication's effectiveness for the patient's condition. Signup and view all the answers

Why is it important to prepare medications for one patient at a time?

It prevents confusion and potential medication errors. Signup and view all the answers

What is the primary purpose of performing hand hygiene in a clinical setting?

To prevent the spread of microorganisms. Signup and view all the answers

What action should be taken to safeguard medications in the cart?

Allow only authorized personnel to access the cart. Signup and view all the answers

What is the first step taken when preparing medications for administration?

Hand hygiene is performed. Signup and view all the answers

How does comparing the medication label with the CMAR/MAR contribute to medication safety?

It serves as a primary check against ordering errors. Signup and view all the answers

What is the rationale behind entering a pass code and scanning employee identification?

It identifies users for documentation and security purposes. Signup and view all the answers

What is the purpose of verifying calculations with another nurse if dosage calculations are necessary?

To ensure the accuracy and safety of medication dosages. Signup and view all the answers

What is the purpose of drawing the prescribed amount of medication while holding the syringe vertically?

To facilitate accurate measurement Signup and view all the answers

Why is it important to recap the needle carefully after withdrawing the medication?

To avoid accidental needlesticks Signup and view all the answers

What should be done before taking the medication to the patient after withdrawal?

Recheck the label with the Medication Administration Record (MAR) Signup and view all the answers

Which of the following is a recommended practice when handling a multi-dose vial?

Recap the needle with one hand cautiously Signup and view all the answers

What is a critical aspect to check during the third verification of medication administration?

The patient's identification Signup and view all the answers

Why is it necessary to label vials with the date and time opened?

To comply with facility policies Signup and view all the answers

What should be done immediately after drawing up the prescribed medication?

Check the amount in the syringe Signup and view all the answers

After ensuring all procedures are followed, when should the final check of the medication occur?

At the bedside, before patient interaction Signup and view all the answers

What is the primary responsibility of the nurse before delegating medication preparation from two vials?

Analyzing the patient’s needs and circumstances Signup and view all the answers

Which scenario indicates a potential risk when preparing insulin from two vials?

Mixing Lantus with Levemir Signup and view all the answers

What is a characteristic of modified preparations of insulin?

They appear as suspensions and not clear Signup and view all the answers

Which of the following actions is NOT a critical assessment before preparing medication from two vials?

Verifying the drug cost Signup and view all the answers

What must be assessed to ensure patient safety before administering insulin?

The patient's blood glucose level Signup and view all the answers

How should the preparation of medication be handled to avoid infection?

With accurate withdrawal into a sterile syringe Signup and view all the answers

Which medical record documentation is used to track medication administration?

Medication Administration Record (MAR) Signup and view all the answers

What is NOT an appropriate nursing diagnosis related to medication administration?

Risk for Falls Signup and view all the answers

Study Notes

Medication Preparation in One Syringe

When preparing medications from a single-dose vial and a multidose vial, draw the medication from the multidose vial first to prevent contamination.
The CDC recommends assigning multidose vials to a single patient whenever possible.
Clean the top of the vial before each entry and use a new sterile needle and syringe for each entry.
Ensure drug compatibility when mixing medications in one syringe.
Diazepam (Valium) is incompatible with other drugs in the same syringe.
Mixing more than two drugs in one syringe is not recommended. Consult a pharmacist for compatibility information.

Insulin Administration

There are various types of insulin; some can be mixed for injection.
Be aware of the onset time, peak, and duration of effects for each type of insulin.
Lantus and Levemir cannot be mixed with other insulins.
Insulin dosages are measured in units on a U100 scale, which is based on 100 units of insulin per mL of solution.

Delegation Considerations

Preparing medication from two vials is not delegated to nursing assistive personnel (NAP) or unlicensed assistive personnel (UAP).
Delegation to a Licensed Practical/Vocational Nurse (LPN/LVN) depends on the state's nurse practice act and organizational policies.

Equipment

Two vials of medication (insulin in this example)
Sterile syringe (insulin syringe in this example)
Antimicrobial swabs
Computer-generated Medication Administration Record (CMAR) or Medication Administration Record (MAR)

Nursing Diagnosis

Risk for Infection
Deficient Knowledge
Risk for Injury

Outcome Identification and Planning

Ensure accurate and sterile withdrawal of medication into a syringe.
Prepare the correct dosage.

Implementation

Gather supplies and verify medication orders against the original order in the medical record.
Assess the medication, including its actions, nursing considerations, safe dose ranges, purpose of administration, and adverse effects.
Perform hand hygiene to prevent the spread of microorganisms.
Organize medication administration to prevent errors and save time.
Unlock the medication cart or drawer and enter a pass code to ensure medication safety and security.
Prepare medication for one patient at a time.
Read the CMAR/MAR and select the proper medications.
Compare medication labels with the CMAR/MAR and perform dosage calculations.
Cleanse the rubber tops of vials with antimicrobial swabs.
Draw back an amount of air into the syringe equal to the dose of medication.
If medication is a suspension, roll and agitate the vial to mix well.
Involve a second nurse to verify calculations for safety.
Check the amount of medication in the syringe against the prescribed dose.
Conduct a third check of the label for accuracy before administering the medication.
Label vials with the date and time opened for future use.

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Description

Test your knowledge on best practices for preparing and administering unmodified insulin. This quiz covers important steps such as air injection, withdrawal techniques, and contamination prevention. Ensure you're well-prepared for safe medication handling.