The supervising nurse is observing several different nurses. Which action will cause the supervising nurse to intervene?
a. A nurse administers a vaccine without aspirating.
b. A nurse gives an IV medication through a 22-gauge IV needle without blood return.
c. A nurse draws up the NPH insulin first when mixing a short-acting and intermediate-acting insulin.
d. A nurse calls the health care provider for a patient with nasogastric suction and orders for oral meds.
ANS: C
The supervising nurse must intervene with the nurse who is drawing up the NPH insulin first; if regular and intermediate-acting (NPH) insulin is ordered, prepare the regular insulin first to prevent the regular insulin from becoming contaminated with the intermediate-acting insulin. All the other actions are appropriate and do not need follow-up. The CDC no longer recommends aspiration when administering immunizations to reduce discomfort. In some cases, especially with a smaller gauge (22) IV needle, blood return is not aspirated, even if the IV is patent. If the IV site shows no signs of infiltration and IV fluid is infusing without difficulty, proceed with IV push slowly. Oral meds are contraindicated in patients with nasogastric suction.
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