A client has a prescription for NPH insulin 25 units before breakfast and insulin aspart before meals and hour of sleep per sliding scale. The sliding scale parameters are:. 0 units for finger stick glucose less than 170 mg/dL;. 5 units for finger stick glucose 171 to 219 mg/dL;. 10 units for finger stick glucose 220 to 269 mg/dL;. 15 units for finger stick glucose 270 to 300 mg/dL.
Call healthcare provider for finger stick glucose greater than 300 mg/dL. The client's 0730 finger stick glucose is 271 mg/dL. What is the total amount of insulin this client should receive? (Enter numeric value only.).
The Correct Answer is ["40"]
The client’s 0730 finger stick glucose is 271 mg/dL. According to the sliding scale parameters, the client should receive:
Step 1: Determine the amount of insulin aspart based on the sliding scale. Since the glucose level is 271 mg/dL, which falls in the range of 270 to 300 mg/dL, the client should receive 15 units of insulin aspart.
Step 2: Add the amount of NPH insulin to the amount of insulin aspart. The client has a prescription for NPH insulin 25 units before breakfast. So, the total amount of insulin this client should receive is 25 units (NPH insulin) + 15 units (insulin aspart) = 40 units.
So, the total amount of insulin this client should receive is 40 units.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A thready pulse is a weak and rapid pulse that is easily obliterated by light pressure. It indicates poor blood flow and perfusion, and may be caused by conditions such as shock, dehydration, or hemorrhage.
The other options are not correct because:
- A missing pulse is a pulse that is absent or cannot be detected, even with firm pressure. It indicates a complete blockage of blood flow, and may be caused by conditions such as arterial occlusion, embolism, or trauma.
- Light pressure applied to pulse is not a documentation of the pulse quality, but a description of the technique used to palpate the pulse.
- Pulse skips beats is a documentation of an irregular pulse rhythm, not a pulse volume. It indicates that the heart beats are unevenly spaced, and may be caused by conditions such as arrhythmia, stress, or caffeine intake.
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Correct Answer is B
Explanation
The infant has hypoglycemia, which is a low blood glucose level that can cause jitteriness, lethargy, seizures, or coma. Hypoglycemia is common in infants of mothers with gestational diabetes, as they produce excess insulin in response to high maternal glucose levels. The PN should begin frequent feedings of breast milk or formula, as this can provide a source of glucose and stimulate the infant's own glucose production.
The other options are not correct because:
A. Offering nipple feedings of 10% dextrose may be indicated in some cases of severe hypoglycemia, but it is not the first intervention. The PN should try oral feedings of breast milk or formula first, as they are more natural and less invasive.
C. Repeating the heel stick for glucose in one hour may be necessary to monitor the infant's glucose level, but it is not the first intervention. The PN should treat the hypoglycemia first, as it can have serious consequences if left untreated.
D. Assessing for signs of hypocalcemia may be important, as hypocalcemia is another possible complication in infants of mothers with gestational diabetes, but it is not the first intervention. The PN should address the hypoglycemia first, as it is more urgent and more likely to cause jitteriness.
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