A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?
NPH insulin
Insulin glargine
Insulin detemir
Regular Insulin
The Correct Answer is D
A. NPH insulin: NPH insulin, also known as Neutral Protamine Hagedorn, is an intermediate acting insulin. It has a slower onset of action and a longer duration compared to regular insulin. It is not the best choice for treating diabetic ketoacidosis (DKA) because it does not act quickly enough to lower dangerously high blood glucose levels in this acute situation.
B. Insulin glargine: Insulin glargine is a long-acting basal insulin. It has a slow, steady release and provides a consistent level of insulin over an extended period. Like NPH insulin, it is not suitable for rapidly lowering blood glucose levels in a DKA emergency.
C. Insulin detemir: Insulin detemir is another long-acting basal insulin similar to glargine. It has a slow onset and provides a sustained release of insulin. It is not the first-line choice for treating DKA due to its slower action.
D. Regular Insulin: Regular insulin, also known as short-acting or fast-acting insulin, has a rapid onset of action. When administered intravenously, it can quickly lower blood glucose levels. This makes it the preferred choice for treating diabetic ketoacidosis (DKA) where prompt action is essential to correct the severe hyperglycemia and associated metabolic imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Take thyroid replacement medication, as ordered. This is crucial for individuals who have undergone a thyroidectomy, as they will likely need thyroid hormone replacement therapy to maintain normal thyroid function.
B. Watch for changes in body functioning, such as lethargy, restlessness, sensitivity to cold, and dry skin. Report them to the physician.
These symptoms could indicate potential issues with thyroid hormone levels and should be reported to the physician for further evaluation.
C. Recognize the signs of dehydration. This is important for overall health and can be especially relevant post-surgery. Dehydration can exacerbate other issues and slow down the healing process.
D. Carry injectable dexamethasone at all times. This is not a standard discharge instruction after a thyroidectomy. Dexamethasone may be prescribed for specific situations, but it is not a routine medication for all patients post-thyroidectomy.
E. Report any signs and symptoms of hypoglycemia. This is important because thyroidectomy can affect blood sugar levels. Monitoring for signs of hypoglycemia is crucial for the client's well-being.
Correct Answer is ["B","C"]
Explanation
A. NPH insulin may be mixed with pens. This statement is correct. NPH insulin can be mixed with other insulins, and it is available in pens for ease of administration.
B. Insulin detemir is administered once or twice daily, not necessarily with meals. Detemir is a long-acting insulin and can be taken once or twice daily, depending on the individual's specific treatment plan. It does not need to be strictly timed with meals.
C. Insulin glargine is a long-acting insulin and is generally not used as a first-line treatment for gestational diabetes. Short-acting insulins are typically recommended. Gestational diabetes is usually managed with short-acting insulins (like regular insulin) due to their faster onset and shorter duration of action. Long-acting insulins like glargine are not typically used in this context.
D. Regular insulin can be administered intravenously. This is a correct statement. Regular insulin can indeed be given intravenously in a hospital setting for precise control of blood glucose levels.
E. Lispro is a rapid-acting insulin. This statement is accurate. Lispro is a rapid-acting insulin analog used to control high blood sugar levels during and after meals. It has a fast onset of action.
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