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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Flaccid muscles are associated with conditions like hypokalemia, not hypoparathyroidism. In hypoparathyroidism, there is a deficiency of parathyroid hormone (PTH), which leads to low calcium levels and can result in muscle spasms and tetany, not flaccid muscles.
B. While anorexia can occur in clients with various health conditions, it is not a specific finding associated with hypoparathyroidism.
C. Correct. Hypoparathyroidism is characterized by low levels of parathyroid hormone (PTH), which leads to low calcium levels in the blood. This can cause symptoms such as numbness, tingling, and muscle cramps, especially in the extremities.
D. A positive Chvostek's sign is associated with hypocalcemia, which can be caused by hypoparathyroidism. Therefore, a negative Chvostek's sign would not be an expected finding in a client with hypoparathyroidism.
Correct Answer is A
Explanation
1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical period for monitoring blood glucose levels.
B. 8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been about 3 hours since administration, and the insulin is still working to lower blood glucose levels. This time frame is not associated with the highest risk of hypoglycemia.
C. 6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as it would be later in the night.
D. 11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the previous evening have largely worn off. This time frame is not associated with a high risk of hypoglycemia related to the evening dose of NPH insulin.
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