A nurse is collecting data from a client who has diabetes mellitus.
The client is confused, flushed, and has an acetone odor on their breath.
The nurse should anticipate a prescription for which of the following types of insulin to treat the client.
Regular insulin.
NPH insulin.
Lispro insulin.
Glargine insulin.
The Correct Answer is A
The client’s symptoms of confusion, flushed appearance, and acetone odor on their breath suggest that they may be experiencing diabetic ketoacidosis (DKA), a serious complication of diabetes that occurs when the body produces high levels of ketones.
Treatment for DKA typically involves administering intravenous fluids and insulin to lower blood sugar levels and suppress ketone production 1.
Regular insulin is a fast-acting insulin that can be given intravenously to quickly lower blood sugar levels 1.
Choice B is incorrect because NPH insulin is an intermediate-acting insulin that takes longer to start working and would not be appropriate for treating DKA.
Choice C is incorrect because lispro insulin is a rapid-acting insulin but it is not typically given intravenously.
Choice D is incorrect because glargine insulin is a long-acting insulin that takes several hours to start working and would not be appropriate for treating DKA.
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Related Questions
Correct Answer is D
Explanation
NPH insulin is an intermediate-acting insulin that usually starts to work about 1 to 3 hours after injection and peaks 4 to 12 hours later12.
Peak time is when insulin has its strongest effect on lowering blood glucose1.
Choice A: 30 minutes to 3 hours is not the answer because NPH insulin usually starts to work about 1 to 3 hours after injection and peaks 4 to 12 hours later12.
Choice B: 2 to 6 hours is not the answer because NPH insulin usually starts to work about 1 to 3 hours after injection and peaks 4 to 12 hours later12.
Choice C: 4 to 5 hours is not the answer because NPH insulin usually starts to work about 1 to 3 hours after injection and peaks 4 to 12 hours later12.
Correct Answer is B
Explanation
NPH insulin has an onset of action of about 1 to 2 hours, peaks in 4 to 12 hours, and lasts up to 24 hours. Given the administration at 0700, the onset of action would typically occur between 0800 and 0900. Hypoglycemia is most likely to occur during the onset or peak periods due to the insulin's glucose-lowering effect.
Among the options:
- A. 0715: Too early, as NPH insulin's onset is not within 15 minutes.
- B. 0800: Within the onset window (1 hour after administration), making it a plausible time to observe for hypoglycemia.
- C. 0900: Also within the onset window (2 hours after administration), another reasonable time to monitor.
- D. 1000: Slightly beyond the typical onset but still early in the action profile, where hypoglycemia could occur if glucose levels drop.
Since the question asks for the time to observe for hypoglycemia caused by the onset, the earliest time within the onset window is most appropriate. Thus, B. 0800 is the best answer, as it aligns with the start of NPH insulin’s onset period.
Final Answer: B. 0800
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