A nurse is providing education about insulin management to a client newly diagnosed with type 1 diabetes mellitus. Which of the following statements by the nurse about injection site selection is accurate?

Injections will work most quickly when given in the thigh.

Injections will work most quickly when given in the upper arm.

Injections will work most quickly when given in the buttocks.

Injections will work most quickly when given in the abdomen.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Injections in the thigh are absorbed more slowly compared to the abdomen. The thigh is a common site for insulin injections, but it does not provide the fastest absorption rate. The absorption rate can be influenced by physical activity, as exercise can increase blood flow to the muscles, potentially speeding up insulin absorption. However, under normal conditions, the thigh is not the fastest site for insulin absorption.

Choice B reason:

Injections in the upper arm have a moderate absorption rate. The upper arm is another common site for insulin injections, but it is not the fastest. The absorption rate from the upper arm is generally faster than the thigh but slower than the abdomen. This site can be convenient for injections, especially for those who find it difficult to reach other areas.

Choice C reason:

Injections in the buttocks have the slowest absorption rate among the common injection sites. The buttocks are less commonly used for insulin injections due to the slower absorption rate and the difficulty some individuals may have in administering injections in this area. The high fat content in the buttocks slows down the absorption of insulin.

Choice D reason:

Injections in the abdomen provide the fastest absorption rate for insulin. The abdomen is the preferred site for many people with diabetes because it has a large surface area and is easy to access. The insulin injected into the abdominal area is absorbed quickly into the bloodstream, making it the most effective site for rapid-acting insulin. This is particularly important for managing blood sugar levels around meal times

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Correct Answer is D

Explanation

Choice A: Hypokalemia

Hypokalemia refers to a low level of potassium in the blood. It can cause muscle weakness, cramps, and arrhythmias, but it is not directly related to Kussmaul breathing. Hypokalemia can occur in diabetic ketoacidosis (DKA) due to the loss of potassium in urine, but it is not the primary cause of Kussmaul breathing. Kussmaul breathing is a deep, labored breathing pattern that occurs as a compensatory mechanism for metabolic acidosis, not directly due to low potassium levels.

Choice B: Metabolic Alkalosis

Metabolic alkalosis is a condition characterized by an elevated pH in body tissues due to an excess of bicarbonate or a loss of acid. It is the opposite of metabolic acidosis. Kussmaul breathing is specifically a response to metabolic acidosis, not alkalosis. Therefore, metabolic alkalosis is not related to Kussmaul breathing.

Choice C: Lipolysis

Lipolysis is the metabolic process of breaking down lipids (fats) into free fatty acids and glycerol. This process is accelerated in diabetic ketoacidosis (DKA) due to the lack of insulin, leading to the production of ketone bodies, which contribute to metabolic acidosis. While lipolysis is a part of the pathophysiology of DKA, it is not directly related to Kussmaul breathing. Kussmaul breathing is a compensatory mechanism for the acidosis caused by the accumulation of ketone bodies.

Choice D: Hyperglycemia

Hyperglycemia, or high blood sugar, is a hallmark of diabetic ketoacidosis (DKA). In DKA, the lack of insulin leads to elevated blood glucose levels and the breakdown of fats into ketones, causing metabolic acidosis. Kussmaul breathing is the body’s attempt to compensate for this acidosis by increasing the rate and depth of breathing to expel more carbon dioxide, thereby reducing the acidity of the blood. Therefore, hyperglycemia is directly related to the occurrence of Kussmaul breathing in DKA.

A. Blood flow is altered due to restricted stretching of the ventricles, impairing the heart’s ability to contract. B. Blood flow is altered due to increased pressure in the arteries.

Correct Answer is B

Explanation

Choice A reason:

“Blood flow is altered due to restricted stretching of the ventricles, impairing the heart’s ability to contract” is not accurate in the context of peripheral arterial disease (PAD). PAD primarily affects the arteries outside the heart, particularly those supplying the legs and feet. It is caused by atherosclerosis, which leads to the narrowing and hardening of the arteries, reducing blood flow to the extremities. The statement about restricted stretching of the ventricles and impaired heart contraction is more relevant to conditions like heart failure or cardiomyopathy.

Choice B reason:

“Blood flow is altered due to increased pressure in the arteries” is a more accurate description of PAD. In PAD, the buildup of fatty deposits (plaques) in the arterial walls leads to increased resistance and pressure within the arteries. This condition reduces the flow of oxygenated blood to the limbs, causing symptoms such as pain, cramping, and fatigue, especially during physical activity. Managing PAD involves lifestyle changes, medications, and sometimes surgical interventions to improve blood flow and reduce symptoms.

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A nurse is providing education about insulin management to a client newly diagnosed with type 1 diabetes mellitus. Which of the following statements by the nurse about injection site selection is accurate?

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