At 8 a.m. the nurse is reviewing patient assignments and notes one of the patients has a current blood glucose of 264. Breakfast is routinely served at 8:30. The following orders are noted in the chart. What action should the nurse take? Accucheck before meals and at bedtime with sliding scale insulin aspart SQ: Glucose 0-150 Administer 0 units; 151-200 Administer 2 units; 201-250 Administer 4 units: 251-300 Administer 6 units: 301-350 Administer 8 units; 351- 400 Administer 10 units; >400 Notify physician.
Provide 2 units insulin aspart 50
Provide 6 units insulin aspart 50
Provide 10 units insin apart SQ
Provide 4 units insulin aspart 50
The Correct Answer is B
A. This option corresponds to the blood glucose range of 151-200. However, the patient's current blood glucose level is 264, which falls into the range of 251-300. Therefore, administering 2 units would not be appropriate in this case.
B. The patient's current blood glucose level is 264, which falls into the range of 251-300. According to the sliding scale insulin aspart orders, for this range, 6 units should be administered. This option aligns with the patient's blood glucose level and the prescribed protocol.
C. This option corresponds to the blood glucose range of 351-400. The patient's blood glucose level of 264 does not fall into this range, so administering 10 units would be excessive and potentially lead to hypoglycemia.
D. This option corresponds to the blood glucose range of 201-250. The patient's current blood glucose level is 264, which falls into the range of 251-300. Therefore, administering 4 units would not be sufficient to address the elevated blood glucose level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is A
Explanation
A. Correct. Propylthiouracil (PTU) is an antithyroid medication used to treat hyperthyroidism, including Graves' disease. It can sometimes cause agranulocytosis, a condition characterized by a severe reduction in white blood cells, which can lead to symptoms like a sore throat and fever. These symptoms should be reported immediately.
B. Constipation is not a common side effect of propylthiouracil. If it occurs, it is usually not an urgent concern, and can often be managed with dietary and lifestyle changes.
C. Increased urine output is not typically associated with propylthiouracil. It is more likely to be seen with diuretic medications or conditions like diabetes.
D. Painful, excessive menstruation is not a direct side effect of propylthiouracil. However, hormonal changes related to hyperthyroidism can affect menstrual patterns. If the client is experiencing significant changes in menstrual bleeding, it should be reported to the healthcare provider, but it may not be considered an immediate emergency.
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