Mr Ozz, a 45-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830.

The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

Choice A rationale: Low blood pressure sensed by baroreceptors in the kidneys would stimulate the renin-angiotensin-aldosterone system, which regulates blood pressure and sodium balance.

Choice B rationale: Low osmolality sensed by osmoreceptors in the kidneys would

indicate that the body has excess water and needs to excrete it, which would inhibit ADH release.

Choice C rationale: ADH, or antidiuretic hormone, is a peptide hormone that regulates the water balance in the body. It is released from the posterior pituitary gland in response to signals from the hypothalamus. When the plasma osmolarity, or the concentration of solutes in the blood, is high, it means that the body is dehydrated and needs to conserve water. The osmoreceptors in the hypothalamus detect this change and stimulate the release of ADH, which acts on the kidneys to increase water

reabsorption and decrease urine output. This helps to lower the plasma osmolarity and restore the water balance.

Choice D rationale: High concentration of potassium sensed by chemoreceptors in the carotid body would affect the acid-base balance and respiratory rate, but not ADH

release.

Choice A rationale: An increase in serum lipid levels is associated with nephrotic syndrome, not recovery.

Choice B rationale: A decrease in blood pressure to normal might be beneficial but is not a definitive indicator of recovery from nephrotic syndrome.

Choice C rationale: Gain in body weight can occur due to fluid retention, which is a symptom of nephrotic syndrome, and doesn't indicate recovery.

Choice D rationale: The disappearance of protein from the urine is a sign of recovery in nephrotic syndrome.