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?

Choice A reason: This is incorrect because the dosage is given in the prescription as 500 mg, which indicates the amount of the drug to be administered.

Choice B reason: This is incorrect because the route is given in the prescription as PO, which stands for per os or by mouth, which indicates how the drug is to be administered.

Choice C reason: This is correct because the medication is not given in the prescription, which is the name of the drug to be administered. The nurse should ask the provider to clarify the medication name and spell it out if necessary.

Choice D reason: This is incorrect because the time/frequency is given in the prescription as BID, which stands for bis in die or twice a day, which indicates when and how often the drug is to be administered.

Choice A reason: Venous thromboembolism is a contraindication for taking SERMs. SERMs are drugs that act like estrogen in some tissues and block estrogen in others. They can help prevent bone loss and fractures in postmenopausal women, but they can also increase the risk of blood clots in the veins, such as deep vein thrombosis and pulmonary embolism. Therefore, women who have a history of or are at high risk for venous thromboembolism should not take SERMs.

Choice B reason: Breast cancer is not a contraindication for taking SERMs. In fact, some SERMs, such as tamoxifen and raloxifene, are used to treat or prevent breast cancer in women who have estrogen receptor-positive tumors. These SERMs block the effects of estrogen in the breast tissue and reduce the growth of cancer cells.

Choice C reason: Hypocalcemia is not a contraindication for taking SERMs. Hypocalcemia is a low level of calcium in the blood. SERMs do not affect calcium levels directly, but they can help prevent calcium loss from the bones by mimicking the effects of estrogen in the bone tissue. However, women who take SERMs should also take adequate calcium and vitamin D supplements to maintain bone health.

Choice D reason: Stress fractures are not a contraindication for taking SERMs. Stress fractures are small cracks in the bones that result from repeated stress or overuse. SERMs can help prevent stress fractures by strengthening the bones and reducing the risk of osteoporosis. However, women who take SERMs should also avoid excessive or inappropriate physical activity that can cause stress fractures.