The physician orders strict I & O for a critically ill patient with CHF on a furosemide drip.
The RN knows that it would be appropriate to ask the physician for an order to place a Foley catheter for this patient.

Choice A rationale

Insulin glargine (Lantus) is a long-acting insulin used for basal glycemic control in diabetic patients. It has a slow onset and a steady release over approximately 24 hours, mimicking natural insulin secretion to stabilize blood glucose levels and prevent fluctuations.

Choice B rationale

Rapid-acting insulins, such as insulin lispro or aspart, have fast onsets and short durations to manage postprandial glucose spikes. Insulin glargine does not have these properties, as it is used for long-term basal control rather than immediate blood sugar regulation.

Choice C rationale

Intermediate-acting insulins like NPH have a shorter duration and peak effect compared to long-acting insulins. Insulin glargine provides a consistent effect over 24 hours, distinguishing it from intermediate-acting options.

Choice D rationale

Short-acting insulins are designed for pre-meal blood sugar control with a quick onset and limited duration. Insulin glargine does not fit this description due to its long-acting properties.

Choice A rationale

Loss of sensation to the perineum, buttocks, inner thighs, and back of the legs may indicate cauda equina syndrome, a surgical emergency. This condition involves compression of the spinal nerve roots and can lead to permanent neurological damage if not promptly addressed. Immediate medical intervention is critical.

Choice B rationale

Nausea and delayed voiding postoperatively are common, potentially due to anesthesia effects or limited mobility. While these findings warrant monitoring, they do not typically indicate an urgent issue unless prolonged or associated with other complications.

Choice C rationale

Mild low back pain is expected after lumbar spinal surgery due to manipulation of spinal structures. Pain management with prescribed analgesics and gradual mobilization is part of the standard postoperative care plan, and it does not usually necessitate immediate reporting.

Choice D rationale

A single episode of emesis can result from anesthesia effects or medication. Unless accompanied by persistent vomiting, signs of aspiration, or electrolyte imbalances, isolated emesis is not typically urgent and should be managed with antiemetics if necessary.