With what client should the nurse question the administration of human insulin?
A client who has been diagnosed with gestational diabetes.
A client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection.
A client whose type 2 diabetes is controlled by diet and exercise.
A client who has been living with type 1 diabetes for 20 years.
The Correct Answer is C
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
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Correct Answer is D
Explanation
Glulisine is a rapid-acting insulin that has an onset of action of 2 to 5 minutes and peaks in 30 to 90 minutes, making it the fastest among the choices. Some possible explanations for the other choices are:
Choice A. Aspart is also a rapid-acting insulin, but it has a slightly longer onset of action (10 to 20 minutes) and peak time (1 to 3 hours) than glulisine.
Choice B. Lispro is another rapid-acting insulin, but it has a similar onset of action (<15 minutes) and peak time (30 to 90 minutes) as glulisine, so it is not the fastest.
Choice C. Regular is a short-acting insulin that has a much longer onset of action (30 to 60 minutes) and peak time (2 to 4 hours) than glulisine, so it is not suitable for fast therapeutic effects.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
Insulin doses are adjusted based on blood glucose monitoring, carbohydrate intake, physical activity, and other factors.
Correct Answer is D
Explanation
Glargine is a long-acting insulin that can provide a steady level of insulin for up to 24 hours. This would be suitable for a client who does not want to administer insulin on the plane, as they would only need one injection per day.
Choice A. Aspart is wrong because aspart is a rapid-acting insulin that has a peak effect within 1 to 3 hours and lasts for 3 to 5 hours.
This would require frequent injections and monitoring of blood glucose levels.
Choice B. Lispro is wrong because lispro is also a rapid-acting insulin that has a similar onset and duration as aspart.
It would not provide adequate coverage for a long international flight.
Choice C. Glulisine is wrong because glulisine is another rapid-acting insulin that has an onset of 15 minutes and a duration of 2 to 4 hours.
It would also require multiple injections and frequent blood glucose checks.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
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