A 55-year-old patient with type 2 diabetes is admitted to the hospital and is on NPH insulin. The patient experiences symptoms of hypoglycemia. At what time after administration of NPH insulin should the nurse be most vigilant for signs of hypoglycemia due to the peak action of the insulin?
18-24 hours after administration
4-12 hours after administration
12-18 hours after administration
1-2 hours after administration
The Correct Answer is B
Choice A Reason:
NPH insulin is an intermediate-acting insulin that typically has a duration of action of about 12 to 16 hours. The peak action, however, occurs much earlier, making 18-24 hours after administration an incorrect choice for the peak time of hypoglycemia risk.
Choice B Reason:
NPH insulin generally peaks 4 to 12 hours after administration This is the period when the insulin is most effective at lowering blood glucose levels, and therefore, the time when the patient is at the highest risk for hypoglycemia. Monitoring for signs of hypoglycemia during this window is crucial to ensure patient safety.
Choice C Reason:
While NPH insulin can have effects lasting up to 16 hours, the peak action occurs earlier, between 4 to 12 hours. Therefore, 12-18 hours after administration is not the correct time frame for the peak action of NPH insulin.
Choice D Reason:
NPH insulin starts to act within 1 to 2 hours after administration, but this is not the peak time. The peak action, when the risk of hypoglycemia is highest, occurs later, between 4 to 12 hours after administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Testing blood glucose levels every 6 hours during illness is crucial for managing type 1 diabetes. Illness can cause blood glucose levels to fluctuate unpredictably, and frequent monitoring helps in making timely adjustments to insulin doses and dietary intake. This practice helps prevent both hyperglycemia and hypoglycemia, ensuring better overall control of diabetes during periods of illness.
Choice B Reason:
Administering the usual daily dose of insulin is important even during illness. Skipping insulin doses can lead to dangerously high blood glucose levels and increase the risk of diabetic ketoacidosis (DKA). It is essential to continue taking insulin as prescribed and to consult with a healthcare provider if any adjustments are needed based on blood glucose readings.
Choice C Reason:
Limiting juices, soda, and gelatin is not typically recommended during illness for patients with type 1 diabetes. These items can be useful for maintaining hydration and providing quick sources of carbohydrates if the patient is unable to eat solid foods. Instead of limiting these items, it is more important to monitor carbohydrate intake and adjust insulin doses accordingly.
Choice D Reason:
Reporting a blood glucose level greater than 300 is critical for preventing complications. High blood glucose levels can indicate the onset of DKA, a serious condition that requires immediate medical attention. Promptly reporting elevated blood glucose levels allows for timely intervention and management to prevent severe complications.
Correct Answer is A
Explanation
Choice A Reason:
Stopping the transfusion immediately and notifying the healthcare provider is the most appropriate initial action when a transfusion reaction is suspected. This action helps to prevent further complications and allows for prompt evaluation and management of the reaction. The nurse should also keep the IV line open with normal saline to maintain venous access.
Choice B Reason:
Administering antipyretics and continuing the transfusion is not appropriate. Continuing the transfusion could exacerbate the reaction and lead to more severe complications. The priority is to stop the transfusion and assess the patient before considering any further interventions.
Choice C Reason:
Slowing down the rate of the transfusion and reassessing in 30 minutes is not a safe approach. Any signs of a transfusion reaction, such as chills and fever, require immediate cessation of the transfusion. Delaying intervention could result in worsening of the patient’s condition.
Choice D Reason:
Continuing the transfusion and monitoring the patient closely is not appropriate. Immediate cessation of the transfusion is necessary to prevent further exposure to the potentially harmful blood product. Monitoring alone is insufficient without stopping the transfusion.
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