A client diagnosed with type 1 diabetes has been prescribed 12 units of regular insulin and 34 units of NPH insulin in the morning. How should the nurse explain why two different types of insulin are required to control the client's blood glucose?
"The different onsets and peaks of the two types provide better overall glucose control."
"NPH prevents regular insulin from being broken down in the body, allowing the use of a lower dose."
"The combination negates the risk of adverse effects that would likely accompany a single, larger dose."
"NPH stimulate the pancreas to produce more insulin, while regular insulin provides your body's short-term needs."
The Correct Answer is A
A. "The different onsets and peaks of the two types provide better overall glucose control.": Regular insulin has a rapid onset and short duration, while NPH insulin has a slower onset and longer duration. When used together, they mimic the body's natural insulin release pattern, offering both immediate and sustained glucose control throughout the day.
B. "NPH prevents regular insulin from being broken down in the body, allowing the use of a lower dose.": NPH does not alter how regular insulin is metabolized. Each insulin type acts independently, and NPH does not preserve or enhance the activity of regular insulin.
C. "The combination negates the risk of adverse effects that would likely accompany a single, larger dose.": The primary reason for using two types is to align insulin activity with the body’s varying needs. Risk reduction from side effects is not the primary purpose.
D. "NPH stimulates the pancreas to produce more insulin, while regular insulin provides your body's short-term needs.": NPH insulin is synthetic and does not stimulate pancreatic insulin production. Clients with type 1 diabetes lack insulin production altogether, so both types must be provided exogenously.
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Related Questions
Correct Answer is B
Explanation
A. being sick increases the need for insulin: Illness can elevate blood glucose levels and increase insulin requirements, but this is a temporary condition. It does not explain the fundamental need for insulin in clients with Type 1 Diabetes.
B. people with Type 1 Diabetes produce no insulin at all: Type 1 Diabetes is characterized by autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. These clients are entirely dependent on exogenous insulin to regulate blood glucose and sustain life.
C. healthcare providers can manage diabetes better with insulin when the client is in the hospital: While insulin is often used during hospitalizations for tight glucose control, this does not explain why all Type 1 diabetics require insulin therapy continuously, not just during hospital stays.
D. all people with diabetes need insulin: Not all individuals with diabetes require insulin. Many people with Type 2 Diabetes can manage their condition with oral medications, lifestyle changes, or non-insulin injectables.
Correct Answer is A
Explanation
A. chronic diabetic gastroparesis: Metoclopramide is commonly prescribed for gastroparesis, especially in diabetic clients. It enhances gastric emptying by increasing motility and decreasing nausea, making it particularly effective for treating delayed gastric emptying due to autonomic neuropathy.
B. impaction: Fecal impaction typically requires enemas or manual disimpaction rather than prokinetic agents. Metoclopramide acts on the upper gastrointestinal tract and has limited usefulness for resolving impaction in the colon.
C. encopresis: Encopresis, the repeated passing of stool in inappropriate places (often due to chronic constipation in children), is not treated with metoclopramide. Management usually involves stool softeners, behavior training, and addressing constipation.
D. clients requiring diagnostic procedures: Although some GI procedures may involve medications to enhance motility or reduce nausea, metoclopramide is not routinely administered for diagnostic preparation. Bowel cleansing agents or sedatives are more commonly used.
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