A client has a Sliding Scale for Insulin dosages sub-cut. The order is for Humulin Regular Insulin U-100 q6h as follows:
0-180 mg/dL No Coverage
181-240 mg/dL 2 units sub-cut 241-300 mg/dL 4 units sub-cut
301-490 mg/dL 6 units sub-cut
Greater than 400 mg/dL administer 8 units sub-cut and repeat finger stick in 2 hr, call MD/Provider At 3:30 PM. the client's finger stick is 164 mg/dL How much coverage should the patient receive?
6 Units Regular Insulin sub-cut
2 Units Regular Insulin sub-cut
0.5 Units Regular insulin sub-cut
No coverage
The Correct Answer is D
A) 6 Units Regular Insulin sub-cut:
According to the sliding scale, a blood glucose level of 164 mg/dL would not fall within the range requiring 6 units of insulin. The 6-unit dose is for blood glucose levels between 301-490 mg/dL. Since the client's reading of 164 mg/dL is lower than 181 mg/dL, this dosage is not applicable.
B) 2 Units Regular Insulin sub-cut:
This is also incorrect. The 2-unit dose is prescribed for blood glucose levels between 181-240 mg/dL. Since the client's reading is 164 mg/dL, it falls below this range, so 2 units is not appropriate.
C) 0.5 Units Regular insulin sub-cut:
This is not correct because there is no provision in the sliding scale for administering 0.5 units of insulin. The scale provides dosing for specific ranges and does not include fractional doses. Additionally, the blood glucose reading of 164 mg/dL does not require any insulin according to the prescribed sliding scale.
D) No coverage:
According to the sliding scale, a blood glucose level of 164 mg/dL falls within the 0-180 mg/dL range, which specifies no coverage or insulin administration. The sliding scale clearly indicates that no insulin is needed when the blood glucose level is within this range.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) They should not be abruptly stopped:
Beta blockers should not be abruptly discontinued because sudden withdrawal can lead to rebound hypertension, tachycardia, and even a risk of acute myocardial infarction (MI) in patients with heart disease. Gradual tapering is recommended to allow the body to adjust and avoid these adverse effects.
B) They are safe to take with herbal medications:
Herbal medications can interact with beta blockers and alter their effectiveness or increase the risk of side effects. For example, herbs like St. John's wort can decrease the effectiveness of beta blockers, while others like ginseng may increase the risk of side effects like high blood pressure. It is important to consult with a healthcare provider before taking any herbal supplements with beta blockers.
C) It isn't necessary to monitor lab results:
While beta blockers don't require regular lab tests for their direct effects, monitoring is important in certain patients, especially those with underlying conditions like heart failure, kidney disease, or diabetes. For example, monitoring renal function, electrolytes, and blood glucose may be necessary for patients who are taking other medications alongside beta blockers or who have coexisting conditions.
D) Taking over-the-counter medications is acceptable:
Many over-the-counter (OTC) medications can interact with beta blockers and affect their effectiveness or cause adverse effects. For example, decongestants (found in many cold medications) can raise blood pressure and counteract the effects of beta blockers.
Correct Answer is C
Explanation
A) Check the weight of the patient:
While weight monitoring is important in managing heart failure and tracking fluid retention, it is not the most critical action before administering digoxin. Digoxin primarily affects heart rate and rhythm, so the priority assessment is related to the cardiovascular system.
B) Check the skin for bruising:
Checking for bruising is not a necessary step before administering digoxin. Bruising could be an indication of an underlying bleeding disorder or anticoagulant therapy, but it is not directly related to the administration of digoxin. The primary concern with digoxin is its effect on the heart, particularly heart rate and rhythm.
C) Check the apical pulse:
It is crucial to check the apical pulse before administering digoxin, as one of the major effects of the drug is to slow the heart rate (negative chronotropy). If the heart rate is below 60 beats per minute (bpm), the nurse should hold the medication and consult the healthcare provider, as digoxin can further decrease the heart rate and lead to bradycardia or other complications.
D) Check the temperature of the patient:
Although monitoring vital signs, including temperature, is important in overall patient care, temperature does not specifically impact the administration of digoxin. A normal or abnormal temperature would not typically influence the decision to give digoxin unless the patient had a fever due to an underlying infection that could complicate the clinical picture. The priority is assessing the pulse to ensure safe administration of the medication.
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