A client in DKA is ordered regular insulin at 5 units per hour for the current blood glucose level. The institution protocol is to add 125 units of regular insulin to a 250 mL bag of normal saline. What is the correct rate for the nurse to set the IV pump for this dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Early signs of hypoxia, which is a condition where the body or a region of the body is deprived of adequate oxygen supply, often include symptoms such as restlessness, confusion, and tachycardia (rapid heart rate). These symptoms occur because the body is trying to compensate for the lack of oxygen by increasing heart rate and causing a state of agitation or confusion.

Choice A reason:

Bradycardia, lethargy, confusion are not typically early signs of hypoxia. Bradycardia (slow heart rate) is more commonly associated with severe or prolonged hypoxia rather than early stages. Lethargy and confusion can occur, but they are not as immediate as restlessness and tachycardia.

Choice B reason:

Hypotension, vomiting, cyanosis are also not early signs of hypoxia. Hypotension (low blood pressure) and cyanosis (bluish discoloration of the skin) are more advanced signs indicating severe hypoxia. Vomiting is not a common symptom of hypoxia and is more likely related to other conditions.

Choice C reason:

Bradycardia, dyspnea, cyanosis includes symptoms that are more indicative of advanced hypoxia. Dyspnea (difficulty breathing) and cyanosis are signs that the body has been deprived of oxygen for a longer period. Bradycardia is not an early sign and usually occurs later in the progression of hypoxia.

Choice D reason:

Restlessness, confusion, tachycardia are classic early signs of hypoxia. Restlessness and confusion occur due to the brain’s response to low oxygen levels, while tachycardia is the body’s attempt to increase oxygen delivery to tissues by pumping blood more rapidly. These symptoms are the body’s initial compensatory mechanisms to address the lack of oxygen.

Choice A reason:

Administering inhaler medications and increasing oxygen may be necessary if the client is experiencing respiratory distress. However, since the client is not currently reporting increased dyspnea, this intervention is not immediately required. The focus should be on addressing the client’s anxiety.

Choice B reason:

Notifying the physician and administering lorazepam may be appropriate if the client’s anxiety is severe and not manageable through non-pharmacological means. However, it is generally best to try comfort measures and non-pharmacological interventions first.

Choice C reason:

Dimming the lights and encouraging the client to take a nap can help reduce anxiety, but it may not be the most effective initial intervention. Providing direct comfort and reassurance is often more beneficial in addressing immediate anxiety.

Choice D reason:

Sitting with the client and providing comfort measures is the most appropriate intervention. This approach helps to alleviate anxiety through direct support and reassurance. Techniques such as deep breathing exercises, talking calmly, and providing a comforting presence can significantly reduce anxiety.