A client presents with diaphoresis, palpitations, nervousness, and tachycardia approximately 4 hours after taking his usual morning insulin. Which treatment is appropriate for this client?

Check blood glucose level and administer carbohydrates.

Give nitroglycerin and perform an electrocardiogram (ECG).

Check pulse oximetry and administer oxygen therapy.

Restrict salt, administer diuretics, and perform paracentesis.

Answer and Explanation

The Correct Answer is A

Choice A rationale: The described symptoms—diaphoresis, palpitations, nervousness, and tachycardia—are classic signs of hypoglycemia, or low blood glucose. These symptoms are caused by the release of counter-regulatory hormones like epinephrine and cortisol. The first appropriate action is to check the blood glucose level to confirm hypoglycemia and then administer carbohydrates to rapidly raise it back to a safe range.
Choice B rationale: Giving nitroglycerin and performing an electrocardiogram are interventions for cardiac issues, such as angina or myocardial infarction. While palpitations and tachycardia are present, they are secondary to the hypoglycemia-induced stress response, not a primary cardiac event. Addressing the underlying hypoglycemia is the priority, as these cardiac symptoms are a direct physiological consequence of the low blood sugar.
Choice C rationale: Checking pulse oximetry and administering oxygen are interventions for respiratory compromise or hypoxemia. The client's symptoms are not indicative of an issue with oxygenation. Although the body is under stress, the primary problem is a metabolic imbalance, specifically low blood glucose. Providing oxygen would not correct the underlying physiological cause of the symptoms.
Choice D rationale: Restricting salt, administering diuretics, and performing paracentesis are treatments for fluid overload, ascites, and conditions like congestive heart failure or severe liver disease. The client's symptoms are not consistent with these conditions. These interventions would be inappropriate and could be harmful, as they do not address the metabolic derangement causing the hypoglycemia.

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Correct Answer is C

Explanation

Choice A rationale: Taking insulin immediately before exercise can be dangerous for a person with diabetes. Physical activity increases glucose uptake by muscle cells, which, when combined with the effect of exogenous insulin, can lead to a rapid and significant drop in blood glucose levels, resulting in exercise-induced hypoglycemia.
Choice B rationale: Eating a large meal immediately before or during exercise is not the recommended treatment for hypoglycemia. While a large meal will raise blood glucose, it is not the most rapid or efficient method. A concentrated source of simple carbohydrates is required to quickly raise blood sugar to a safe level.
Choice C rationale: Hard candy contains simple carbohydrates, such as sucrose or dextrose, which are rapidly absorbed into the bloodstream. This quick absorption is crucial for reversing the symptoms of hypoglycemia, such as lightheadedness and shakiness, which are caused by insufficient glucose delivery to the brain.
Choice D rationale: For many people with diabetes, adjusting insulin dosage is necessary to prevent hypoglycemia during exercise. However, a blanket recommendation to take no insulin before exercise is not scientifically sound or safe. The appropriate action depends on the type, duration, and intensity of exercise, as well as current blood glucose levels.

A. Administering insulin intramuscularly. B. Rotating sites of administration. C. Using human insulin. D. Using insulin at room temperature.

Correct Answer is B

Explanation

Choice A rationale: Administering insulin intramuscularly is generally discouraged. The absorption of insulin from intramuscular sites is more rapid and can be unpredictable, increasing the risk of hypoglycemia. This is not a recommended method for routine insulin administration and does not address the issue of lipodystrophies, which are localized tissue changes resulting from repeated injections in the same area. The primary route is subcutaneous.
Choice B rationale: Lipodystrophies, which include lipohypertrophy (lumps of fat) and lipoatrophy (depressions in the skin), are localized tissue changes that result from repeated injections into the same exact spot. By rotating injection sites within and between different anatomical regions, the tissue has an opportunity to heal. This prevents the inflammatory response and subsequent fat deposition or breakdown that characterizes these localized complications.
Choice C rationale: Using human insulin has significantly reduced the incidence of immunogenic lipoatrophy compared to older animal insulins. However, it does not completely eliminate the risk of lipohypertrophy, which is a consequence of repeated local tissue trauma. Even with human insulin, it is essential to rotate sites to prevent this mechanical and inflammatory response.
Choice D rationale: Using insulin at room temperature is a recommended practice to reduce injection site discomfort, as cold insulin can be irritating to the tissue. This, however, is not a strategy to prevent lipodystrophies. Lipodystrophies are caused by mechanical and biochemical changes in the tissue from repetitive use of the same injection site, not by the temperature of the insulin itself.

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A client presents with diaphoresis, palpitations, nervousness, and tachycardia approximately 4 hours after taking his usual morning insulin. Which treatment is appropriate for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Which of these nursing interventions would minimize a client's risk of developing lipodystrophies?

Correct Answer is B

Explanation

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