A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

0900

1400

2100

1100

Answer and Explanation

The Correct Answer is D

A.   This time falls shortly after the onset of NPH insulin. While hypoglycemia could start to occur around this time, it is less likely to be at its peak.
B.   This time is past the peak range of NPH insulin. The likelihood of hypoglycemia is lower as the insulin effect would be tapering off.
C.   This time is well past the usual duration of NPH insulin. By this point, the risk of hypoglycemia would be significantly decreased.
D.   This time falls within the peak action of NPH insulin (approximately 4-12 hours post-administration). This is when hypoglycemia is most likely to occur due to the greatest effect of the insulin.

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Correct Answer is C

Explanation

A. While taking vital signs can provide useful information about the client's overall condition, it does not address the immediate concern of potential hypoglycemia. The priority is to assess blood glucose levels directly.
B. Glucagon can be administered in cases of severe hypoglycemia where the patient is unable to ingest glucose orally. However, before administering glucagon, the nurse should first check the blood glucose level to confirm hypoglycemia.
C. Checking the blood glucose level will provide immediate information about whether the client is experiencing hypoglycemia. If the blood glucose is low, appropriate treatment (such as administering glucose or a fast-acting carbohydrate) can be initiated. If it’s within normal limits, other causes for the symptoms can be explored.
D. While it may be necessary to notify the physician depending on the outcome of the blood glucose reading or if the client’s condition worsens, it is not the first action. Immediate assessment of the blood glucose level is essential to determine the correct course of action.

A. mental status = lethargic, oriented X 3 but unsure of reason for presenting for care B. arterial blood gas pH 7.47/ pCO2-40/HCO3-33/ pa02 = 95 C. arterial blood gas pH=7.31/pCO2-34/HCO3-17/pa02=98 D. heart rate=52, regular E. respiratory rate = 31, deep

Correct Answer is ["A","C","E"]

Explanation

A. Lethargy can occur in DKA due to the effects of hyperglycemia, acidosis, and dehydration. Even if the client is oriented, confusion about the reason for care suggests an altered mental state, which can be common in DKA.
B. This ABG indicates alkalosis (pH > 7.45), which is not typical for DKA. In DKA, we would expect a lower pH (acidosis). This set of values does not align with the expected clinical picture of DKA.
C. This ABG shows a pH of 7.31, indicating acidosis. The low HCO3 (17) supports metabolic acidosis, which is characteristic of DKA. This finding is consistent with the expected laboratory results in a patient experiencing DKA.
D. A heart rate of 52 (bradycardia) is not a common finding in DKA. In fact, tachycardia (elevated heart rate) is typically observed due to dehydration and compensatory mechanisms. Bradycardia would not be expected in this context.
E. A respiratory rate of 31, particularly if deep (known as Kussmaul respirations), is a classic sign of metabolic acidosis, including DKA. Kussmaul respirations are the body’s attempt to compensate for acidosis by increasing carbon dioxide elimination.

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A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

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Explanation

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