A hospitalized patient who is diabetic received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient was away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray.
What is the best action by the nurse to prevent hypoglycemia?
Request that if testing is further delayed, the patient will eat lunch first.
Send a glass of orange juice to the patient in the diagnostic testing area.
Save the lunch tray for the patient's later return.
Plan to discontinue the evening dose of insulin.
The Correct Answer is B
The patient received 38 U of NPH insulin at 7:00 AM, and by 1:00 PM, the insulin has been active for approximately 6 hours. The patient has missed lunch, which may lead to hypoglycemia, especially with the activity of the insulin.
Sending a glass of orange juice will provide the patient with a quick source of glucose to prevent hypoglycemia. If testing is further delayed, the nurse may request that the patient be allowed to eat lunch first or save the lunch tray for later, but immediate intervention is necessary to prevent hypoglycemia. Discontinuing the evening dose of insulin is not an appropriate action and should not be considered without consulting the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Gas pains and abdominal distention are common postoperative complications following small bowel resection. Ambulation is a simple and effective nursing intervention that can help alleviate these symptoms. Walking helps stimulate peristalsis, which can help move gas and stool through the gastrointestinal tract. It can also help prevent postoperative complications such as pneumonia and deep vein thrombosis.
Administering morphine sulfate (option A) may relieve pain, but it can also worsen constipation and abdominal distention. Promethazine (option C) is an antiemetic medication and may be helpful if the patient is experiencing nausea, but it is not the best intervention for gas pain and abdominal distention. Instilling a mineral oil retention enema (option D) may also be helpful in some cases, but it is not typically the first intervention for these symptoms and should be ordered by a healthcare provider.
Correct Answer is ["A","B","C"]
Explanation
b. Monitoring blood glucose levels: This is an essential nursing intervention as patients with Cushing syndrome are at risk for developing diabetes mellitus because of cortisol on glucose metabolism. The nurse should monitor the patient's blood glucose levels regularly and report any abnormal readings to the healthcare provider.
c. Protecting patients from exposure to infection: Patients with Cushing syndrome are also at risk for developing infections due to the immunosuppressive effects of cortisol. The nurse should take appropriate infection control measures, such as frequent handwashing, wearing gloves, and isolation precautions if necessary.
a. Observing for signs of hypotension: Although hypotension is not typically seen in patients with Cushing syndrome, it can occur in some cases due to the depletion of cortisol. The nurse should monitor the patient's blood pressure regularly and report any abnormal readings to the healthcare provider.
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