A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? (Select all that apply.)

A. NPH insulin may be mixed with pens. This statement is correct. NPH insulin can be mixed with other insulins, and it is available in pens for ease of administration.

B. Insulin detemir is administered once or twice daily, not necessarily with meals. Detemir is a long-acting insulin and can be taken once or twice daily, depending on the individual's specific treatment plan. It does not need to be strictly timed with meals.

C. Insulin glargine is a long-acting insulin and is generally not used as a first-line treatment for gestational diabetes. Short-acting insulins are typically recommended. Gestational diabetes is usually managed with short-acting insulins (like regular insulin) due to their faster onset and shorter duration of action. Long-acting insulins like glargine are not typically used in this context.

D. Regular insulin can be administered intravenously. This is a correct statement. Regular insulin can indeed be given intravenously in a hospital setting for precise control of blood glucose levels.

E. Lispro is a rapid-acting insulin. This statement is accurate. Lispro is a rapid-acting insulin analog used to control high blood sugar levels during and after meals. It has a fast onset of action.

A. Administering aspirin for hyperthermia is not a standard intervention for hyperthyroidism. Hyperthermia can occur in severe cases of hyperthyroidism, but the primary intervention is to address the underlying thyroid dysfunction and provide supportive care.

B. Keeping the client NPO (nothing by mouth) is not directly related to preventing a thyroid crisis in hyperthyroidism. It may be necessary for certain pre-operative preparations or if the client is undergoing specific procedures, but it does not address the prevention of a thyroid crisis.

C. While monitoring for signs of hypocalcemia is important in some cases of thyroid dysfunction, it is not the primary action to prevent a thyroid crisis. In hyperthyroidism, the focus is on managing excessive thyroid hormone levels.

D. Correct. Providing a quiet, low-stimulus environment is a crucial nursing intervention for clients with hyperthyroidism. They can be highly sensitive to external stimuli due to their increased metabolic rate. A calm environment helps reduce stress and the risk of exacerbating symptoms, potentially preventing a thyroid crisis.