A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?
NPH insulin
Insulin glargine
Insulin detemir
Regular Insulin
The Correct Answer is D
A. NPH insulin: NPH insulin, also known as Neutral Protamine Hagedorn, is an intermediate acting insulin. It has a slower onset of action and a longer duration compared to regular insulin. It is not the best choice for treating diabetic ketoacidosis (DKA) because it does not act quickly enough to lower dangerously high blood glucose levels in this acute situation.
B. Insulin glargine: Insulin glargine is a long-acting basal insulin. It has a slow, steady release and provides a consistent level of insulin over an extended period. Like NPH insulin, it is not suitable for rapidly lowering blood glucose levels in a DKA emergency.
C. Insulin detemir: Insulin detemir is another long-acting basal insulin similar to glargine. It has a slow onset and provides a sustained release of insulin. It is not the first-line choice for treating DKA due to its slower action.
D. Regular Insulin: Regular insulin, also known as short-acting or fast-acting insulin, has a rapid onset of action. When administered intravenously, it can quickly lower blood glucose levels. This makes it the preferred choice for treating diabetic ketoacidosis (DKA) where prompt action is essential to correct the severe hyperglycemia and associated metabolic imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
A: Hepatomegaly is a common manifestation of acromegaly, as excess growth hormone can cause organ enlargement.
B: Moon face is associated with Cushing's syndrome, not acromegaly. In acromegaly, facial changes are characterized by bony enlargement and coarsening of features, not the rounded face seen in Cushing's syndrome.
C: Coarse facial features are a classic sign of acromegaly due to the overgrowth of facial bones and soft tissue, leading to prominent brows, a larger nose, and a protruding jaw.
D: Enlarged distal extremities, such as hands and feet, are typical in acromegaly because of excessive growth hormone, which affects the growth plates in the bones and causes an increase in size and thickness.
E: This can occur due to optic nerve involvement, which is associated with pituitary tumors that can cause acromegaly. Vision changes, including loss of color discrimination, may be noted as a result of pressure on the optic chiasm.
Correct Answer is D
Explanation
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.
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