A nurse is preparing to administer insulin lispro to a patient with type 1 diabetes mellitus. Which action should the nurse plan to take?
Inject the insulin lispro 15 minutes before a meal
Administer insulin lispro in the same syringe as regular-acting insulin
Check the patient for hypoglycemia 4 hours after the insulin lispro injection
Monitor the patient for polyuria after the insulin lispro injection
The Correct Answer is A
Choice A reason: Insulin lispro, a rapid-acting insulin, has an onset of 15-30 minutes, peaking in 1-2 hours. Administering it 15 minutes before a meal aligns with its pharmacokinetics, ensuring glucose uptake matches postprandial glucose rise, preventing hyperglycemia in type 1 diabetes, making this the correct action.
Choice B reason: Mixing insulin lispro with regular insulin in the same syringe is not recommended, as it may alter lispro’s rapid onset. Regular insulin has a slower onset and longer duration, potentially causing unpredictable glucose control, making this an incorrect and potentially unsafe administration practice.
Choice C reason: Checking for hypoglycemia 4 hours after lispro is unnecessary, as its action duration is 3-5 hours, with peak effect earlier. Hypoglycemia risk is highest 1-2 hours post-injection, not 4 hours, making this timing incorrect for monitoring lispro’s effects in type 1 diabetes.
Choice D reason: Monitoring for polyuria after lispro is inappropriate, as polyuria is a hyperglycemia symptom, not a direct insulin effect. Lispro reduces glucose, decreasing polyuria risk. Monitoring should focus on hypoglycemia or injection site reactions, not polyuria, which is unrelated to lispro’s immediate action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Right shoulder pain post-laparoscopic cholecystectomy is not due to prolonged positioning. It results from carbon dioxide used to insufflate the abdomen, irritating the diaphragm and causing referred pain via the phrenic nerve, making this statement incorrect for explaining the pain’s origin.
Choice B reason: Nitrous dioxide is not used in laparoscopic cholecystectomy; carbon dioxide is the standard insufflation gas. This gas causes diaphragmatic irritation, leading to referred shoulder pain, not nitrous dioxide, making this statement factually incorrect regarding the cause of postoperative pain.
Choice C reason: Ambulation helps dissipate carbon dioxide gas trapped in the abdomen post-laparoscopic cholecystectomy, reducing diaphragmatic irritation and referred shoulder pain. Movement facilitates gas absorption and excretion via the lungs, alleviating discomfort, making this the correct nursing statement to relieve the patient’s pain.
Choice D reason: Residual pain from cholecystitis is unlikely post-cholecystectomy, as the gallbladder, the source of inflammation, is removed. Shoulder pain is due to surgical gas, not ongoing cholecystitis, making this statement incorrect for explaining the postoperative pain experienced by the client.
Correct Answer is B
Explanation
Choice A reason: The Dawn phenomenon involves morning hyperglycemia due to nocturnal growth hormone and cortisol surges, increasing hepatic glucose production. It is not triggered by hypoglycemia, unlike the Somogyi effect, making it an incorrect explanation for rebound glucose elevation following low blood sugar.
Choice B reason: The Somogyi effect is rebound hyperglycemia following hypoglycemia, caused by counter-regulatory hormones (glucagon, cortisol, epinephrine) increasing glucose production and release. This occurs as the body overcorrects low blood sugar, often overnight, leading to elevated morning glucose, making this the correct term.
Choice C reason: Systemic alkalosis, an acid-base imbalance, is unrelated to glucose regulation. It may occur in conditions like vomiting but does not cause rebound hyperglycemia. Glucose fluctuations in diabetes are driven by hormonal and metabolic responses, not pH changes, making this incorrect.
Choice D reason: Systemic acidosis, such as in diabetic ketoacidosis, results from ketone accumulation, not rebound hyperglycemia. It is a complication of uncontrolled hyperglycemia, not a response to hypoglycemia, making it unrelated to the Somogyi effect or glucose rebound mechanisms.
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