1. A patient with type 1 diabetes is prescribed a sliding scale insulin regimen using regular insulin before meals. The sliding scale is as follows:

Blood glucose 150-199 mg/dL: 2 units

Blood glucose 200-249 mg/dL: 4 units

Blood glucose 250-299 mg/dL: 6 units

Blood glucose 300-349 mg/dL: 8 units

Blood glucose >350 mg/dL: Call provider

The patient's blood glucose before lunch is 278 mg/dL. The patient is also prescribed 0.1 units/kg of insulin glargine (Lantus) once daily. The patient weighs 70 kg.

How many total units of insulin should the nurse administer at this time? (LABEL CORRECTLY: NO SPACES IN ANSWER)

Rationale:

A. Iodine: Thyroid hormone productionis highly dependent on iodine, which is used by the thyroid gland to produce thyroid hormones T3(triiodothyronine) and T4(thyroxine). Without sufficient iodine, the thyroid cannot produce these hormones, leading to hypothyroidism.

B. Sodium and potassium: While sodiumand potassiumare important for overall body function, they do not play a direct role in thyroid hormone production. These electrolytes are more involved in fluid balance, nerve function, and muscle contraction.

C. Fats and vitamins: While certain vitamins(such as vitamin D) may influence thyroid function, fatsdo not directly contribute to the production of thyroid hormones. Iodineis the key nutrient for thyroid hormone synthesis.

D. Carbohydrates and minerals: Carbohydratesprovide energy, and mineralslike seleniumcan support thyroid function, but iodineis the primary mineral required for the production of thyroid hormones.

A. Hypoparathyroidism: Hypoparathyroidism presents with low calcium levels and symptoms like muscle cramps, tetany, or numbness around the mouth and in the extremities. It is not associated with flushed skin, bulging eyes, or irritability.

B. Cushing's Disease: Cushing's disease is caused by excessive levels of cortisol. Symptoms include weight gain, moon face, buffalo hump, and hypertension. The findings described, such as flushed skin, bulging eyes, and irritability, are not characteristic of Cushing's disease.

C. Hypothyroidism: Hypothyroidism is associated with symptoms such as fatigue, weight gain, cold intolerance, dry skin, and constipation, not flushed skin, bulging eyes, or irritability. The symptoms described are not typical of an underactive thyroid.

D. Hyperthyroidism: Hyperthyroidism (often associated with Graves' disease) presents with flushed skin, irritability, palpitations, bulging eyes (exophthalmos), and perspiration due to the overproduction of thyroid hormones.