Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?

Choice A reason: Hyperthyroidism involves elevated T3 and T4 with low TSH due to excessive thyroid hormone production. The patient’s low T3/T4 and high TSH indicate reduced thyroid activity, not overactivity, as the pituitary increases TSH to stimulate the underactive thyroid, making this choice incorrect.

Choice B reason: Hypothyroidism is characterized by low T3 and T4 levels due to underactive thyroid function, prompting the pituitary to secrete more TSH to stimulate hormone production. This matches the patient’s lab results (low T3/T4, high TSH), often seen in primary hypothyroidism, making this the correct choice.

Choice C reason: Thyroid cancer may alter thyroid function but typically doesn’t present with consistently low T3/T4 and high TSH. It’s more likely to cause nodules or abnormal growths, not this specific hormonal pattern, which aligns with hypothyroidism, making this choice less likely.

Choice D reason: Pituitary adenoma causing secondary hypothyroidism would lower TSH, T3, and T4 due to impaired pituitary function. High TSH with low T3/T4 suggests primary thyroid failure, not pituitary dysfunction, making this choice incorrect for the patient’s hormonal profile.

Choice A reason: Decreased blood pressure triggers the baroreceptor reflex, increasing sympathetic activity to raise heart rate and vasoconstriction to restore pressure. A decreased heart rate would occur with increased blood pressure, not hypotension, as parasympathetic activation dominates. This choice is incorrect as it opposes the body’s compensatory response to low blood pressure.

Choice B reason: Erythema, or skin redness, results from vasodilation or inflammation, not directly from hypotension. While compensatory vasoconstriction occurs in hypotension, it reduces skin perfusion, potentially causing pallor, not erythema. This manifestation is unrelated to the cardiovascular response to decreased blood pressure, making this choice incorrect.

Choice C reason: Increased temperature is not a direct response to decreased blood pressure. Hypotension triggers sympathetic activation, prioritizing heart rate and vasoconstriction to maintain perfusion. Temperature changes may occur in shock states, but they’re not primary manifestations of routine hypotension, making this choice irrelevant to the expected clinical response.

Choice D reason: Decreased blood pressure activates the baroreceptor reflex, stimulating sympathetic nervous system activity. This increases heart rate (tachycardia) to enhance cardiac output, compensating for low pressure to maintain tissue perfusion. This is a primary physiological response to hypotension, making it the correct clinical manifestation expected in this scenario.