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?
Insulin glargine
Regular insulin
Insulin detemir
NPH insulin
The Correct Answer is B
Choice A reason: Insulin glargine is not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 24 hours and no peak effect. It is used to provide basal insulin coverage and prevent hyperglycemia.
Choice B reason: Regular insulin is the type of insulin to use for diabetic ketoacidosis, as it is a short-acting insulin that has an onset of 30 to 60 minutes and a peak of 2 to 4 hours. It is used to lower the blood glucose level rapidly and correct the acidosis.
Choice C reason: Insulin detemir is also not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 12 to 24 hours and no peak effect. It is also used to provide basal insulin coverage and prevent hyperglycemia.
Choice D reason: NPH insulin is also not the type of insulin to use for diabetic ketoacidosis, as it is an intermediate-acting insulin that has an onset of 2 to 4 hours and a peak of 4 to 12 hours. It is used to provide intermediate insulin coverage and prevent hyperglycemia.
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Correct Answer is D
Explanation
Choice A reason: This is incorrect because insulin glargine has a longer duration than 6 to 10 hr. Insulin glargine is a long-acting insulin that provides a steady and continuous level of insulin in the blood. It is usually given once daily at the same time.
Choice B reason: This is incorrect because insulin glargine has a longer duration than 3 to 6 hr. Insulin glargine is not a short-acting or rapid-acting insulin that peaks quickly and lasts for a few hours. It is a long-acting insulin that does not have a peak and lasts for up to 24 hr.
Choice C reason: This is incorrect because insulin glargine has a longer duration than 16 to 24 hr. Insulin glargine is a long-acting insulin that can last for up to 24 hr, but not more than that. It is not an ultra-long-acting insulin that can last for more than 24 hr.
Choice D reason: This is correct because insulin glargine has a duration of 18 to 24 hr. Insulin glargine is a long-acting insulin that provides a steady and continuous level of insulin in the blood. It is usually given once daily at the same time.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because insulin can be given intravenously in certain situations, such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, or perioperative care.
Choice B reason: This is correct because regular insulin is the only type of insulin that can be administered intravenously, as it is a short-acting insulin that has a rapid onset and peak. Other types of insulin, such as intermediate-acting or long-acting, are not suitable for intravenous use, as they have a delayed onset and peak and may cause hypoglycemia.
Choice C reason: This is incorrect because insulin aspart and insulin lispro are rapid-acting insulins that have a faster onset and peak than regular insulin. They are not recommended for intravenous use, as they may cause severe hypoglycemia. They are usually given subcutaneously before meals to control postprandial blood glucose levels.
Choice D reason: This is incorrect because not all forms of insulin can be administered intravenously, as explained above. Only regular insulin can be given intravenously, and the dose may differ from the subcutaneous dose depending on the patient's blood glucose level and insulin sensitivity.
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