Order: 200 mL normal saline bolus IV over 15 minutes

On hand: 500 mL normal saline bags

What rate will the nurse set the pump to deliver the fluid?

Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.

Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.

Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.

Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.

Choice A reason: This is incorrect because labetalol is a safe and effective medication for treating hypertension in pregnancy. Labetalol is a beta-blocker that lowers blood pressure by reducing the heart rate and the force of contraction. It does not affect the blood flow to the placenta or the fetus.

Choice B reason: This is incorrect because labetalol is not contraindicated for smokers. However, smoking is a risk factor for cardiovascular disease and should be discouraged by the nurse. Smoking can increase blood pressure, heart rate, and the risk of blood clots.

Choice C reason: This is correct because labetalol is contraindicated for clients with a history of uncontrolled asthma. Labetalol is a non-selective beta-blocker that can block the beta-2 receptors in the lungs and cause bronchoconstriction. This can worsen asthma symptoms and trigger an asthma attack.

Choice D reason: This is incorrect because labetalol is a suitable medication for clients who had a myocardial infarction. Labetalol can prevent further damage to the heart muscle by reducing the oxygen demand and the workload of the heart. It can also prevent arrhythmias and angina.